Explanation:Polyethylene wear in total knee arthroplasty is primarily influenced by contact stress and limb alignment. Malalignment increases localized contact pressure leading to accelerated wear. Excessive wear generates debris that can trigger osteolysis and implant loosening. Correct alignment during surgery distributes loads more evenly across the implant surfaces. Implant design and material quality also influence wear characteristics. Long-term success of knee arthroplasty depends heavily on maintaining optimal biomechanical alignment. Reference: Insall JN. "Total Knee Arthroplasty." Clinical Orthopaedics and Related Research, 1985.