This work investigates the effect of surface texturing on the coefficient of friction (COF) of tibial inserts (TIs), of total knee replacements (TKRs), using a servomechanical knee simulator operating under the conditions prescribed by ISO 14243-3:2014, which requires strict control of flexion/extension (FE), anterior/posterior displacement (AP), inward/outward rotation (IOR) movements, and load variation. Tests were carried out lubricating with fetal bovine serum solution with a protein concentration of 20 g/L at 37±" role="presentation" style="position: relative;"> ± ± 2 °C. TIs were manufactured by fused deposition modeling (FDM) using polylactic acid (PLA) because of the advantages associated with rapid prototyping and customization. The acquired COF data were analyzed using statistical parametric mapping (SPM) to determine how the surface of the TIs affects the COF, identifying ranges where significant differences occurred. Textured surfaces led to significant reductions in COF during the swing phase of the walking cycle.