Purpose : To examine the relationship between self efficacy and health-related quality of life (HRQOL) in patients who received total joint replacement (TJR). Methods : This multicentre, prospective, observational study was conducted from April to September 2009 and included the Timed Up and Go (TUG) test, a visual analogue scale (VAS) for pain, and the Falls Efficacy Scale (FES) as independent variables and SF-36, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) as dependent variables. Scores were evaluated 1 month prior to surgery, at discharge, and at 1 month after discharge. ANCOVA was conducted to assess the relationship between the dependent and independent variables. Results : Eighty-one patients were included in this study. After TJR, the VAS, TUG, and FES, scores all improved. In addition, scores on the Physical Functioning (PF) subscale of SF-36 and on the WOMAC functional domain improved. FES scores at discharge were associated with PF (F=10.32, p< 0.01) at 1 month after discharge. Higher self efficacy at discharge was associated with higher HRQOL (average WOMAC score : 84.5) at 1 month after discharge. Lower self efficacy was associated with poor HRQOL (average WOMAC score : 74.8) at 1 month after discharge. Conclusion : After TJR, patient HRQOL was associated with self efficacy at discharge. To facilitate rehabilitation, self efficacy must be improved in patients with low perceived self efficacy by, for example, presenting the cases of other patients with TJR as models.