This article presents the 2-year clinical results of primary total knee arthroplasty (TKA) performed with a zirconia ceramic femoral component. A posterior-stabilized TKA was performed for degenerative arthritis in 36 patients (39 knees). The components included a zirconia femoral component, a cobalt-chrome alloy tibial baseplate, and a polyethylene patella; all were implanted with bone cement. The ultra-high molecular-weight polyethylene-bearing insert had a deep-dish, ultra-congruent design. At the 2-year interval, mean Western Ontario and McMaster Universities (WOMAC) osteoarthritis indices improved from 41 to 86, and mean Knee Society Scores improved from 40 to 92. Revision to constrained implants was necessary in one patient for persistent knee instability after trauma. These early results are encouraging, but more data are needed to determine whether ceramics are a suitable alternative to metal countersurfaces in TKAs.