A patient-specific osteotomy guide according to the present disclosure includes a three-dimensional bone-engaging inner surface configured to closely mate and conform to a corresponding portion of a specific patient's tibia. A resection slot at a patient-specific position and orientation to guide a cutting tool to perform an osteotomy according to a preoperative plan for the patient. An axial guide at a patient-specific position and orientation to guide a tool to perform an ACL/PCL reconstructive procedure according to a preoperative plan for the patient.