A system and method for is provided for operation of an orthopedic system. The system includes a load sensor for converting an applied pressure associated with a force load on an anatomical joint, and an inertial sensing device configured to measure alignment. The inertial sensing device provides alignment measurement data to measure alignment. An ultrasonic transducer, MEMs microphone, electromagnets, optical elements, metallic objects or other transducers can be configured to convert or convey a physical movement to an electrical signal and support measurement of muscular-skeletal alignment. The load sensor can be used to measure load magnitude and position of load of an applied load by the muscular-skeletal system.