The new 3rd edition “Knee Replacement” was thus conceptualized and comes with chapters on alignment philosophies, deep vein thrombosis (DVT) prophylaxis, implant options (including unicompartmental, bicompartmental, and bicruciate sparing knees), and technology (navigation, robotics, 3D printing, patient specific instrumentation, and custom implants) to achieve the goal of personalized knee replacement. The new chapters on compartmental total knee arthroplasty (TKA) and technology in TKA give insights into the present-day trends and options available to restore alignment, balance, native anatomy, and function. Among all these shifts in alignment-based, technology-assisted implantation philosophy, we must remind one and all that this surgery continues to be an artful soft tissue and bone balancing act.