Nine studies including 1389 patients undergoing total joint arthroplasty were included in this systematic review and meta-analysis comparing cognitive behavioral therapy (CBT) versus usual care. Pooled outcomes of interest included Pain Catastrophizing Scale (PCS), Numerical Rating Scale (NRS), Visual Analog Scale (VAS), Western Ontario and McMaster Osteoarthritis Index (WOMAC) Pain Scale, Oxford Knee Score (OKS), Hospital for Special Surgery (HSS) Knee Rating Scale, Knee range of motion (ROM), and EuroQol 5-dimensions (EQ-5D). CBT showed significant improvement in early-term pain outcomes but not in long-term joint function. The main findings suggest that CBT can be beneficial for short-term pain relief post-arthroplasty, although more research is needed to confirm long-term benefits.