Twenty-nine female patients with osteoarthritis undergoing total knee arthroplasty were randomized to receive virtual reality combined with exercise (n=15) or exercise alone (n=14). Outcomes of interest were pain intensity on a Numeric Rating Scale (NRS), Tampa kinesiophobia, pain catastrophizing scale (PCS), knee range of motion (ROM), Timed Up and Go (TUG), stair-climb test (SCT), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and quality of life using the Short-Form 26 score (SF-36). Outcomes were assessed up to four weeks postoperatively. Overall, the results of the study revealed that the VR group showed significantly greater reductions in pain at rest, at night, and during the Timed Up and Go Test, as well as reductions in kinesiophobia and pain catastrophizing compared to the exercise group. There were also significant improvements in knee flexion and functional test scores. These findings suggest that integrating VR with exercise can enhance early rehabilitation outcomes for pain and function in female TKA patients.