PURPOSE: The purpose of this study is to evaluate the result of primary total knee arthroplasty(TKA) with using NexGen CR-Flex(R) (Zimmer, Warsaw, IN, USA) after a follow-up of at least 2 years. MATERIALS AND METHODS: A total of 63 patients (98 knees) were included in this study. The same surgeon performed all the TKAs between August 2005 and May 2006 with using NexGen CR-Flex(R). The patients' age ranged from 52 to 81 years, and the mean follow-up period was 28 months. The patients were assessed clinically and radiographically with using the HSS score, the possibility that they could squat or kneel, the tibiofemoral angle, the radiolucency and the posterior condylar offset. RESULTS: The mean HSS score was 58.3 points preoperatively, and it was 91.1 points at the last follow-up. The mean range of motion improved from 123.2degrees preoperatively to 137.1degrees postoperatively. Forty-nine patients (78%) were able to squat and 24 patients (38%) could kneel down at the last follow-up. The mean tibiofemoral angle was 6degrees of varus preoperatively, and 7degrees of valgus postoperatively. And there was no radiolucency in any case. The mean posterior condylar offset was 26.1mm preoperatively and 27.2 mm postoperatively. CONCLUSION: TKA with using NexGen CR-Flex(R) showed favorable results at a mean follow-up of 28 months. Adequate patient selection, restoration of the posterior condylar offset and thorough clearing of posterior condylar osteophytes are thought to be the key elements to achieve a satisfactory range of motion after TKAs.