Femoral head repair

Abstract

The present disclosure provides a surgical instrument and method for assessing the repair of the femoral head center. The instrument includes a body (100) having a first connector (104) for attaching the body to a femoral portion (442), and wherein the body defines a plurality of apertures (110, 112, 114, 116, 118) therein, wherein each aperture corresponds to a respective femoral head center produced by a respective corresponding femoral neck; and a gauge (140), wherein the gauge includes a pin (142) at a first end and an arm (144) extending laterally from the pin, and wherein the pin is capable of being received in each of the plurality of apertures and the arm bears a scale indicating the distance from the pin. The method seeks to provide a simple and / or easy to use method to repair the native femoral head position during a hip arthroplasty surgical procedure.

Description

[0001] This disclosure relates to surgical instruments and methods, and more particularly to surgical instruments and methods for repairing the center of the femoral head in hip replacement surgery.

[0002] Various hip replacement surgeries are generally known. Some of these surgeries involve removing the native femoral head and replacing it with a prosthetic femoral head. Typically, a trunk consisting of a prosthetic femoral neck is used, to which the prosthetic femoral head is attached. Sometimes, an acetabular cup may also be used to replace the patient's native acetabulum. Specific details may vary depending on the implantation system used.

[0003] The placement of prosthetic components can be a crucial factor in the outcome of hip replacement surgery. There are various principles or methods for implant placement, and they may differ depending on the implantation system and / or the individual patient's circumstances.

[0004] One approach is the restorative approach, in which surgeons attempt to replicate or repair the patient's original anatomy before hip replacement surgery.

[0005] For example, preoperative images (such as X-ray images or CT scans) can be used to determine the anatomy of a patient's femur, and these images can then be used to plan the prosthetic implant and its placement in an attempt to repair the patient's native anatomy. However, such methods require available imaging equipment, may take longer, may be more complex, and may require more experience or skill from the surgeon.

[0006] Therefore, simpler methods that help repair original anatomical structures would be beneficial.

[0007] This disclosure relates to surgical instruments, devices, parts kits, and methods that provide simple and / or easy-to-use methods for restoring the original femoral head position during hip replacement surgery.

[0008] A first aspect of this disclosure provides a surgical instrument for evaluating the repair of a femoral head center, the surgical instrument comprising: a body having a first connector for attaching the body to a femoral portion, and wherein the body defines a plurality of orifices therein, wherein each orifice corresponds to a corresponding femoral head center arising from a corresponding femoral neck; and a measuring instrument comprising a pin at a first end and an arm extending laterally from the pin, wherein the pin is receptacle in each of the plurality of orifices and the arm has a scale indicating the distance from the pin.

[0009] Multiple orifices may include orifices corresponding to the femoral neck with different medial and lateral offsets.

[0010] Multiple orifices may include orifices corresponding to the femoral neck with different neck angles.

[0011] Multiple orifices may include orifices corresponding to femoral necks with different leg lengths.

[0012] The body may have a front surface, and the front surface may include at least a first linear mark that extends parallel to the inner and outer axes and passes through at least a first orifice among a plurality of orifices and corresponds to a first position on the upper and lower axes.

[0013] The front surface may include at least a second linear mark that extends parallel to the inner and outer axes and passes through at least a second of the plurality of orifices and corresponds to a second position on the upper and lower axes.

[0014] The body may have a rear surface, and the rear surface may include the same markings as the front surface, and may be configured such that the same body can be used for both the right-hand and left-hand hip joints.

[0015] The body may have a rear surface that defines a rear plane, and a front surface that defines a front plane that is parallel to the rear plane.

[0016] Each of the multiple orifices may include a channel that extends through the entire thickness of the body. Each channel may extend from the front surface through the body to the rear surface or the rear surface.

[0017] A second aspect of this disclosure provides a surgical instrument system comprising: the surgical instrument of the first aspect; and a center seeker. The center seeker may include a plurality of marks configured to indicate the center of the center seeker.

[0018] The center seeker may include a circular ring. Multiple markings may include a first pair of diametrically opposed markings and / or a second pair of diametrically opposed markings.

[0019] The surgical instrument system may also include a puller. The puller may include a second connector configured to engage the first connector to attach the body to the puller.

[0020] Surgical instrument systems can also include multiple femoral necks. Each neck can produce a different femoral head center location.

[0021] Multiple femoral necks may include femoral necks with different offsets along the medial and lateral axes.

[0022] Multiple femoral necks can include femoral necks with different neck angles.

[0023] Multiple femoral necks may include femoral necks with different leg lengths along the superior and inferior axes.

[0024] The femoral neck can be a trial neck or a prosthesis neck.

[0025] A third aspect of this disclosure provides a method for assessing the repair of the femoral head center of a patient's femur. The method may include one or more of the following steps: determining the center of the original femoral head of the patient's femur; marking the location of the center of the original femoral head on the original femoral head; marking the location on the greater trochanter of the femur relative to the center of the original femoral head, said location having a known separation from the center of the original femoral head along the medial and lateral axes and being at the same location as the center of the original femoral head along the lateral and superior axes; resecting the original femoral neck; attaching a body to the resected femoral neck, wherein the body defines a plurality of orifices, each orifice corresponding to a corresponding femoral head center generated by a corresponding femoral neck; attaching a graduated measuring instrument to the body using a first orifice of the plurality of orifices; and using the measuring instrument to determine whether the femoral head center generated by a first femoral neck corresponding to the first orifice of the plurality of orifices would repair the original femoral head center.

[0026] The method may further include: attaching a measuring instrument to a body using a second orifice among the plurality of orifices; and using the measuring instrument to determine whether a femoral head center generated by a second femoral neck corresponding to the second orifice among the plurality of orifices will repair the original femoral head center.

[0027] The method may also include aligning the measuring instrument with a linear mark on the body, the linear mark being parallel to the medial and lateral axes of the femur.

[0028] The method may further include: using a scale on a measuring instrument to determine whether the femoral head center generated by the femoral neck corresponding to one of the plurality of orifices has a separation that repairs a known separation.

[0029] The method may also include: using a center-finding guide placed on the original femoral head to determine the center of the original femoral head and / or marking the location of the center of the original femoral head.

[0030] The implementation scheme will now be described in detail by way of example and with reference to the accompanying drawings, in which:

[0031] Figure 1 A side view of the main body of the head center repair device is shown;

[0032] Figure 2 A perspective view of the measuring section of the head center repair instrument is shown;

[0033] Figure 3 A perspective view of a head-center repair instrument, including the measuring instrument and the main body, is shown.

[0034] Figure 4A flowchart illustrating a method for repairing the original femoral head center using a head-center repair instrument as part of a hip replacement surgery is shown.

[0035] Figure 5 An anterior view of the proximal portion of the native femur and the guide is shown;

[0036] Figure 6 A guide for marking the femoral resection height is shown;

[0037] Figure 7 A guide is shown for marking the greater trochanter relative to the center of the native femoral head;

[0038] Figure 8 The image shows a laparoscopy device in the femur after neck resection;

[0039] Figure 9 The main body of the head-center repair instrument mounted on a broach is shown; and

[0040] Figure 10 The measuring instrument section is shown for use with the main body of the head center repair instrument to evaluate which test neck to use for repairing the center of the femoral head.

[0041] In the various figures of the accompanying drawings, unless otherwise specified, similar items in different figures share common reference numerals.

[0042] refer to Figure 1 The diagram shows a side view of the first part 100 of the head-centered repair device. The first part of the device 100 provides the body of the head-centered repair device. The body includes a main part 102 and a connecting part 104, through which the body 100 can be attached to the femoral portion in use, as described in more detail below.

[0043] The main portion 102 of the body 100 defines a plurality of orifices therein. In the illustrated embodiment, the body defines five orifices 110, 112, 114, 116, and 118. Each orifice extends completely across the entire width of the main portion of the body 102 and must also have an opening on either side of the body. It should be understood that five orifices are merely an example, and in other embodiments, more or fewer orifices may be provided. As described in more detail below, the location of each orifice corresponds to a corresponding femoral neck, and specifically, corresponds to the center of the femoral component when mounted on the corresponding neck. Thus, in the illustrated embodiment, when five orifices are present, five femoral necks are also present. The geometry of each femoral neck corresponds to a slightly different position of the center of the femoral component when mounted on the corresponding neck. The femoral necks may have different neck angles (e.g., 125° or 135°) and / or different medial and lateral offsets and / or different leg lengths.

[0044] For example, the fourth orifice 116 may correspond to the fourth femoral neck, which may be considered a standard or reference femoral neck. A standard femoral neck may have a neck angle of 125° and generate the center of the femoral component at a standard position in terms of medial and lateral offset and leg length. A standard femoral leg may be considered to provide a low femoral head position.

[0045] The third orifice 114 can be associated with the third femoral neck, which also has a neck angle of 125°. However, the center of the femoral component generated by this femoral neck causes a lateral displacement of the femur relative to the pelvis. For example, the amount of increased lateral displacement can be approximately 7 mm.

[0046] The fifth orifice 118 may correspond to the fifth femoral neck, which again has a neck-shaft angle of 125°. However, the center of the femoral component produced by this femoral neck has a reduced distance in the medial and lateral directions and corresponds to the medial offset of the femur relative to the pelvis. For example, the amount of medial offset may be approximately 5 mm.

[0047] The second orifice 112 may correspond to a second femoral neck having a neck angle of 135°. This second femoral neck can produce the same medial and lateral position as the standard femoral neck, but the resulting center of the femoral head will cause an increase in leg length in the vertical direction. For example, the increase in leg length may be approximately 5 mm.

[0048] The first orifice 110 may correspond to a first femoral neck, which also has a neck-shaft angle of 135°. The femoral head center generated by the first femoral neck has an increased leg length relative to the standard neck, and also an increased lateral offset relative to the standard neck. The increase in leg length may be approximately 5 mm, and similarly, the amount of lateral offset may be approximately 7 mm.

[0049] The first and second femoral necks can be referred to as "high" femoral necks, while the third, fourth, and fifth femoral necks can be referred to as "low" femoral necks.

[0050] like Figure 1 As shown, various markings and symbols can be provided on the anterior surface 120 of the main body portion 102 to indicate to the user the femoral neck associated with each of the corresponding orifices. Similar markings can also be provided on the posterior surface of the main body, such as... Figure 1 As shown, the rear surface is generally parallel to the front surface. Therefore, the same body can be used for both the right-hand and left-hand hip joints, or for either the anterior or posterior path, because it is essentially symmetrical about a central plane parallel to the front and rear surfaces of the body.

[0051] Similarly, Figure 1 As shown, a first linear mark 122 and a second linear mark 124 are also provided on the anterior surface 120. In use, when the body 100 is mounted on a patient's femur, the first linear mark 122 passes through the first and second orifices and extends generally along the internal and external axes of the patient's anatomy. Similarly, in use, when the body 100 is mounted on a patient's femur, the second linear mark 124 extends through the third, fourth, and fifth orifices and also extends generally parallel to the internal and external axes of the patient's anatomy.

[0052] The connecting portion or foot portion 104 defines a pin 130 and a cavity 132, which provide first and second attachment features for releasably attaching the body 100 to the femoral component during use. The provision of the pin and cavity helps ensure that the body 100 is properly attached to the femoral component during use.

[0053] Figure 2 A perspective view of the measuring instrument 140 portion of the head-center repair instrument is shown. The measuring instrument 140 has a pin 142 at its first end. The pin 142 is sized to fit snugly into any one of the plurality of orifices in the body 100. Figure 2 As shown, the nail has a roughly circular cylindrical shape.

[0054] The measuring instrument 140 also includes an arm or member 144 extending generally transversely to the longitudinal axis of the pin 142. This arm includes a plurality of markings on a first surface 146 and on a reverse surface 148. For example... Figure 2 As shown, the markings on the arm 144 provide a scale indicating the distance or separation between the starting point defined by the position of the pin 142 and the lateral distance along the longitudinal axis of the arm 144.

[0055] In some implementation schemes, such as Figure 2 As shown, the scale can also provide a ruler and include numerical values ​​indicating distance. For example, 10mm, 20mm, 30mm, 40mm, 50mm, 60mm. However, in other embodiments, the measuring instrument may not be in the form of a ruler and may simply include any markings that allow visual assessment of the distance between a point on arm 144 and the position of pin 142.

[0056] Figure 3 A perspective view of a head center repair device 150, including a measuring instrument 140 mounted on the main body 100, is shown. Figure 3 As shown, pin 142 is received within the first aperture 110. The longitudinal axis of the pin extends substantially transversely to the plane of the front surface 120 of the body. Similarly, as... Figure 3 As shown, the longitudinal axis of arm 144 is substantially parallel to the first linear notation 122.

[0057] Figure 3 The configuration of the main body and measuring instrument shown corresponds to the relative positions of the main body and measuring instrument in use, as described in more detail below.

[0058] Figure 4 An example is shown as part of a hip replacement surgery. Figure 3 A flowchart illustrating the general method of use of the head-centered repair device 150 is shown. The various parts of hip replacement surgery are generally known to those skilled in the art and therefore are not described in detail here. Figure 4 As shown in the flowchart. Therefore, Figure 4 Only a subset of surgical methods are shown to avoid obscuring the description of the invention. Further references will now be made. Figures 5 to 10 A more detailed description Figure 4 Method 200 is shown.

[0059] Figure 5 This shows an anterior-posterior view of the proximal portion of the femur 300 in a patient. Line 302 is generally parallel to the anatomical axis of the femur 300. The proximal portion of the femur 300 typically includes the progenitor femoral head 304, the progenitor femoral neck 306, and the progenitor greater trochanter 308.

[0060] Figure 5 A guide component 400 is also shown, which can optionally be used to improve the overall accuracy of the procedure. The guide component 400 includes a central locating portion 402, a first arm 404, and a second arm 406. The central locating portion 402 generally has a circular annular configuration. Therefore, due to its generally circular annular form, when the central locating portion 402 is mounted on the generally spherical femoral head 304, its center naturally aligns generally with the center of the original femoral head 304. The first arm 404 is aligned parallel to the anatomical femoral axis 302. The length of the first arm 404 and the angle between the second arm 406 and the first arm 404 are predefined to indicate the preferred resection height and angle for resecting the original femoral neck 306. The upper edge 408 of the second arm 406 can be used to define a first resection height (standard resection height), and the lower edge 410 can be used to define a second resection height (corresponding to a high neck resection).

[0061] At position 202, the guide 400 is positioned on the native femoral head and oriented such that the first arm 404 is substantially parallel to the anatomical axis of the femur 302, as shown below. Figure 5 As shown. Then, at 204, the second arm 406 can be used to mark the resection height and angle on the original femoral neck, as... Figure 6 As shown. For example, the upper edge 408 of the second arm 406 can be used to position the chisel instrument 420 on the femoral neck and to mark the neck resection height and angle on the original femoral neck 306.

[0062] Then, guide 400 is used at position 206 to mark the approximate center of the native femoral head 304. (See image below.) Figure 5 and Figure 6 As shown, the annular ring 402 of the guide component 400 includes four markings, each in the form of an arrow, such as 412. A first pair of markings defines a first axis that is substantially parallel to the axis of the first arm 404 or the superior-inferior axis of the patient's femur. A second pair of markings defines a second axis that is substantially perpendicular to the first axis and the longitudinal axis of the first arm 404 and generally parallel to the medial and lateral axes of the patient's femur. Thus, the second pair of markings defines a second axis that is generally parallel to the medial and lateral axes of the progenitor femur. Therefore, at 206, the surgeon can mark the approximate center of the progenitor femoral head by drawing a first line 414 between the first pair of markings and a second line 416 between the second pair of markings. Since the markings in each pair are diametrically opposed, the intersection of the two lines generally corresponds to the center of the annular ring 402, and therefore also generally corresponds to the approximate center of the progenitor femoral head 304.

[0063] After the center of the femoral head is marked, the guide 400 can be removed. Figure 7 The original femur after removal of guide 400 is shown, and markings indicating the preferred neck resection height and angle are shown on the original femoral neck 422. At 208, a marking is made on the portion of the original femur remaining after resection of the original femoral head. This marking can be made at any suitable portion of the remaining femur, and as... Figure 7 As shown, this is typically in the region of the large rotor. (As...) Figure 7 As shown, the markings on the greater trochanter are made at a known distance from the center of the original femoral head. Marking can be done by placing a measuring instrument 140 or a ruler or similar object near the original femoral head 304 and generally aligning it with the second line 416 and thus with the medial and lateral axes of the original femur. The markings 424 on the greater trochanter 308 include a first line 425 generally parallel to the medial and lateral axes and a second line 427 perpendicular to the first line, thus clearly indicating the separation between the markings 424 on the greater trochanter 308 and the center of the original femoral head 304. The distance along the medial and lateral axes is arbitrary, and the position of the vertical marking 427 can depend more on which part of the greater trochanter is more accessible. The position of the vertical marking 427 does not need to correspond to any specific distance value. It is sufficient that the vertical markings provide a fixed separation from the center of the original femoral head, and that distance is known. For example, as... Figure 7 As shown, the distance between the center of the original femoral head and mark 424 is approximately 4 cm.

[0064] After marking the greater trochanter, at position 210, the femoral neck can be removed using neck resection marker 422 to achieve the desired neck resection height and angle. The intramedullary canal of the femur can then be formed as is generally known in the art. Formation of the intramedullary canal can involve the use of various cutting instruments, such as files and pullers. Finally, once the cavity reaches the size required for the desired prosthetic implant, a final puller can be used.

[0065] Figure 8 The femur is shown, along with marker 424 on the remaining portion of the original femur and the final puller 440 located within the intramedullary canal. (See diagram.) Figure 8 As shown, the final broach 440 includes a convex attachment forming portion 442 extending therefrom, and also includes a concave attachment forming portion (not visible) positioned and configured to mate with the convex attachment forming portion 130 on the body 100. In other embodiments, the attachment forming portions on the broach and the body can be interchanged. For example, a concave broach can be used instead, and then a convex attachment forming portion is provided on the body to engage with it.

[0066] At position 214, the main body 100 is mounted on the broach 440, as follows: Figure 9 As shown. If necessary, marking 424 can extend the vertical line, typically parallel to the anatomical femoral axis, as shown. Figure 9 As shown. Then at 216, the measuring instrument 140 can be attached to the body 100 by inserting the pin 142 into one of the corresponding holes 110 to 118 (each hole corresponds to a different femoral neck). Figure 10 As shown, pin 142 has been inserted into the first aperture 110 and thus corresponds to a neck angle of 135°, which is a high neck compared to a standard neck. Arm 144 is aligned with the first linear mark 122 so as to be generally parallel to the inner and outer axes. Figure 10 As shown, the measuring arm 144 typically covers the horizontal line marked 424. Therefore, this indicates to the user that the femoral neck corresponding to the currently used orifice will produce a femoral head center that substantially reproduces the position of the original femoral head center in the vertical direction.

[0067] Therefore, at 218, the surgeon uses measuring instrument 140 to assess which orifice in the body 100 can most tightly position the prosthetic femoral head to the center closest to the original femoral head for restoration. At 218, the surgeon can consult the scale on measuring instrument 140 to assess the position in the medial-lateral direction. For example, if the scale on arm 144 indicates that the separation in the medial-lateral direction will be approximately 5 cm, the surgeon can determine at 220 that the femoral neck corresponding to the first orifice may be inappropriate because the preferred separation between the center of the femoral head and the mark on the trochanter has previously been determined to be approximately 4 cm. Therefore, at 220, if the surgeon determines that the femoral neck corresponding to the currently used orifice may be inappropriate, the method returns as shown in process flow lines 222 through 218. At 218, the surgeon can remove measuring instrument 140 from the body 100 and engage pin 142 with another orifice among the plurality of orifices. For example, if the surgeon positions the measuring instrument such that pin 142 is in the second orifice 112, this will reduce the medial-lateral offset of the femoral head placed on the corresponding femoral neck. As described above, the second opening 112 corresponds to a reduced femoral neck separation of approximately 7 mm in the medial-lateral direction. Therefore, the surgeon can position the measuring instrument 140 aligned with the first linear mark 122 and use the scale on the measuring instrument to determine that the resulting separation will be approximately 4.3 cm. This is then considered acceptable at 220, as the initially determined ideal separation for repairing the original femoral head is determined to be approximately 4 cm. Therefore, at step 220, an acceptable femoral neck has been identified, roughly repairing the center of the original femoral head, and thus the remainder of the neck replacement surgery can continue at 224.

[0068] Alternatively, at 220, it can be determined that the femoral neck corresponding to the currently selected orifice in the body will be positioned incorrectly in the vertical direction because the measuring instrument deviates from mark 424 when aligned with linear mark 122. Therefore, the surgeon can select another orifice (e.g., orifice 116) and attach the measuring instrument with its pin positioned in that orifice, wherein the arm of the measuring instrument 144 is aligned with the second linear mark 124. The surgeon can then visually inspect mark 424 to assess whether the corresponding femoral neck produces a sufficiently close femoral head position in both the vertical and medial directions. If the arm of the measuring instrument 144 is sufficiently close to the horizontal portion of mark 424 and the vertical portion of mark 424 corresponds to a sufficiently tight separation on the medial and lateral axes, the surgeon can select the corresponding femoral neck accordingly.

[0069] Therefore, the multiple orifices in the body 100 and the measuring instrument 140 can be used to determine which of the multiple femoral necks will produce a replacement femoral head whose center most closely matches the center of the original femoral head. This is achieved by providing markings on the remaining portion of the original femur 424, which has a known positional relationship with the center of the original femoral head. Thus, the measuring instrument 144 and the orifices, along with the linear markings 122, 124, allow the surgeon to compare the resulting leg lengths and medial / lateral offsets produced by the respective femoral necks corresponding to the respective orifices in the body.

[0070] Although the use of scales and the measurement of specific distances have been described above, it should be understood that this is not necessary. Instead, scales can simply be used with different markings to indicate different separation amounts. The absolute value of the distance is not required.

[0071] Similarly, as mentioned above, although the described embodiments use five orifices each corresponding to a different femoral neck, more or fewer orifices corresponding to the femoral neck can be used. Likewise, the specific geometry described regarding variations in the femoral neck angle and the leg length and medial / lateral offset is not required.

[0072] Furthermore, although specific bootloaders in Figure 5 and Figure 6 The image is shown as an approximate center for determining the original femoral head, but the use of such a guide is not necessary. Any device capable of approximating the center of the femoral head can be used. Identification of the preferred neck resection height and angle is merely incidental and not necessary to achieve the benefit of approximate restoration of the femoral head center.

[0073] In this specification, exemplary embodiments have been presented with respect to a selected set of details. However, those skilled in the art will understand that many other exemplary embodiments, including combinations of different selections of these details, can be practiced. The following claims are intended to cover all possible exemplary embodiments.

[0074] Unless a specific order is explicitly specified, any instructions and / or flowchart steps may be performed in any order. Furthermore, those skilled in the art will recognize that while a set of exemplary instructions / methods has been discussed, the material in this specification can be combined in various ways to produce other examples, and should be understood within the context provided by the specific implementation.

[0075] While this disclosure is open to various modifications and alternatives, its specific details have been shown and described in detail by way of example in the accompanying drawings. However, it should be understood that other embodiments are possible besides the specific embodiments described. All modifications, equivalents, and alternative embodiments falling within the scope of the appended claims are also covered.

Claims

1. A surgical instrument for assessing the repair of the femoral head center in a patient, comprising: A body having a first connector for attaching the body to a femoral portion, and wherein the body defines a plurality of orifices therein, wherein each orifice corresponds to a corresponding femoral head center generated by a corresponding femoral neck; and A measuring instrument, wherein the measuring instrument includes a pin at a first end and an arm extending laterally from the pin, wherein the pin is capable of being received in each of the plurality of orifices and the arm has a scale indicating the distance from the pin.

2. The surgical instrument of claim 1, wherein the plurality of orifices includes orifices corresponding to the femoral neck with different medial and lateral offsets.

3. The surgical instrument according to claim 1 or 2, wherein the plurality of orifices includes orifices corresponding to the femoral neck with different neck angles.

4. The surgical instrument according to claim 1 or 2, wherein the plurality of orifices includes orifices corresponding to femoral necks with different leg lengths.

5. The surgical instrument according to claim 1 or 2, wherein the body has a front surface, and wherein the front surface includes at least a first linear mark extending parallel to the inner and outer axes and passing through at least a first orifice of the plurality of orifices and corresponding to a first position on the upper and lower axes.

6. The surgical instrument of claim 5, wherein the anterior surface includes at least a second linear mark extending parallel to the inner and outer axes and passing through at least a second of the plurality of orifices and corresponding to a second position on the upper and lower axes.

7. The surgical instrument of claim 5, wherein the body has a posterior surface, and wherein the posterior surface includes the same markings as the anterior surface, and is configured such that the same body can be used for both right-handed and left-handed hip joints.

8. The surgical instrument according to claim 1 or 2, wherein each of the plurality of orifices comprises a channel extending through the entire thickness of the body.

9. A surgical instrument system, comprising: Surgical instruments according to any one of claims 1 to 8; and A center seeker, the center seeker comprising a plurality of marks configured to indicate the center of the center seeker.

10. The surgical instrument system of claim 9, wherein the central seeker comprises a circular ring, and wherein the plurality of marks comprises a first pair of diametrically opposed marks and a second pair of diametrically opposed marks.

11. The surgical instrument system according to claim 9 or 10, further comprising: A puller, wherein the puller includes a second connector configured to engage the first connector to attach the body to the puller; and Multiple femoral necks, each of which produces a different femoral head center location.

12. The surgical instrument system of claim 11, wherein the plurality of femoral necks comprises femoral necks having different offsets along the internal and external axes of the femur.

13. The surgical instrument system of claim 11, wherein the plurality of femoral necks comprises femoral necks with different neck angles.

14. The surgical instrument system of claim 11, wherein the plurality of femoral necks comprises femoral necks having different leg lengths along the superior and inferior axes of the femur.

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