Abstract: Objective To explore the effect of ultra-early functional exercise on the rehabilitation of elderly patients with osteoporosis after total hip arthroplasty.Methods From December 2014 to December 2017,92 elderly patients with osteoporosis admitted to the First People’s Hospital of Nanning were prospectively collected.All patients underwent total hip replacement with biological prosthesis.The patients were randomly divided into an observation group and a control group,46 cases in each group.The observation group was given ultra-early functional exercise,while the control group was given routine treatment after operation.The prosthesis stability and functional recovery were observed in both groups.Results There was no significant difference in visual analogue scores of pain between the two groups at 6,24 and 48 h after operation（P＞0.05）.The hospitalization time of the patients in the observation group was shorter than that in the control group（P＜0.05）.The incidence of abdominal distension and lower limb venous thrombosis in the observation group was significantly lower than that in the control group（P＜0.05）.There was no significant difference in the incidence of other adverse reactions and complications between the two groups（P＞0.05）.The Harris score of the observation group was significantly higher than that of the control group at 1 month after operation（P＜0.05）.There was no significant difference in Harris score between the two groups at 2 and 3 months after operation（P＞0.05）.Conclusion Ultra-early functional exercise after total hip replacement with biological prosthesis in elderly patients with osteoporosis can reduce postoperative complications,promote rapid recovery of hip function,and do not increase the prosthesis sinking distance.