“Patient Specific” technology introduced in last 5 years, slowly gained popularity but has currently plateaued. We have a number of studies on patient specific instruments where they have been compared with conventional jigs in total knee arthroplasty and reported to have no clear additional benefits. This review discusses their intraoperative and postoperative advantages/disadvantages and cost effectiveness and provides a synopsis in light of current literature. Patient specific implants are not freely available yet, and there is no scientific literature reporting on their use in clinical practice.