Two hundred forty patients with primary, Kellgren-Lawrence grade 3-4 knee osteoarthritis were randomized to receive either a novel TKR implant design (Persona CR, n=80) or one of two conventional TKR designs (PFC CR, n=80 and NexGen CR, n=80). The primary outcome of interest was the Oxford Knee Score (OKS). Secondary outcomes included the Forgotten Joint Score (FJS), the 15D, the UCLA activity score, and the visual analog scale (VAS) pain score. Outcomes were assessed at 2–3 months, 1 year, and 2 years. Overall, the results of the study revealed that the OKS improved significantly in all groups, with no clinically relevant differences between the novel and conventional designs at the 2-year follow-up. This suggests that the novel TKR implant design does not provide superior functional outcomes compared to conventional designs.