Objective:To systematically evaluate the effects of preoperative resistance training on postoperative pain, knee function, and quadriceps muscle strength in patients undergoing total knee arthroplasty.Methods:Randomized controlled trials on the effectiveness of preoperative resistance training in patients undergoing total knee arthroplasty were conducted by computer retrieval on PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, WanFang Data, VIP, and China Biomedical Literature Database. The search period was from the establishment of the database to December 1, 2022. Meta-analysis was conducted using RevMan 5.4 software.Results:A total of 8 articles were included. Meta-analysis showed that preoperative resistance training could improve postoperative pain [ SMD=-0.97, 95% CI (-1.26, -0.68), P<0.01], promote postoperative knee function [ MD=-13.31, 95% CI (-16.97, -9.65), P<0.01], and quadriceps muscle strength [ MD=0.74, 95% CI (0.22, 1.25), P<0.01]in patients with total knee arthroplasty in the short term (<6 weeks), with statistically significant differences. Conclusions:Preoperative resistance training can alleviate the postoperative pain, promote knee joint function, and restore quadriceps muscle strength of patients undergoing total knee arthroplasty.