56 patients undergoing unilateral total knee arthroplasty (TKA) were randomized to compare the clinical and radiological outcomes, as well as the safety, of two types of bearing systems. Patients underwent TKA using either a mobile- or fixed-bearing system (Scorpio + Single Axis and Duracon systems, respectively). Results at a final follow-up of 4-6.5 years indicated that most of the clinical outcomes were similar when TKA was performed using either a mobile- or fixed-bearing system, with the exception of range of motion, which favoured the mobile-bearing group. Radiological outcomes, patient satisfaction and the incidence of complications were also statistically similar between groups. Furthermore, the survival rate was 100% using both techniques.