A stratified approach to pre-clinical tribological evaluation of joint replacements representing a wider range of clinical conditions advancing beyond the current standard.

A new stratified approach to pre-clinical tribological simulation of joint replacements is presented, which extends beyond present standard conditions used. It includes variations in surgical delivery, variations in kinematics, variations in the patient population and degradation of the biomaterials technology. Examples of the new methods are presented, which have been validated against clinical experience of existing devices. The stratified approach has differentiated the performance of joint replacements, which had previously been shown to have similar tribological performance under standard conditions. The stratified approach to pre-clinical tribological simulation of joint replacements has the potential to support the development of robust designs and improve safety and reliability of joint replacements in the future.