Purpose: The purpose of this study was to encourage the exercise for total knee replacement patients. The study was to identify the effects of motivational interviewing based exercise program on exercise performance and maintenance, self efficacy, pain, functional status, quality of life for patients with total knee replacement. Methods: The research design used was a nonequivalent control group non-synchronized design. A total of 100 patients with total knee replacement (33 patients in motivational interviewing group, 33 patients in exercise group, 34 patients in comparison group) were involved in this study. Motivational interviewing group and exercise group received scheduled 7 sessions for 4 weeks. Data were analyzed with IBM SPSS Statistics 20 using repeated measure ANOVA. Results: There were significant differences in exercise maintenance(x²=16.402, p〈.001), self efficacy for exercise(F=15.703, p〈.001), self efficacy for pain(F=11.058, p〈.001), pain(F=2.806, p=.024), muscle strength(F=6.228, p=.001), knee flexion(F=3.778, p=.004), knee extension(F=6.423, p〈.001), 6 minutes walk(F=5.741, p=.002), WOMAC index(F=8.032, p〈.001), mental quality of life(F=15.619, p〈.001) among groups. Conclusion: The motivational interviewing based exercise group could be an effective intervention for elderly patients with total knee replacement.