Harmer JR, Wyles CC, Mara KC, et al. - This study was undertaken to ascertain the relationship between perioperative pain levels and knee range of motion (ROM) at a 3-month follow-up or need for manipulation under anesthesia (MUA). Researchers retrospectively examined 2,243 primary total knee arthroplasty (TKAs) performing between 2002 to 2019 at a single academic center applying an institutional total joint registry (the Mean age was 68, mean body mass index was 32.8, and 59% were female). They assessed Knee ROM preoperatively and 3 months postoperatively. They also evaluated alteration in knee ROM, rates of soft tissue contracture, and MUA in relation to in-hospital 10-point pain visual analogue scale (VAS) measurements. In this large series of primary TKA patients, comparable ROM, and rates of MUA based on in-hospital pain levels were observed. This does not seem to have a marked effect on ROM-related complications for most patients, while significant early pain may limit participation in ROM exercises initially.