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To examine the association between pain and satisfaction with medical rehabilitation in patients with hip or knee replacement approximately 90 days after discharge from inpatient medical rehabilitation.A cross-sectional design.The sample included 2507 patients with hip or knee replacement using information from the IT Health Track medical outcome database.Satisfaction with medical rehabilitation.The average age was 70.2 years, 66.5% were female, and 88.5% were non-Hispanic white. Pain scores were significantly and inversely associated with satisfaction with medical rehabilitation after adjustment for possible confounding factors. In patients with hip replacement each one-point increase in pain score was associated with a 10% decreased odds ratio (OR) of being satisfied with medical rehabilitation (OR 0.90, 95% confidence interval (CI) 0.84, 0.96). In patients with knee replacement, each one-point increase in pain score was associated with a 9% decreased odds ratio (OR 0.91, 95% CI 0.87, 0.96) of being satisfied with medical rehabilitation.Our data indicate that postoperative pain from hip or knee replacement is associated with reduced satisfaction with medical rehabilitation. Better postoperative pain control may improve a patient's level of satisfaction.