145 patients, between the ages of 50 and 70 years, who were admitted for primary TKA and who had moderate to severe femorotibial gonarthrosis were randomly assigned into 1 of 2 groups to compare the efficacy of a tibial component fixed by a porous tantalum system to a conventional cemented implant in terms of clinical outcomes, complications/reoperations, and radiographic results. The findings of the study indicate that at the 5 year follow-up mean KSS and mean WOMAC scores were significantly better in the cementless group when compared to the cemented group. However, no differences in frequency of complications or aseptic loosening between the two groups were found.