Mobile bearing total knees avoid the conformity/constraint tradeoff of fixed bearing total knees. However, a recent in vivo fluoroscopic study of the most popular mobile bearing total knee in the U.S. showed that bearing motion failed to occur in half of the patients observed. A nonlinear, multiple-surface contact finite element model of a rotating platform total knee was therefore developed to investigate the interaction at the “mobile” interface (contact between the tibial tray and the polyethylene insert) under physiologically relevant loads (1–4 BW) and rotations (10° endorotation). The data showed that there was a linear relationship between axial load and the torque resisting endorotation. Peak contact stresses were located on the medial and lateral peripheral edges of the polyethylene insert. All relative rotation occurred at the “mobile” interface. The same trends were seen in a complementary experimental study of the same components, suggesting that the finite element model is valid under these loading conditions.

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