Thirty orthopedic residents were randomized to receive training in total knee arthroplasty using either virtual reality (VR) simulation (n=fifteen) or traditional instrumentation on sawbones (SB) (n=fifteen), stratified by postgraduate year. Both groups completed three training procedures followed by a final test on a sawbones model. The primary outcome was the Objective Structured Assessment of Technical Skills (OSATS) global rating scale. Secondary outcomes included step checklist performance, procedure time, accuracy of bone cuts and implant sizing, and self-reported confidence. Outcomes were assessed after the final test procedure. Overall, the results of the study revealed no difference in OSATS scores between groups; however, the SB group had faster procedure times and greater tibial sizing accuracy. VR participants reported improved procedural confidence. These findings suggest that VR provides comparable technical training outcomes and may be a valuable adjunct in residency education.