Eleven randomized controlled trials analyzing the effect of pre-operative physiotherapy on postoperative outcomes in patients undergoing total knee arthroplasty (TKA) were included. The purpose of this systematic review was to determine whether pre-operative physiotherapy (prehabilitation) improves patient outcomes following TKA. The results of this systematic review indicated that pre-operative physiotherapy has no significant effect on any post-operative outcomes, including pain, function, range of motion and hospital length of stay when compared to a control group.