Accurate soft tissue balancing during total knee arthroplasty has a direct effect on patellofemoral tracking and knee range of motion. Numerous instruments and methods are available to balance knee prostheses. The eLIBRA Dynamic Knee Balancing System (Synvasive Technology, Inc, Reno, Nevada) is an electronic device that establishes femoral component rotation using ligamentous tone. The eLIBRA is an articulating spacer that emulates implant trials before anteroposterior femoral cuts are made to obtain a dynamic gap symmetry.