Virtual reality is starting to make its way into total knee arthroplasty (TKA) rehabilitation, and the growing interest makes sense: immersive platforms could help patients engage more, recover at home, and even reduce in-person visits—a big advantage during COVID-19. We reviewed seven RCTs comparing VR-based rehab with traditional therapy, and the overall picture is mixed. Some trials found gains in proprioception, early pain, or balance, while others showed no meaningful differences. A small number of studies suggested VR may match traditional rehab on key functional outcomes and could even reduce costs and rehospitalizations, but evidence quality remains very low. Taken together, VR-guided rehab shows promise, especially as a complement to standard care, but larger, well-designed RCTs are needed before strong clinical recommendations can be made.