The success of total knee arthroplasty has contributed to its
widening application to younger, more active patient populations whose daily
regimen includes more demanding high-flexion activities. Worldwide expansion
to patient populations in the Middle East and Asia, where the attainment of
high degrees of knee joint flexion is often a cultural requirement, has been
steadily increasing in recent years. The present study reveals the contact
areas and stresses that are associated with polymer insert abrasion.
Finite-element models were created of four total knee designs during the most
highly loaded portions of three different high-flexion activities, and the
results suggest their efficacy in clinical use.