147 patients scheduled for a primary total knee arthroplasty for arthritis were randomized to receive the same cruciate-retaining implant with either cemented fixation or cementless, biological fixation. The primary outcome of interest was the Oxford Knee Score (OKS). Secondary outcomes of interest included the Knee Society Score (KSS), the Forgotten Joint Score (FJS), the percentage of normal knee function, overall health rating, satisfaction with overall function, radiographic outcomes, the incidence of of failure or component subsidence, and the incidence of revision. Follow up was performed at 4-6 weeks, 1 year and 2 years post-operation. Results revealed no significant differences in OKS, KSS, FJS, or the percentage of normal knee function between the two groups at all time points. There were no significant differences in overall health rating or the satisfaction with overall function at 2 years. No cases of failure or component subsidence were reported. 1 case of revision was reported in the cemented group. The mean thicknesses of the clear zones around the tibial and femoral components were significantly larger in the cementless group.