With the accelerating aging of the global population, diseases of the osteoarticular system, especially hip and knee disorders, have increasingly become a worldwide health concern. As the standard treatment for end-stage hip and knee diseases, total joint arthroplasty (TJA) has witnessed expanding clinical application and a steady surge in surgical volume due to its proven efficacy. However, the incidence of osteoporosis remains high among patients undergoing hip and knee arthroplasty—nearly two-thirds of these patients have low bone mass or osteoporosis, while the treatment rate for osteoporosis at the time of arthroplasty is less than one-third. Osteoporosis is a key factor contributing to periprosthetic bone loss, aseptic loosening of the prosthesis, periprosthetic fractures, and increased revision risk after joint replacement, which severely impacts patient prognosis and long-term prosthetic survival. Despite the availability of mature clinical treatment protocols for osteoporosis, unified standards have not yet been established for perioperative bone health assessment, timing of intervention, and treatment strategies in patients undergoing hip and knee arthroplasty. To standardize the diagnosis of osteoporosis and optimize perioperative and postoperative bone health management in this patient population, Joint Surgery Branch of the Chinese Orthopedic Association organized domestic experts in related fields to jointly formulate the Expert Consensus on Osteoporosis Management in Patients Undergoing Hip and Knee Arthroplasty (2025 Edition). This consensus puts forward 13 recommendations covering pre-operative bone health assessment, timing and protocols of perioperative and postoperative osteoporosis intervention, surgical planning and prosthesis selection, prevention of osteoporosis-related complications during and after surgery, as well as postoperative rehabilitation and bone mineral density monitoring. The aim is to improve the bone optimization system for hip and knee arthroplasty in osteoporotic patients, reduce prosthesis-related complications and revision rates, improve long-term prognosis, and provide evidence-based guidance for clinical practice.