A patient-specific tibial pin guide for placement on a tibia during a joint arthroplasty procedure on a patient is disclosed. The tibial pin guide includes a patient-specific inner surface having a first offset portion and a second offset portion. The first offset portion is configured to be offset from and mimic a first bone surface. The first offset portion of the patient-specific inner surface is shaped to form a gap to accommodate soft tissue overlying a proximal surface of the tibia of the patient. The second offset portion of the patient-specific inner surface is shaped to provide clearance for a patella tendon of the patient. The tibial pin guide also has a first patient-specific contact area configured for direct bone registration without intervening soft tissue and a second patient-specific contact area that is configured for direct bone registration without intervening soft tissue. The second patient-specific contact area is non-contiguous with the first patient-specific contact area.