The authors performed a systematic review and meta-analysis of six randomized controlled trials comparing cemented versus cementless total knee arthroplasty in patients younger than 60 years of age. The authors searched four databases and included six trials, with 255 patients in the cemented group and 229 patients in the cementless group. Outcomes of interest were the Knee Society Score (KSS), Range of Motion (ROM), pain, presence of radiolucent lines, aseptic loosening, and major complications (revisions + deep infections). The patients in the cementless group performed significantly better in terms of pain scores and range of motion.There was no significant difference in terms of KSS, ROM, aseptic loosening, or complication rates.