Systems and methods for implant optimization using intraoperative scanning are set forth. According to one embodiment, a method comprising intraoperatively scanning a joint surface, processing the scan and creating a three-dimensional computer model, performing simulations with the three-dimensional computer model, determining an optimal implant attribute from analysis of the simulations, selecting an optimal implant, determining an ideal positioning and orientation of the selected implant relative to scanned anatomical features, rapidly creating a patient-matched guide to facilitate bone surface preparation in order to achieve ideal positioning and orientation of the selected implant, preparing the surface using the patient matched guide, and implanting the optimal implant is set forth.
