Is Normal Knee Biomechanics Reproduced by Modern Total Knee Arthroplasty Designs? The Role of Fluoroscopy

Knee kinematics has been studied since the seventeen century with increasing enthusiasm: recent studies showed that femoral rollback, femoral external rotation and tibia internal rotation are all required for normal daily living. Total Knee Arthroplasty (TKA) is a successful procedure in treating subjects with severe knee osteoarthritis: unfortunately, knee joint kinematic after TKA can differ substantially when compared to the kinematic of the normal knee. Numerous kinematic studies using standing and mobile fluoroscopy, gait analysis technologies and simple in vitro techniques have extensively evaluated those differences. In this review article, the authors reviewed the contribution of different fluoroscopic studies in understanding the biomechanical differences between the native and the replaced knee.