Knee kinematics is an analysis of motion patterns and understanding knee kinematics is essential for successful total knee arthroplasty (TKA). There is a wide variety of TKA designs available today with various geometries and kinematic profiles. Despite improvements in TKA design, there is still approximately 10–15% dissatisfied patients. It may be that variations in the knee kinematics between the native knee and replaced knee may impact patient satisfaction, as it has been reported that kinematic patterns have correlated with patient satisfaction, outcome score and overall survivorship. While there is no established consensus, variations from normal knee kinematics in TKA design will impact the functional outcome with limited range of motion, paradoxical sagittal femorotibial translation and loss of axial rotation.