Total knee replacements (TKR) have been used for the past four decades [1]. Conventional knee (tibiofemoral) wear simulators have been used to facilitate improvements in the design of TKRs [2]. This, along with surgical improvements has caused the success rate of implants to increase to 97% over a period of ten years [3, 4, and 5]. However the decision to resurface the patella still remains an issue [6, 7]. Research has been performed into the in vitro wear simulation of the patella femoral joint (PFJ) [8, 9, and 10] but to date none of these simulations have employed all six degrees of freedom (DOF).

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