###### Abstract
Virtual reality systems require two characteristics: immersion and presence [22]. Related to the level of immersion that can be experienced in the virtual world, we find immersive virtual reality and non-immersive virtual reality. Immersive virtual reality manages to recreate virtual scenarios in 360\({}^{\circ}\) with a greater degree of realism, in addition to introducing tactile and auditory stimulation. This fact allows the patient to interact more realistically with the environment through their own hands [23]. Non-immersive virtual reality devices project a 2D environment on a screen with the possibility of interacting with it using a joystick or keyboard. It is cheaper and more accessible to the user and has been included in home rehabilitation protocols [24; 25]. VRBR is postulated as an innovative, active, and playful treatment method that increases patient motivation and adherence to therapy [26], allowing each patient to adjust the intensity of the sessions [27] and train more functional movements or activities in a ludic environment. During the COVID-19 pandemic, telerehabilitation has experienced a large growth allowing the patients to continue with the rehabilitation and recovery in their own houses, supervised at a distance by a physiotherapist [28; 29; 30]. Telerehabilitation consists of the use of new technologies as a method of rehabilitation and remote monitoring [31], accessible to all patients and non-expensive. The inclusion of VRBR in telerehabilitation has allowed the patients to follow their recovery after hospital discharge or outside of the physiotherapy center, avoiding a decrease in their recovery [32]. The combination of telerehabilitation and the potential benefits of VRBR could reduce complications after TKA, increase the frequency and number of sessions, and shorten recovery times [33]. Evidence suggests that 40% of men and 57% of women with OA are sedentary, so they could benefit from the positive effects of VRBR as a method of movement at home [34]. In the last five years, some reviews assessing the effect of VRBR have been published [7; 35; 36; 37], although these reviews did not include all randomized controlled trials (RCT) published to date when these reviews were published. [PERSON] et al. (2019) assess the effect of all technologies-assisted rehabilitation after TKA, including a few studies of VRBR, but not all [7]. In 2019, [PERSON] et al. performed a systematic review without meta-analysis, including six studies suggesting no differences between CT and VRBR on enhanced knee function and pain. Finally, in 2021, [PERSON] et al. and in 2022 [PERSON] et al. developed two meta-analyses to assess the effect of VRBR on knee pain in both meta-analyses [36; 37] and on knee function and dynamic balance (only in [PERSON], 2022). Controversial findings on knee pain were found between these two meta-analyses, so it is difficult to support whether VRBR is more effective than CT. In addition, other important limitations in these meta-analyses are the low number of studies included, the assessment of the effect if VRBR is more effective than CT when it is used alone or combined with CT, and what modality of VRBR may present more benefits (immersive or non-immersive VRBR). It is necessary to perform a more specific literature search, avoiding losing potential studies to be included or compiling new studies published since the search of the last reviews. The aim of this meta-analysis was to analyze the effect of VRBR in improving knee pain, knee function, balance, knee flexion ROM and extension strength, gait speed, aerobic capacity, and functional independence after TKA. Secondarily, we want to assess if the effect of VRBR will be maintained at 3 and 6 months after the end of VRBR and if VRBR is more effective when it is used as isolated therapy or combined with CT. Finally, we assessed whether the VRBR modality (immersive or non-immersive) is more appropriate for each variable.