An orthopedic device for joint arthroplasty includes a patient-specific alignment guide constructed and configured for a specific patient from medical scans that show a bone surface of a bone of the patient without any overlying soft tissue. The patient-specific alignment guide includes a patient-specific inner surface configured to be offset from and mimic the bone surface and form a clearance for soft tissue overlying the bone surface. The alignment guide also includes a plurality of patient-specific contact areas configured to mate and register directly on the bone surface without intervening soft tissue for direct bone registration. The plurality of patient-specific contact areas includes non-contiguous surface contact areas.
