Modern computerized knee navigation systems aid surgeons both in the conventional and in the minimally invasive approach to optimize mechanical and rotational alignments of the components in all three planes to avoid any malrotation and/or any errors in coronal, sagittal, and axial alignments. The advantages of minimally invasive total knee arthroplasty can be achieved without loss of accuracy. There is increasing evidence of a positive correlation between accurate mechanical alignment after total knee arthroplasty and functional as well as quality-of-life patient outcomes.