Within the limits studied, the presence of ADL did not significantly increase the wear rate of crosslinked and conventional UHMWPE inserts. CR and CR-Flex knees produced similar wear rates during walking and multigait motions. Testing under high flexion and high load dramatically increased the wear rates of both type of inserts. The wear of HXPE doubled while that of CPE increased by more than an order of magnitude. Wear reduction and delamination resistance of HXPE was more pronounced for high flexion accommodating implants and activities. CPE inserts underwent delamination and fracture while the HXPE inserts remained intact with only minor surface changes.
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