Objective To evaluate the wear of rotating hinge knee prosthesis(RHKP) during the horizontal walking gait, and provide data reference for wear prediction and clinical application of this kind of prosthesis. Methods A finite element wear model of RHKP was established according to ISO14243-1, and the simulation results were compared with the results from in vitro experiments with the same type of prosthesis. Results The mass wear rate of polyethylene insert was 26.01mg/MC from FEA and (30.06±1.21)mg/MC from in vitro experiments. The mass wear rate of the upper surface from FEA is about 3.3 times higher than that of the lower surface. The wear area obtained by FEA is basically consistent with that obtained by in vitro wear measurement. Conclusions The mass wear rare of RHKP, as a semi-restrictive prosthesis, is obviously more than the primary total knee joint prosthesis. It should be paid more attention to the wear testing and evaluation of RHKP.