Fifteen studies involving 1,714 patients with end-stage knee osteoarthritis were included in this systematic review and meta-analysis, comparing posterior cruciate-retaining (CR) and posterior-stabilizing (PS) prostheses in total knee arthroplasty. Outcomes analyzed included range of motion (ROM), various knee pain scores, total blood loss, revision rates, and complications. The pooled results indicated that the PS group achieved a higher ROM and slightly better HSS scores, while the CR group experienced less blood loss. No significant differences were noted between the groups in most knee scores, complication rates, or revisions. This meta-analysis suggests that both CR and PS approaches yield comparable outcomes, allowing flexibility in prosthesis choice without a marked impact on clinical outcomes.