We sought to determine what dimensional changes occurred from wear testing of a total knee implant, as well as any changes within the polyethylene subsurface. Three fixed bearing implants underwent wear simulator testing to 6.1 million cycles. Gravimetric analysis and micro-CT scans were performed pre-test, mid-test, and post-test. Wear volume and surface deviations were greater during 0–3.2 million cycles (91 ± 12 mm3) than from 3.2 to 6.1 million cycles (52 ± 18 mm3). Deviations (wear and creep) occurred across all surfaces of the tibial inserts, including the articular surface, backside surface, sides, and locking mechanism. No subsurface changes were found. The micro-CT results were a useful adjunct to gravimetric analysis, defining the dimensional changes that occurred with testing and ruling out subsurface fatigue.