Systems, devices, and methods are provided for implanting and aligning orthopedic implants. A patient-matched alignment guide is used to orient tools and implants intraoperatively. In certain embodiments, the systems, devices, and methods include an orthopedic guide comprising a body having a bottom surface, wherein at least a portion of the bottom surface has predetermined surface characteristics that correspond to respective characteristics of a patients bony anatomy, and a pliable flange that extends from the bottom surface and is shaped to be received within an undercut of an implant to releasably couple the orthopedic guide to the implant.
