Objective To analyze the risk factors for aseptic inflammation in elderly osteoporosis pa-tients after artificial knee replacement surgery.Methods The clinical data of 223 elderly osteoporosis patients who underwent artificial knee replacement surgery were retrospectively analyzed.The incidence of postopera-tive aseptic inflammation was counted.Patients were divided into occurrence and non-occurrence groups based on whether aseptic inflammation occurred.Univariate and multivariate logistic regression were used to analyze the risk factors for concurrent aseptic inflammation.Results Among all patients,31 cases developed postoper-ative aseptic inflammation,with an incidence rate of 13.90%.The proportions of elderly patients,obese pa-tients,patients with diabetes,those with poor postoperative drainage,patients with hypoproteinemia,and those with excessive postoperative exercise were higher in the occurrence group than in the non-occurrence group(P<0.05).Advanced age,obesity,diabetes,poor postoperative drainage,hypoproteinemia and excessive post-operative exercise were risk factors for aseptic inflammation after total knee arthroplasty in elderly osteoporo-sis patients(OR=2.204,2.261,2.540,2.177,2.109,2.079;P<0.05).Conclusion Advanced age,obesity,diabetes,poor postoperative drainage,hypoproteinemia and excessive postoperative exercise are risk factors for aseptic inflammation after total knee arthroplasty in elderly osteoporosis patients.