A patient-specific alignment guide for an orthopedic implant. The alignment guide can include a body having first and second opposing surfaces, the second surface adapted for positioning over a skin surface, and at least one extension extending from the second surface body. The extension has a distal end defining a patient-specific end surface that is mateable in form-fitting manner with a subcutaneous portion of the patients anatomy, and at least one guiding passage extending between the first surface of the body and the distal end of the extension.