Traditional techniques to balance total knee arthroplasties are often subject to variability, as they are usually based on the surgeon's subjective assessment. Improperly balanced total knee arthroplasties can cause complications such as stiffness, pain, or instability, which may ultimately result in a revision procedure. In an effort to mitigate this, a tibial insert sensor technology has recently been developed to allow for quantifiable, objective measurements of soft-tissue balancing. A systematic review of the current literature was performed, highlighting the utility of this sensor tibial insert with focus on: (1) compartment loading pressures; (2) component orientations; and (3) clinical outcomes.