111 patients eligible for primary total knee arthroplasty (TKA) were randomly allocated to receive either a posterior stablized (PS) post/cam tibial insert or a more congruent cruciate-substituting (CS) insert. This study aimed to compare the clinical outcomes during the postoperative period and radiographic and functional outcomes at a minimum 2-year follow-up between the two devices. At 2-years the PS and CS groups demonstrated equivalent functional and radiographic outcomes. Tourniquet time was significantly shorter in the CS group. Intraoperative estimated blood loss, hemoglobin, and units of blood transfused were not significantly different, however, in a subgroup analysis of males, the CS group required significantly fewer units of blood transfused.