59 patients scheduled for total knee arthroplasty were randomized to participate or not participate in a preoperative progressive resistance training program. The purpose of this study was to determine if preoperative resistance training led to significantly increased preoperative and short-term postoperative functional performance and muscle strength. Patients allocated to preoperative progressive resistance training participated in a 4-week program; patients of both groups participated in a 4-week postoperative progressive resistance training program. Results demonstrated significantly better functional performance measures ahead of surgery and at 6 and 12 weeks postoperatively in those who received preoperative progressive resistance training compared to the control group. In addition, postoperative muscle strength was also significantly greater in the preoperative progressive resistance training group compared to the control group. Despite these results, no significant differences were observed in patient-reported outcome measures.