Twenty-eight randomized controlled trials including 2,296 patients with osteoarthritis undergoing total knee or hip arthroplasty were included in this systematic review and meta-analysis comparing prehabilitation vs. usual care. Pooled outcomes of interest included self-reported function, pain, health-related quality of life (HRQoL), and performance-based measures of strength, range of motion (ROM), balance, and functional mobility. Prehabilitation demonstrated significant improvements in function, pain, HRQoL, strength, ROM, and functional mobility postoperatively. However, no significant effect was observed for balance. High risk of bias and significant heterogeneity across studies limit the reliability of the findings, preventing definitive conclusions about the effectiveness of prehabilitation up to one year post-surgery.