A system and method for measuring medial-lateral tilt of a bone is disclosed. The bone is coupled to a joint of the muscular-skeletal system. The method comprises coupling a three-axis accelerometer to a prepared bone surface of a bone. The three-axis accelerometer is configured to measure position, rotation, and tilt. The joint is rotated between two points. The rotation between the two points traverses an arc having a maximum therebetween. The joint pivots off of a surface to which the bone is coupled. In one embodiment, a pivot point and joint rotation relates to a mechanical axis of the joint and bone. The three-axis accelerometer measures data points along the arc as it is rotated between the two points. Multiple passes along the arc generates sufficient data points to determine the maximum. The position of the maximum is used to calculate the medial-lateral tilt of the bone.