Twenty percent of patients receiving total hip or knee replacement (TJR) report non- optimal postoperative outcome. Increasing preoperative lower-limb-strength prior to TJR may improve postoperative functional performance. MATERIALS AND METHODS Eligibility criteria: RCTs 1) comparing preoperative lower-limb-exercises before TJR with standard care 2) explicitly reporting the exercise intensity and 3) reporting functional performance were included. Information sources: Cochrane Central, MEDLINE, EMBASE, and PEDro were searched in August 2021. Risk of bias: Cochrane Risk of Bias tool was used to evaluate the risk of bias and conducted by to reviewers. Synthesis of results: Functional performance knee-extensor strength 3 months postoperatively as well as 12 months postoperative. RESULTS Seven RCTs including 234 participants were included. A moderate effect favoring prehabilitation training on sit-to-stand performance was observed three months postoperatively (SMD(95%CI) (0.77; 0.43 to 1.12), along with moderate-to-large effects on Timed Up&Go (-1.33; -2.55 to -0.11), walking speed (-0.78; - 1.16 to -0.41) and knee extensor-strength (0.55; 0.11 to 0.99). Small-to-moderate effects favoring prehabilitation were observed twelve months postoperatively for sit-to-stand (0.49; 0.12-0.86), walking speed (-0.37; -0.74 to -0.00), stair climbing (-0.55;-1.03 to -0.06) and knee-extensor strength (0.49; 0.16 to 0.81). CONCLUSION Prehabilitation prior to TJR induce long-lasting improvements in functional performance and knee extensor muscle strength that are of moderate-to-large effect size.