A system and method for knee arthroplasty procedures, using a novel leg rotation fixture to enable the leg mechanical axis, the tibia and the femur to be mutually disposed such that the load bearing, mechanical axis of the leg runs through the center of the knee joint. A measurement gauge is provided for mounting on the tibia and for aligning a baseplate in a known position on the tibia. This baseplate supports an X-ray target plate in a known position relative to the tibia, used in determining the mechanical axis, and an optional surgical robot, used to perform tibial and femoral cuts. The position of the femur relative to the robot may be determined from X-ray imaging of the pelvic region after attachment to the baseplate of an additional target extending to the pelvic region. The system enables improvement in the accuracy of knee arthroplasty procedures.