My dads got a Ramsey PTO on his truck (465/205, 1974 frame) I believe it to be an 8K variant. As it's setup, transmission gear determines line speed and direction.
No idea how old the winch is, it's probably 30 years at least. Not once has it ever failed, although sometimes getting the lever on the winch "in gear" is difficult. Then again, in it's entire life with my dad, he's done NOTHING to it except maybe lube it once, and replace the cable.
The major disadvantage I see is that if the engine is dead, you aren't winching. Of course, running the driveshaft is more complex than wiring an electric, plus the PTO actuator cable you need, but that's fairly easy. Spooling line up and what not is a two person job, one controlling the transmission/clutch, one guiding the cable.
The PTO driveshaft simply passes through the front frame crossmember, on his '74 the factory hole lined up pretty well for the shaft, he just hogged it out a bit.