Objective To explore the impact of an outcome expectation management program on patients undergoing total knee arthroplasty. Methods A total of 86 patients with osteoarthritis of the knee were selected, with 43 cases hospitalized within the period from March to June 2022, into the control group, who received routine care, and 43 cases from May to April 2022, into the experimental group, who received outcome expectation management on the basis of routine care. The outcome expectation scores, the functional exercise adherence scores, the level of achievement of the outcome expectations, and the knee satisfaction scores of the two groups were compared before and after the intervention. Results Forty-one patients in the control group and 42 patients in the experimental group completed this study. There were significant differences in group effects, time effects, and group-by-time effects in the outcome expectation scores, adherence to functional exercise scores, achievement scores of outcome expectations, and knee satisfaction scores between the two groups after the intervention (all P<0.05). Conclusion Outcome expectation management helps to rationalize outcome expectations for patients undergoing total knee arthroplasty, improves patient functional exercise adherence and satisfaction with knee function, and promotes the achievement of patient outcome expectations.