**Abstract**

One of the most common causes of disability in older adults is osteoarthritis (OA), which often affects the knee. When conventional treatments fail to produce positive changes in patients' physical function, pain relief, and quality of life, replacement of the degenerated and/or malformed joint is recommended. Total knee arthroplasty (TKA) has been shown to be beneficial in improving aforementioned factors in patients with OA. However, despite comprehensive surgical methods and postoperative rehabilitation approaches, knee extensor weakness persists over a long period of time and may not reach the preoperative level of the non-OA leg for up to 6 months after surgery. Therefore, current rehabilitation programs do not seem to be sufficient to counteract these negative changes after TKA. When overt movement is limited due to various factors, several cognitive strategies have been shown to be useful in improving neuromuscular function without mechanically loading the muscles. One of the most studied strategies is motor imagery (MI). While there is some preliminary evidence supporting the use of MI in TKA rehabilitation practice, an umbrella review with meta-analysis is needed to summarize these findings and draw a clear conclusion about the efficacy of MI in terms of physical function and pain relief in TKA patients.

**Keywords:** cognitive practice, total knee replacement, pain relief, physical function, functional performance, strength, range of motion
