Total knee arthroplasty (TKA) is one of the most common surgical procedures in orthopaedics. The aim of TKA is to achieve long-term implant survival and successful functional outcome with minimal complications and cost effectiveness. The aim of the study is to evaluate soft tissue balance at midflexion in addition to routine balancing of knee at extension and 90° flexion before and after placing final prosthetic components in total knee arthroplasty and to assess and look for reasons of variability of soft tissue balance at midflexion compared to balancing at full extension and 90° flexion.