Direct skeletal fixation (DSF) involves the attachment of the intra medullary portion of a prosthesis directly to the skeletal residuum, providing an alternative for amputees who face challenges mobilising with socket-based prostheses. This study investigates the effects of DSF on physical and mental health outcomes at 6- and 8-year follow-up in a cohort of military bilateral transfemoral traumatic amputees in the United Kingdom. Eight male bilateral transfemoral military amputees who underwent implantation with the Osseointegration Group of Australia-Osseointegration Prosthetic Limb (OGAP-OPL) prosthesis consented to participate in the study. All patients are routinely reviewed annually in a dedicated clinic with this paper focused on the follow-ups conducted at both 6- and 8-years post-implantation. Patient-reported outcomes were assessed using the Short Form Health Survey (SF-36) questionnaire. Complications data were recorded at an 8-year follow-up. The SF-36 physical component score significantly increased from pre-operative levels at both 6 years (median 29 vs 47, p=0.003) and 8 years (median 29 vs 45, p=0.024). The SF-36 mental health component score showed significant improvement at 6 years from pre-op (median 39 vs 57, p=0.011). There was no significant difference in the mental health score between the 6 years and 8 years mark. Among 16 femoral residuums, there was one explantation due to infection at 8.5 years post implantation and two cases managed with long-term suppressive antibiotics. 17 additional procedures were performed on 9 residuums, including 11 for soft tissue revision, 5 for infection, and 1 for fracture repair. This research adds to the growing evidence base that DSF has the potential to enhance the health and well-being of amputee veterans and potentially the broader amputee population, although medical complications remain an important consideration.