Objective To explore the effects of family-integrated functional training based on the 5A model on patients undergoing total knee arthroplasty (TKA). Methods Knee osteoarthritis patients undergoing TKA were selected and randomized into a control group and an experimental group using a random number table, with 56 patients in each group.The control group received routine care, while the experimental group additionally conducted family-integrated functional training based on the 5A model.The active knee range of motion, knee function, pain intensity, exercise adherence, patient satisfaction, and caregiver competence were assessed and compared between the two groups at discharge, 6 weeks and 12 weeks after surgery. Results Generalized Estimating Equations (GEE) analysis revealed that, there were statistically significant group, time, and group × time interaction effects on active knee range of motion, knee function, pain intensity, exercise adherence, patient satisfaction, and caregiver competence (all P＜0.05).Furthermore, the experimental group demonstrated significantly better scores across all indicators than the control group at discharge, 6 weeks and 12 weeks after surgery (all P＜0.05). Conclusion The family-integrated functional training based on the 5A model is conducive to improving knee range of motion and function for patients after TKA, reducing their pain, increa-sing their adherence to functional exercises and satisfaction, and enhancing caregivers′ caregiving capacity.