This paper reports the clinical outcomes and survivorship of a prospective series of Advantim cementless TKR performed at the RAH between 1993 and 2005. There were 210 knees in 176 patients. All procedures were performed or supervised by a single surgeon. All patients were followed up at regular intervals, up to 15 years later, with Knee Society Cinical Rating System and X-Rays. No patients were lost to follow-up. The knee rating improved from a median of 47 to 90. The median range of motion was 0–100. At 11 years the survivorship of the tibial component was 95.5% and femur was 93.7%. There were two major revisions and three minor revisions for polyethelene exchange. There was no deep sepsis. There was no knee stiffness requiring arhrolysis or manipulation. No screw osteolysis observed. Advantim was the best perfoming TKR in the AOA registry in 2008 with 0.3 revisions per 100 observed component years. Advantim has excellent clinical outcomes and survivorship. Screws provide rigid initial and ongoing stability to tibial implant-bone construct. Screw osteolysis should not be a concern in a good implant design.Conclusions