Objective To investigate the impacts of an attending physician-led full-cycle rehabilitation management model based on multi-disciplinary collaboration (integrating anesthesia, rehabilitation and nursing resources) on functional recovery and medical safety in patients undergoing primary unilateral total hip arthroplasty (THA) or total knee arthroplasty (TKA) day surgery. MethodsPatients scheduled for primary unilateral THA or TKA at the Department of Orthopedics, Guizhou Provincial People’s Hospital, between April 2024 and March 2025 were included. Participants were randomly allocated to an intervention group or control group using block randomization in a 1:1 ratio. The improvement in Western Ontario and McMaster Universities Osteoarthritis Index total score at 6 weeks postoperatively, successful discharge within 48 hours, rate of unplanned readmission at 30 days and 90 days, Harris Hip Score / Hospital for Special Surgery Knee Score scores, and patient satisfaction, were analyzed in both groups six weeks after surgery. Results A total of 200 patients were enrolled, with 100 cases in each group. Compared with the control group, the intervention group showed greater improvements in Western Ontario and McMaster Universities Osteoarthritis Index scores (32.7±6.4 vs. 26.1±7.2), 48-hour discharge success rate (92.0% vs. 79.0%), 30-day unplanned readmission rate (4.0% vs. 11.0%), 90-day unplanned readmission rate (6.0% vs. 14.0%), 6-week hip function (in the THA subgroup) (42.1±10.3 vs. 34.8±11.5), Knee Society score (in the TKA subgroup) (39.4±9.1 vs. 31.2±10.0), and patient satisfaction (70.2±4.3 vs. 63.5±5.6) (P<0.05). The effective response rate to post-discharge alerts within 48 hours was 95.2%, and the training completion rate was (87.5±9.2)%. No serious complications such as deep vein thrombosis or pulmonary embolism occurred in either group. Conclusion A multidisciplinary, full-cycle rehabilitation model led by the attending physician enables continuous care from pre-hospitalization through post-discharge, promoting better functional recovery and higher discharge efficiency than conventional enhanced recovery after surgery protocols, without increasing safety risks.