30 patients scheduled for total knee arthroplasty (TKA) were randomized to one of two groups: one group underwent the procedure with the use of patient-specific instrumentation (PSI), and the other with conventional instrumentation. The purpose of this study was to determine whether the use of PSI in TKA led to significantly improved CT alignment of components in the coronal, sagittal, and axial planes. Overall, postoperative alignment appeared similar between groups, with a maximum of one patient from either group considered an outlier in any of the three planes of alignment.