Introduction and objectives: The potential of virtual reality (VR) as an adjunct to physiotherapy in patients with musculoskeletal disorders has been investigated. This randomized clinical trial evaluates the clinical efficacy of VR integration using Microsoft Kinect® in physical therapy treatment to improve function in patients with total hip arthroplasty (THA). Materials and methods: A total of 74 patients who underwent surgery for THA were randomly assigned to two groups. The control group (n = 37) received conventional physical therapy for six weeks, while the intervention group (n = 37) received the same treatment plus Microsoft Kinect® VR training. Both groups were evaluated at the beginning and at the end of the treatment. The primary measure was function according to the WOMAC questionnaire. Secondary outcomes include Berg balance scale, distance covered with the 6 minute Walk Test, WOMAC pain, and the difference in weight load on the lower extremities. Results: At the end of the treatment, statistically significant differences (p < 0.05) were observed in function and pain according to the WOMAC questionnaire and the 6-minute walk test. There were no statistically significant differences in weight load or in the Berg balance scale. Conclusion: In the short term, the integration of VR through Microsoft Kinect® provides significant clinical benefits in the functionality of patients with ATC.