Total knee arthroplasty (TKA) has been shown to improve the quality of daily activities for those with disabling knee arthritis. The positive impact this procedure has on the patient’s life is significantly influenced by the accuracy of component alignment and restoration of alignment. Precise execution of the surgical technique, with accurate soft tissue balancing and limb alignment is important. Conventional TKA with manual instrumentation is an accepted, safe and cost-effective procedure. Yet in search of improving patient satisfaction, technological advancements have resulted in the invention of more advanced joint navigation and robotic systems.