Purpose <p>Hemophilic Arthropathy (HA) frequently affects the hip and knee joints, with total hip arthroplasty (THA) or total knee arthroplasty (TKA) serving as primary treatment methods for end-stage hemophilic arthropathy. This study aims to retrospectively analyze the functional outcomes and satisfaction levels of hemophilia patients undergoing TKA or THA.</p> Methods <p>We conducted a retrospective analysis of 64 hemophilic patients who underwent total knee arthroplasty (TKA) or total hip arthroplasty (THA) between 2014 and 2024 (including 42 TKA and 30 THA procedures) and performed follow-up evaluations. Clinical outcomes assessed included range of motion (ROM), functional scores (HSS scores for knees, HHS scores for hips, VAS scores, and Barthel Index), overall patient satisfaction, radiographic outcomes (operative side X-rays), and the incidence of postoperative complications.</p> Results <p>Total joint arthroplasty (TJA) can relieve pain, improve joint function, significantly enhance patients’ quality of life, and achieve extremely high satisfaction.</p> Conclusions <p>TJA is an effective surgical option for patients with end-stage hemophilic arthropathy. Following joint arthroplasty, patients with hemophilic osteoarthritis experience improved joint pain and range of motion, as well as enhanced quality of life.</p>