Total knee arthroplasty (TKA) is a highly successful procedure with utilization expected to grow substantially over the coming decades. However, the revision burden has not concurrently improved, with over 30% of revisions related to technical imperfections (Mulhall KJ, Ghomrawi HM, Scully S, Callaghan JJ, Saleh KJ, Clin Orthop Relat Res 446:45, 2006; Sharkey PF, Hozack WJ, Rothman RH, Shastri S, Jacoby SM, Clin Orthop Relat Res 404:7, 2002; Wylde V, Hewlett S, Learmonth ID, Dieppe P, Pain 152(3):566, 2011). Accurate alignment and soft tissue balancing have been identified as important factors in mitigating these risks. Historically, accuracy relating to soft tissue balance has relied upon surgeon experience and subjective tactile feel. This chapter will explore the utilization of intraoperative sensors related to soft tissue balancing in total knee arthroplasty.

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