A novel wear prediction framework was developed by coupling a patient-specific lower extremity musculoskeletal multibody dynamics model with the finite element contact mechanics and wear model of total knee replacement. The tibiofemoral contact forces and kinematics were influenced by articular surface wear, and in turn, the variations from the knee dynamics resulted in increases in the volumetric wear of 404.41 mm3 after 30 million cycle simulation from 380.86 mm3 from the traditional wear prediction using fixed load/motions. The developed patient-specific wear prediction framework provided a reliable virtual platform for investigating articular surface wear of total knee replacements
