Systems and methods for femoral medial condyle spherical center identification and tracking are described herein. Once the spherical center of the medial condyle is identified, the spherical center is tracked using a pin or internal reference. The spherical center may be used to provide a key kinematic motion reference, such as when the medial condyle is adjusted during a surgical procedure. The tracking may be used to provide optical tracking, inertial tracking, or other tracking. In contrast with surface-mounted optical trackers, the spherical center tracking is not lost during resection (e.g., removal) of a bone surface. Tracking the medial condyle spherical center may reduce or eliminate the need for a surface-mounted optical tracker or preoperative 3-D modeling or of the joint.