69 patients undergoing primary TKA for unilateral knee osteoarthritis were randomized to undergo the procedure using either mobile or fixed bearings, with the purpose of comparing incidence of anterior knee pain between groups at a mean of 7.9 years post-surgery. At long-term follow-up, the incidence of anterior knee pain, overall pain, function, and quality of life did not significantly differ between groups. Patients with anterior knee pain reported more pain, lower levels of the AKSS, HSS patella, and Kujala scores compared to patients without anterior knee pain.