Objective To explore the application effect of individualized rehabilitation guidance combined with continuous nursing in elderly patients with knee arthroplasty.Methods A total of 80 patients with total knee arthroplasty treated in Pingxiang People's Hospital from October 2021 to May 2022 were selected as the research objects,they were divided into control group and observation group according to random number table method,with 40 patients in each group.The control group received routine nursing,the observation group adopted individualized rehabilitation guidance combined with continuous nursing on the basis of the control group.The curative effect,knee joint function recovery,daily self-care ability,satisfaction and awareness rate of health knowledge were compared between the two groups.Results The excellent and good rate of the observation group was higher than that of the control group,with statistical significance (P＜0.05).After one month of intervention,the daily activity scale(ADL)scores of the two groups were higher than those before intervention,and after two months of intervention,the ADL scores were higher than those after one month of intervention and before intervention,the differences were statistically significant (P＜0.05).After one month and two months of intervention,the ADL score of the observation group was higher than that of the control group,the difference was statistically significant(P＜0.05).The nursing satisfaction of the observation group was higher than that of the control group,and the difference was statistically significant(P＜0.05).The total awareness rate of health knowledge in the observation group was higher than that in the control group,the difference was statistically significant(P＜0.05).Conclusion Individualized rehabilitation guidance combined with continuous nursing can obviously improve the effect of functional exercise and the prognosis of elderly patients with knee joint replacement,which has good clinical value.