165 patients undergoing total knee arthroplasty with a mobile-bearing knee system were randomized to either cemented fixation or cementless fixation of the tibial component. The purpose of this study was to compare clinical outcome, radiological outcome, and survivorship of the tibial fixation in the mid-term. Mean follow-up was 9.5 years, with minimum follow-up of 8 years. Results demonstrated no statistically significant differences in clinical outcome or radiographical outcome between groups. Both groups exhibited 100% survivorship at a minimum of 8 years postoperatively.