Eighty-five patients under the age of 55 and scheduled for bilateral total knee arthroplasty had one knee randomized to cementless fixation, and the other to cement fixation. The purpose was to determine if there was a difference between fixation types regarding component survival, clinical outcome, complications (ie. osteolysis) and revision. Follow-up was conducted for 16-17 years postoperatively. The results at final follow-up indicated that component survivorship was high and similar between groups. Clinical outcomes improved significantly in both groups, and were similar between them.