Objective To learn the effects on improving mental anxiety and depression in empty-nest elderly with hip replacement by accompany care work, and the factors influencing psychological anxiety and depression after hip replacement in empty-nest eldly. Then to explore comprehensive nursing strategies for hip arthroplasty in empty-nest eldly. Methods We investigated empty-nest elderly with hip arthroplasty by using homemade questionnaire, SAS and SDS scale between november 2015 and october 2017. Different nursing methods were used to treat empty-nesters in different groups, and the influencing factors of anxiety and depression were analyzed.Results It is not statistically significant in demographic characteristics (χ2＜3.84, P＞0.05) and anxiety (t = 1.2037, P=0.2308) and depression (t =1.0094, P=0.3142) at the time of entering the hospital, etc. Patients anxiety is statistically significant at time of discharge (t =-5.0159, P≤0.001) and one month after discharge (t =-9.5160, P ＜ 0.001), Patients depression is statistically significant at time of discharge (t =-2.9271, P = 0.0039) and one month after discharge (t =-8.2383, P＜0.001).The factors causing anxiety is nursing mode, number of chronic diseases and postoperative complications. The factors causing depression are economic income, nursing mode, and number of chronic diseases.Conclusion Accompany care work can improve the problems of anxiety and depression in an empty-nest eldly man after hip replacement. It is related to anxiety in nursing patterns, chronic diseases, postoperative complications.Meanhiwle while depression is related to economic income, nursing patterns, and types of chronic diseases, etc.