This review evaluated (1) original and newer cementless implants; (2) outcomes of newer designs; (3) risks and benefits; and (4) newer cementless vs cemented total knee arthroplasties. A search for all reports on cementless total knee arthroplasties published from January 2010 to April 2017 was performed, and 31 studies were included for final analysis. Newer cementless total knee arthroplasty designs have shown excellent survivorship, functional outcomes, and satisfaction rates in both young and elderly populations. Compared with cement fixation, there may be potential benefits with the newer cementless implants. However, these findings need to be further substantiated with additional studies reporting longer-term results.