This document defines a workflow to design scaffold implants from patient clinical imaging (such as CT-scans). In this workflow the different requirements for the involved steps in implant creation (such as image scan properties, software operations, systematic inclusion of clinicians input, considerations about manufacturability) shall allow repeatability and designer-independent results. This document is intended to be used by clinicians, implant designers and implant manufacturers. The considered implants are primarily intended to address pathologies of musculo-skeletal structures. This document is not intended to be used for the design of soft-tissue implants.