Objective To explore the effect of decision aids on postoperative functional exercise compliance in patients with kinesiophobia after unilateral total knee arthroplasty. Methods A total of 143 patients with kinesiophobia after unilateral total knee arthroplasty were divided into a control group of 72 cases and an intervention group of 71 cases chronologically. The control group was given routine treatment and nursing, while the intervention group constructed and implemented functional exercise decision aids program based on evidence and expert meetings. The compliance of functional exercise, kinesiophobia and knee function of the two groups were compared at discharge, 1 month and 3 months after operation. Results After the intervention, the time effect, intervention effect and time×intervention interaction effect of functional exercise compliance score, kinesiophobia and knee function score of the two groups were significant (P<0.05, P<0.01). Conclusion Decision aids is conducive to enhancing postoperative functional exercise compliance of patients with kinesiophobia after unilateral total knee arthroplasty, reducing the level of kinesiophobia and improving their knee function.