Purposed <p>High survival rates up to ten years have been reported for total knee replacements (TKR). Publications beyond ten years have more diverse conclusions. To study the long-term survival and clinical results of a multi-modular TKR, we examined a series of 120 cases with a minimum ten-years follow-up.</p> Methods <p>This is a prospective multicentric observational study operated for arthritis by five senior surgeons. No control group has been included. Different femoral components (posterior stabilized (PS) or cruciate retaining (PC) versions), different tibial baseplates, both in cemented or cementless versions, were associated with an PS, PC or rotating version (PR) polyethylene insert and a patellar resurfacing or a partial inlay polyethylene component. In some cases the patella was not implanted. At ten years 38 patients were deceased (31.7 %) and 25 patients were lost to follow-up (20.8 %). 57 patients were reviewed at ten years.</p> Results <p>The Kaplan Meier cumulative survival rate of the TKR, by considering revision for any reason as endpoint, at ten years is at 92.6% (CI: 86.2-96.1).They were two infections (1.7%) and eight other revisions for different reasons (6.7 %). Secondary IKS scores were statistically improved. Functional score was 79.4 points (p&lt;0.001) and knee score was 89.2 (p&lt;0.001). Minimal clinically important difference (MCID) were obtained in most of patients. Satisfaction of the patients was obtained in 93.75 % in a correspondence questionnaire.</p> Conclusion <p>At ten year follow-up, this multi-modular TKR provides very good implant survival rates and clinical score with a high patient satisfaction.</p>