Outcomes and component-positioning in total knee arthroplasty may be comparable between supervised trained surgeons and their supervisor

PURPOSE: There are concerns that malalignment in total knee arthroplasty (TKA) occurs with less experienced surgeons. This study investigates the influence of surgical experience on TKA outcomes. MATERIALS AND METHODS: Nineteen patients (38 knees) who underwent bilateral TKA between 2011 and 2015 were included. A supervisor performed knee replacements associated with lower Knee Society Scores (KSS); trainee surgeons operated on the other knee. Knees were categorized into two groups: operations by the supervisor (group S) versus operations by trainee surgeons (group T). Range of motion (ROM), KSS, operative time, hip–knee–ankle angle, and femoral and tibial component angle were evaluated. RESULTS: The mean operative time was 92.5 min in group S and 124.2 min in group T (p < 0.01). The mean postoperative maximal flexion was 113.2° in group S and 114.2° in group T (not significant). The mean postoperative KSS was 92.9 in group S and 93.9 in group T (not significant). No significant differences between groups in terms of proportion of inliers for the hip–knee–ankle angle, femoral component angle, or tibial component angle were observed. CONCLUSIONS: Although operative time was significantly longer for trainee surgeons versus the supervisor, no significant differences in ROM, KSS, or component positioning between supervisor and trainee surgeons were observed. LEVEL OF EVIDENCE: IV (retrospective case series design).