The kinematics of 10 total knee replacements with poor flexion (<90 degrees ) were compared with 11 replacements with good flexion (>110 degrees ) at a mean of 3 years from surgery using optical calibration with implant shape-matching techniques from radiographs taken in standing, early-lunge, and late-lunge positions. There were no significant differences between groups in anteroposterior translation of the medial and lateral femoral condyles or tibial rotation during standing and early lunge. Groups differed in amount of posterior translation of the femoral condyles during late lunge because of the poor-flexion group's inability to achieve the same amount of flexion as the good-flexion group. Poor flexion after total knee arthroplasty, we conclude, is not associated with abnormal kinematics in the setting of well-aligned, well-fixed implants.