Abstract: Objective To investigate the short-term clinical result and prognosis of patients with severe osteoporosis after bilateral knee joint replacement. Methods The clinical data of 32 cases of severe osteoporosis undergoing bilateral knee joint replacement in our hospital from January,2011 to December,2014 were analyzed retrospectively.Among the patients,12 cases were male and 20 were female.Mean age was (64.5±6.5) years old.Mean course of disease was 5.8 years.All patients were completed the operation according to the routine procedures of knee arthroplasty.After the operation,the comprehensive rehabilitation measures were performed.The range of motion (ROM),HSS scores,bone density and quality of life of patients before and after the surgery were compared. Results All operations were successful;there were no complications during the operation.After the operation,one case (1 knee) was with peroneal nerve paralysis,one case (2 knees) was with poor range of motion,both those cases recovered after the symptomatic treatment.The knee prosthesis was implanted satisfactorily.All patients were with good rehabilitation through comprehensive rehabilitation intervention.6 month follow-up showed that the quality of life score and HSS score were significantly improved (P<0.05),but bone density and ROM did not (P>0.05).The osteoporosis drugs were well tolerated by patients.At the end of this study,the limb function of patients recovered well,the pain was significantly reduced,and all patients achieved independent walking ability (50-100 m) without using external force.No long-term complications such as prosthesis loosening,fracture,and cardiac and cerebral vascular accident occurred. Conclusion The comprehensive evaluation of the patient's condition before the bilateral knee joint replacement surgery was necessary.The bilateral knee joint replacement for patients with severe osteoporosis can reach a satisfactory short-term clinical result and prognosis.The postoperative individual rehabilitation plan may promote the efficacy of operation,improve the result of rehabilitation.