Objective To understand the status of continuous nursing needs of middle aged and older patients after total knee arthroplasty in Northern Henan province and analyze the influencing factors. Methods A total of 356 patients undergoing total knee arthroplasty were investigated using the general data questionnaire,the continuing care demand scale for middle aged and older patients with total knee arthroplasty,and the Medical Outcomes Study item short from health survey（SF-36）. Results The total demand for continuous care services of patients after total knee replacement was（110.47±7.08）,with a high degree of demand,in which the physiological needs dimension score was the highest,and the self-actualization demand dimension score was the lowest;the total quality of life score was（374.51±88.52）. Continuing care services through the network communication platform were needed by 68.5% of patients,and following up by phone of 66.0%. The multiple linear regression analysis showed that quality of life and age were the main factors influencing the demand for continuous nursing service after total knee replacement（R²=0.444,F=142.943,P<0.01）. Conclusion The quality of life of middle aged and older patients after total knee arthroplasty is poor.According to the needs,age and quality of life of patients,scientific and effective,individualized continuous nursing intervention measures should be formulated to promote the rehabilitation of patients.