Tibial resection systems and methods for use in a uni- or bi-cruciate retaining knee replacement procedure are disclosed. A tibial resection system can include a tibial block, an alignment guide, and a tibial implant template. The tibial block can be coupled to an anterior side of a tibia and longitudinally extend from a proximal end portion to a distal end portion. The alignment guide can be coupled to the proximal end portion of the tibial block and can include one or more drill guides and a drill guide adjustment mechanism. The tibial implant template can be engaged with the drill guide adjustment mechanism, such that rotational movement of the tibial implant template can adjust an axial direction of the one or more drill guides. An outer profile of the tibial implant template can be selected to substantially match an outer profile of a tibial prosthesis to be implanted.
