One hundred and thirty patients who were scheduled for primary total knee arthroplasty (TKA) for osteoarthritis were randomized to receive cemented femoral component TKA (n=65) or uncemented femoral component (n=65). The tibial components were cemented in both groups. Outcomes of interest included the survival rate, incidence of revision for aseptic loosening or mechanical failure, the International Knee Society (IKS) knee score, IKS function score, and IKS global score, incidence of major complications, range of motion flexion, hip-knee-ankle angle (HKA), incidence of radiolucent line (RLL) (in zone 1, zone 2, zone 3 and zone 4), incidence of progressive RLL, and incidence of bone transparencies. All outcomes were measured at baseline and a minimum 10 years follow-up. Results of this study demonstrated that the survival rate was similar between the two groups, with no statistical difference observed (p>0.05). Radiological outcomes progressive RLL and RLL in zones 1, 2, and 4 were statistically significantly different between the cemented and uncemented TKA groups (p<0.05 for both) in favour of the uncemented femoral group. The incidence of bone transparencies was statistically significantly in favour of the cemented femoral group. All remaining outcomes were not statistically significantly different between the uncemented and cemented femoral TKA groups (p>0.05 for all).