22 randomized controlled trials (1492 patients) were included in this meta-analysis and systematic review to assess the clinical effectiveness of pre-operative rehabilitation (inclusive of physiotherapy and exercise regimens) performed prior to total joint arthroplasty. Pooled results, when compared with patients who did not receive pre-operative therapy, demonstrated that prehabilitation offered patients a statistically significant improvement in postoperative pain and function in the short-term, however, these differences were deemed to be clinically marginal and were based on low-quality evidence (GRADE). Additional outcomes of interest, including activities of daily living, quality of life, and length of hospital stay were clinically comparable throughout reported follow-up periods.