Achieving optimal soft tissue balance intraoperatively is a critical element for a successful outcome after total knee arthroplasty. Although advances in navigation have improved the incidence of angular outliers, spatial distance measurements do not quantify soft tissue stability or degrees of ligament tension. Revisions caused by instability, malrotation, and malalignment still constitute up to one-third of early knee revisions. The development of integrated microelectronics and sensors into the knee trials during surgery allows surgeons to evaluate and act on real-time data regarding implant position, rotation, alignment, and soft tissue balance through a full range of motion.