Sixty patients with osteoarthritis undergoing cemented total knee arthroplasty were randomized to receive either a medial congruent (MC) bearing (n=30) or a cruciate-retaining (CR) bearing (n=30). The primary outcome was tibial implant migration at 2 years, measured by maximal total point motion (MTPM) using radiostereometric analysis (RSA). Secondary outcomes included other RSA migration/rotation measures, patient-reported outcome measures (PROMs: OKS, OKS-APQ, FJS, EQ-5D), and complications. Outcomes were assessed at 3 months, 1 year, and 2 years. Overall, the results revealed no significant difference in tibial implant migration between groups at 2 years and no differences in PROMs or complications. The study suggests that medial congruent bearings do not compromise fixation compared with cruciate-retaining bearings.