Early failure of the NexGen prosthesis with a 3° fluted, 4 hole tibial component has been reported. We evaluated fixation, survival and osteolysis with the NexGen LPS prosthesis with a 7° fluted, solid tibial component at a mean of 10 years. Knees were evaluated using Knee Society and LEAS scores, survival analysis, and univariable modeling. No knee had tibial loosening or debonding. With the endpoint mechanical failure (132 knees), the 12 year survival was 88.8% (CI 61.5-97.1).With failure defined as any reoperation (132 knees), the 12 year survival was 88.1% (CI 62.3-96.7). Osteolysis occurred in 16 knees, associated with male gender and LEAS score>10. Loosening was not seen with this tibial component.