Abstract: Objective To performed WeChat follow-up among the elderly patients in the postoperative rehabilitation after knee replacement surgery and assess evaluate the efficacy of the continuation of rehabilitation program. Methods Seventy patients undergoing total knee arthroplasty in our hospital between June 2016 and November 2017 were enrolled and divided into study group and control group by using the random number table method, with 35 cases in each group. The basic information of all patients was registered before discharge. The patients of study group received the general discharge instructions and follow-up by WeChat after discharge, the suitable rehabilitation intervention was carried out according to the conditions; while the control was given the general discharge instructions. Hospital for Special Surgery (HSS) knee score system (KSS) was used to assess the postoperative rehabilitation of patients 2 weeks, 4 weeks and 3 months after the surgery, including the degree of knee flexion and extension, knowledge and skills for rehabilitation training, self-care ability and psychological health. The result was statistically analyzed. Results There was no significant difference in HSS knee score before the surgery between the two groups (P>0.05). At 2 weeks, 4 weeks and 3 months after the surgery, the knee score of the study group was higher than that of the control group, and the difference was statistically significant (all P<0.05). After the intervention through WeChat follow-up, the knee flexion and extension, knowledge and skills for rehabilitation, self-care ability and psychological health of the patients were significantly improved. Conclusion The rehabilitation intervention by WeChat follow-up can effectively relieve the unhealthy psychological factors of patients, improve the patients' knowledge and skills for rehabilitation, knee function, self-care ability and quality of life, and the follow-up compliance.