130 patients undergoing total knee arthroplasty were randomized in the original study to receive femoral component fixation with either a cemented or cementless prosthesis, to compare clinical and radiological outcomes. This study aimed to provide the results at a 7-year follow-up. Results indicated comparable clinical outcomes and rates of complications between groups. Radiolucent lines were significantly more prevalent in the cemented group when compared to the cementless group. Bony lucency in the cementless group improved from 2-year follow to the 7-year follow-up.