Of 376 cemented posterior stabilized HLS1 TKRs inserted in 329 patients (mean age 70) between 1984 and 1988, information was available on 306 (81.4%) at the third follow-up in 1998: 118 patients deceased; 163 followed up clinically (Knee Society score) and radiographically; 25 revised (15 infections; 10 mechanical failures). At a mean follow-up of 11.5 years, the mean pain score was 43/50, and the mean ROM score 21/25 (both unchanged since 1989). The function score had declined linearly, from 70/100 in 1989 to 60/100 in 1998. Forty percent had tibial radiolucencies correlating with the extent of preoperative bone wear. Polyethylene wear (seen in 35% of knees) was always < 3 mm. The implant survival rate (infections included) was 93.7% (+/- 1.4%) after 10 years. All the mechanical failures were in advanced-OA patients with ACL-deficient knees and major bony deficiencies.