A system is disclosed to support installation of a prosthetic joint or a prosthetic component. The system includes at least one sensor to measure a parameter. The system uses one or more patient specific instruments in conjunction with a tensor to make one or more bone cuts. The patient specific instruments and tensor make the bone cuts such that an installed prosthetic joint is aligned, balanced, loaded correctly, and positioned optimally for performance and reliability. The use of the tensor simplifies the workflow required when using the patient specific instruments. In one embodiment, the patient specific instruments are bone cutting jigs configured for the patient anatomy.