Improved cement technique by interposing less than two layers of hydroxyapatite (HA) granules between bone and bone cement at the cementing (Interface Bioactive Bone Cement : IBBC) have been performed in total knee replacement (TKR). Results of TKRs of the rheumatoid arthritis (RA) who used IBBC were evaluated. 54 knees of the RA could be followed up clinically and radiologically. As a control, clinical results of TKR with conventional cementing (Non-IBBC) were used. In IBBC cases, the appearance rate of the radiolucent lines on the tibial components and the periprosthetic osteolysis of the tibial components were significantly low. In IBBC, bone cement bound to HA mechanically immediately after surgery and HA granules bound to the bone physicochemically after bone ingrowth into the spaces around the HA granules. Thus, we believe that IBBC is a method combining the advantage of cementless HA coating and bone cement.