Orthopedic system and method for placing a cement restrictor component in a direct anterior approach hip replacement surgical procedure - Patents.com

Abstract

An orthopaedic system for use in a direct anterior approach orthopaedic hip replacement procedure on a patient's femur includes a proximal guide instrument (14) for guiding a flexible insertion instrument (12) for placing a cement restrictor component (16, 18). A method for placing a cement restrictor component during performance of a direct anterior approach orthopaedic hip replacement procedure is also disclosed.

Description

[Technical Field]

[0001] The present disclosure relates generally to orthopaedic surgical instruments, and more particularly to orthopaedic surgical instruments for use in hip replacement surgery. [Background technology]

[0002] Joint arthroplasty is a well-known surgical procedure in which a diseased and / or damaged natural joint is replaced with an artificial joint. An artificial joint may include a prosthesis that is implanted into one or more of the patient's bones. Many hip prostheses include a femoral prosthesis that is implanted into the patient's femur. The femoral prosthesis typically includes an elongated stem component that is cemented into the medullary canal of the patient's femur and a spherical head component that abuts the patient's acetabulum or an artificial replacement acetabular cup.

[0003] Some hip replacement procedures are performed using a direct anterior approach. When using a direct anterior approach, the surgeon does not have line-of-sight access to the intramedullary canal of the patient's femur. This limited access and visibility makes it difficult for the surgeon to place certain components, such as cement restrictor components, using instruments designed for other approaches (e.g., posterior approaches). Summary of the Invention [Means for solving the problem]

[0004] According to one aspect, a method for installing a cement restrictor component during a direct anterior approach orthopaedic hip replacement procedure on a patient's femur includes sliding an elongated shaft of an insertion instrument through an elongated bore of a proximal guide instrument. The insertion instrument has a handle at its proximal end. The proximal guide instrument has an elongated post with a bore extending therethrough and a neck extending medially from the elongated post. The cement restrictor component is secured on the distal end of the insertion instrument to slidably capture the proximal guide instrument on the elongated shaft between the insertion instrument handle and the cement restrictor component. The cement restrictor component is then advanced through the surgically-prepared proximal end of the patient's femur and into the intramedullary canal of the patient's femur. The proximal guide instrument is then slid along the shaft of the insertion instrument such that the post and neck of the proximal guide instrument are frictionally secured within the surgically-prepared proximal end of the patient's femur. The shaft of the insertion instrument is slid relative to the fixed proximal guide instrument so that the cement restrictor component is advanced distally into the intramedullary canal of the patient's femur to a desired depth.

[0005] The method may further include unlocking the cement restrictor component from the distal end of the insertion instrument once the cement restrictor component has been advanced to the desired depth, and sliding the shaft of the insertion instrument relative to the secured proximal guide instrument such that the distal end of the insertion instrument is advanced proximally out of the intramedullary canal of the patient's femur.

[0006] In an embodiment, the cement restrictor component is threaded onto the threaded end of the shaft of the insertion tool.

[0007] In an illustrative embodiment, the upper end of the post of the proximal guide instrument defines a plane, and the shaft of the inserter instrument has a depth stop fixed to the shaft at a location between the inserter instrument handle and the distal end of the inserter instrument. The distal face of the depth stop defines the plane. The shaft of the inserter instrument is slid relative to the fixed proximal guide instrument until the flat face of the depth stop engages the flat face of the proximal guide instrument.

[0008] In one embodiment, the cement restrictor component is embodied as a cement restrictor trial component that is advanced distally into the intramedullary canal of the patient's femur to a desired depth.

[0009] In another embodiment, the cement restrictor component is embodied as a cement restrictor implant component that is advanced distally into the intramedullary canal of the patient's femur to a desired depth.

[0010] In an illustrative embodiment, the shaft of the insertion tool is bent during advancement of the cement restrictor component.

[0011] In another aspect, a method for installing a cement restrictor implant component during performance of a direct anterior approach orthopaedic hip replacement procedure on a patient's femur includes sliding an elongated shaft of an insertion instrument through an elongated bore of a proximal guide instrument. The insertion instrument has a handle at its proximal end. The proximal guide instrument has an elongated post with a bore extending therethrough and a neck extending medially from the elongated post. The cement restrictor implant component is secured on the distal end of the insertion instrument to slidably capture the proximal guide instrument on the elongated shaft between the handle of the insertion instrument and the cement restrictor implant component. Thereafter, the cement restrictor implant component is advanced through the surgically-prepared proximal end of the patient's femur and into the intramedullary canal of the patient's femur. The proximal guide instrument is then slid along the shaft of the insertion instrument such that the post and neck of the proximal guide instrument are frictionally secured within the surgically-prepared proximal end of the patient's femur. The shaft of the insertion instrument is slid relative to the fixed proximal guide instrument so that the cement restrictor implant component is advanced distally to a desired depth into the intramedullary canal of the patient's femur, and once the cement restrictor implant component has been advanced to the desired depth, the cement restrictor implant component is unlocked from the distal end of the insertion instrument to implant the cement restrictor implant component at the desired depth.

[0012] The shaft of the insertion instrument may be slid relative to the fixed proximal guide instrument so that the distal end of the insertion instrument is advanced proximally out of the intramedullary canal of the patient's femur.

[0013] The cement restrictor implant component may be threaded onto the threaded end of the shaft of the insertion tool.

[0014] In an illustrative embodiment, the upper end of the post of the proximal guide instrument defines a plane, and the shaft of the inserter instrument has a depth stop fixed to the shaft at a location between the inserter instrument handle and the distal end of the inserter instrument. The distal face of the depth stop defines the plane. The shaft of the inserter instrument is slid relative to the fixed proximal guide instrument until the flat face of the depth stop engages the flat face of the proximal guide instrument.

[0015] In an illustrative embodiment, the shaft of the insertion tool is bent during advancement of the cement restrictor implant component.

[0016] According to another aspect, an orthopedic system for use in a direct anterior approach orthopedic hip replacement procedure on a patient's femur includes a proximal guide instrument having an elongated post with a bore formed therein. The bore extends from an upper end of the elongated post to a lower end of the elongated post and has a common diameter along its entire length. The proximal guide instrument also includes a neck extending inwardly from the elongated post. The orthopedic system also includes an insertion instrument having a handle at its proximal end and a threaded distal end. The insertion instrument also includes a flexible elongated shaft extending distally away from the handle to the threaded distal end. The flexible elongated shaft has a diameter sized for sliding receipt within the bore of the proximal guide instrument. The orthopedic system also includes a cement restrictor component configured to be threaded onto the threaded distal end of the insertion instrument.

[0017] In one embodiment, the flexible elongate shaft is constructed from a superelastic metal.

[0018] In certain exemplary embodiments, the flexible elongate shaft is constructed from a nickel titanium alloy.

[0019] The cement restrictor component may be embodied as a cement restrictor trial component or a cement restrictor implant component.

[0020] In embodiments, the upper end of the post of the proximal guide instrument defines a flat surface, the flexible elongate shaft of the inserter instrument has a depth stop secured to the elongate shaft at a location between the handle of the inserter instrument and the threaded distal end of the inserter instrument, and the distal-most surface of the depth stop defines a flat annular surface having a diameter greater than the common diameter of the bores of the proximal guide instrument. [Brief explanation of the drawings]

[0021] The detailed description makes particular reference to the following drawings: [Figure 1] 1 is an elevational view of an orthopaedic system for use in a direct anterior approach orthopaedic hip replacement procedure on a patient's femur. [Figure 2] 2 is a perspective view of a proximal guide instrument of the orthopedic surgical system of FIG. 1. [Figure 3] 3 is a cross-sectional view of the proximal guide instrument of FIG. 2 taken along line 3-3 of FIG. 2, as viewed in the direction of the arrows. [Figure 4] 2 is an elevational view of the orthopedic surgical system of FIG. 1 showing a cement restrictor trial component secured to an insertion tool such that a proximal guide instrument is slidably captured on a flexible elongate shaft of the insertion tool. [Figure 5] FIG. 1 is a cross-sectional view of a patient's femur during a direct anterior approach hip replacement surgical procedure showing a surgeon introducing a cement restrictor trial component into the intramedullary canal of the patient's femur; note that a proximal guide instrument is shown secured to the bone tissue at the proximal end of the patient's femur. [Figure 6] FIG. 6 is a view similar to FIG. 5, but showing the cement restrictor trial component being advanced distally into the intramedullary canal of the patient's femur using an insertion instrument under the guidance of a proximal guide instrument. [Figure 7] FIG. 7 is similar to FIG. 6, but shows the cement restrictor trial component at a desired depth within the intramedullary canal of the patient's femur. DETAILED DESCRIPTION OF THE INVENTION

[0022] While the concepts of the present disclosure are susceptible to various modifications and alternative forms, specific exemplary embodiments thereof have been shown by way of example in the drawings and are herein described in detail. It should be understood, however, that there is no intention to limit the concepts of the present disclosure to the particular forms disclosed, but on the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention as defined by the appended claims.

[0023] Terms denoting anatomical references, such as anterior, posterior, medial, lateral, superior, inferior, etc., may be used throughout this specification with respect to the orthopedic implants or prostheses and surgical instruments described herein, as well as with reference to the patient's natural anatomy. Such terms have well-understood meanings both in the study of anatomy and in the field of orthopedic surgery. Use of such anatomical reference terms in the written description and claims is intended to be consistent with their well-understood meanings, unless otherwise specified.

[0024] 1, an orthopaedic surgical system 10 is illustratively embodied to include an insertion instrument 12, a proximal guide instrument 14, and a pair of cement restrictor components, specifically, a cement restrictor trial component 16 and a cement restrictor implant component 18. As described in more detail below, the orthopaedic surgical system 10 is used to place the cement restrictor components 16, 18 within an intramedullary canal 24 of a patient's femur 26 during a direct anterior approach surgical hip replacement procedure.

[0025] 1 , the insertion instrument 12 is generally T-shaped and has a handle 30 at its proximal end 32. The opposite distal end of the insertion instrument 12 defines a threaded tip 34 having a number of external threads 36 formed therein. The cement restrictor components 16, 18 have threaded bores 38 formed therein that are sized to threadingly receive the external threads 36 of the threaded distal tip 34 of the insertion instrument 12 to selectively secure the cement restrictor components 16, 18 to the instrument 12.

[0026] The flexible elongate shaft 40 extends distally away from the center of the handle 30 toward the threaded distal tip 34 of the insertion instrument 12. The longitudinal axis of the flexible elongate shaft 40 is perpendicular to the longitudinal axis of the handle 30, thus providing a generally T-shaped configuration of the instrument. The handle 30, flexible elongate shaft 40, and threaded distal tip 34 may be integrally formed with one another or may be provided as separate components that are welded or otherwise secured to one another.

[0027] To facilitate direct anterior hip arthroplasty, the flexible elongate shaft 40 is constructed from a highly flexible metallic material. In embodiments, the flexible elongate shaft 40 is constructed from a metallic material that exhibits superelastic properties. Superelasticity is the ability of a metal to undergo large deformations and quickly return to its pre-deformed shape upon removal of the external load. One superelastic metal that may be used to construct the flexible elongate shaft 40 is a nickel-titanium alloy (commonly referred to as "Nitonol"). This highly deformable metal allows the insertion tool 10 to easily place the cement restrictor components 16, 18 "around the corner" of the proximal end 28 of the patient's femur 26 during direct anterior hip arthroplasty, despite the lack of visual access to the intramedullary canal 24.

[0028] As can be seen in FIG. 1 , the flexible elongate shaft 40 has several depth markings 42 formed thereon at locations above the threaded distal tip 34. Each of the depth markings 42 corresponds to the depth to which the cement restrictor components 16, 18 are advanced into the intramedullary canal 24 of the patient's femur 26 during installation. The flexible elongate shaft 40 of the insertion instrument 12 also has a depth stop 44 secured thereto at a location between the handle 30 and the threaded distal tip 34. As will be described in more detail below, the depth stop 44 engages the upper surface of the proximal guide instrument 14 when the cement restrictor components 16, 18 are advanced to a desired depth into the intramedullary canal 24 of the patient's femur 26 during installation. The distal-most surface 46 of the depth stop 44 defines a flat annular surface having a diameter larger than the bore formed in the proximal guide instrument 14, thereby causing the depth stop 44 to engage the upper surface of the proximal guide instrument 14 (as opposed to entering the bore), thus preventing further advancement of the flexible elongate shaft 40 (and the cement restrictor components 16, 18 secured thereto).

[0029] As shown in FIGS. 2 and 3, the proximal guide instrument 14 includes an elongate post 50 having a bore 52 formed therein. As can be seen in FIG. 3, the bore 52 extends from an upper end 54 of the elongate post 50 to a lower end 56 of the elongate post 50. The bore 52 has a common diameter along its entire length. In other words, the diameter of the bore 52 is the same along its entire length, from its end that opens into the upper end 54 of the elongate post 50 to its end that opens into the lower end 56 of the post 50. As can be seen in FIGS. 5-7, the diameter of the bore 52 is large enough to allow passage of the distal tip 34 and flexible elongate shaft 40 therethrough, but not the depth stop 44. In particular, the flat annular surface defined by the distal-most face 46 of the depth stop 44 has a diameter greater than the diameter of the bore 52, thereby preventing the depth stop 44 from entering the bore 52, and therefore the depth stop 44 instead engages the upper end 54 of the proximal guide instrument 14 so as to prevent further advancement of the flexible elongate shaft 40 (and the cement restrictor components 16, 18 secured thereto).

[0030] The proximal guide instrument 14 also includes a curved neck 60 extending inwardly from the elongated post 50. In this manner, the proximal guide instrument 14 assumes the shape and size of the proximal body component of the femoral hip prosthesis (along with a correspondingly shaped proximal body trial component). The proximal guide instrument 14 may be provided in a range of sizes to accommodate different sizes of femoral implants to be implanted in the patient's femur 26. Across this size range, the length of the portion of the post 50 extending above the neck 60 can be varied to adjust the depth to which the cement restrictor component 16, 18 is seated within the intramedullary canal 24 of the patient's femur. In particular, as described above, the upper end 54 of the elongated post 50 defines a flat stop surface that is engaged by the distal-most surface 46 of the depth stop 44 during advancement of the flexible elongated shaft 40 (and hence the cement restrictor component 16, 18 secured thereto) to prevent further movement of the shaft 40. 5-7 (and discussed in more detail below), the neck 60 of the proximal guide instrument 14 is secured in place within the proximal end 28 of the patient's femur 26 prior to placement of the cement restrictor components 16, 18. By varying the length of the portion of the post 50 that extends above the neck 60, the location of the flat stop surface defined by the upper end 54 of the elongated post 50 can likewise be varied relative to the intramedullary canal 24 of the patient's femur 24. Accordingly, the location at which the depth stop 44 of the flexible elongated shaft 40 engages the proximal guide instrument 14 can likewise be varied, thereby allowing the depth to which the cement restrictor components 16, 18 are placed within the intramedullary canal 24 of the patient's femur 24 to be varied. For example, a proximal guide instrument 14 having a relatively long post 50 will be engaged by the depth stop 44 sooner than a proximal guide instrument 14 having a relatively short post 50, thereby placing the cement restrictor components 16, 18 at a shallower depth within the intramedullary canal 24 compared to use of a proximal guide instrument 14 having a relatively short post 50.Thus, if the surgeon selects a proximal guide instrument 14 with a short post 50, the cement restrictor components 16, 18 will be placed at a greater depth within the intramedullary canal 24 than if the surgeon selects a proximal guide instrument 14 with a long post 50 (and vice versa).

[0031] In use, the orthopaedic system 10 can be used by a surgeon to install the cement restrictor components 16, 18 within the intramedullary canal 24 of a patient's femur 26 during a direct anterior approach hip replacement surgical procedure. Typically, a surgeon assembles and installs a femoral prosthesis trial construct to trial fit before implanting the final prosthesis. Thus, as shown in FIG. 4 , the surgeon first prepares for installation of the cement restrictor trial component 16. To do so, the surgeon first selects a proximal guide instrument 14 having a desired size from a variety of available sizes. As described above, the size of the proximal guide instrument 14 can be selected based on the installation depth desired for the cement restrictor trial component 16. For example, as described above, if the surgeon selects a proximal guide instrument 14 with a short post 50, the cement restrictor trial component 16 will be installed at a greater depth within the intramedullary canal 24 than if the surgeon selects a proximal guide instrument 14 with a long post 50 (or vice versa). Thus, the surgeon selects the size of the proximal guide instrument 14 that meets the needs of the particular patient and surgical situation. The surgeon then installs the selected proximal guide instrument 14 onto the insertion instrument 12 by sliding the distal tip 34 and flexible elongate shaft 40 of the insertion instrument 12 through the upper end 54 of the elongate post 50 and into the elongate bore 52 of the proximal guide instrument 14. Once the threaded distal tip 34 exits the bore 52 through the lower end 56 of the elongate post 50, the cement restrictor trial component 16 is threaded onto the threaded distal tip 34. In doing so, the proximal guide instrument 14 is captured on the flexible elongate shaft 40 so that it may slide freely along the shaft 40, but is retained on the shaft 40 by the depth stop 44 and the installed cement restrictor component 16.

[0032] Once the proximal guide instrument 14 and cement restrictor trial component 16 are assembled to the insertion instrument 12, the surgeon advances the cement restrictor trial component 16 through the surgically-prepared proximal end 28 of the patient's femur 26 and into the intramedullary canal 24, as shown in FIGURE 5. The surgeon then slides the proximal guide instrument 14 distally along the flexible, elongated shaft 40 into the surgically-prepared proximal end 28 of the patient's femur 26. The surgeon continues to advance the proximal guide instrument 14 along the shaft 40 until the post 50 and neck 60 of the instrument 14 are lightly impacted into the bone tissue of the surgically-prepared proximal end 28 of the patient's femur 26, frictionally securing the proximal guide instrument 14 therein, as shown in FIGURE 5.

[0033] With the proximal guide instrument 14 frictionally secured within the bone tissue of the surgically-prepared proximal end 28 of the patient's femur 26, the surgeon grasps the handle 30 and urges the handle 30 distally toward the proximal guide instrument 14. In doing so, the cement restrictor trial component 16 is advanced distally, and therefore further into the intramedullary canal 24 of the patient's femur 26. As shown in FIG. 6 , during such advancement of the cement restrictor trial component 16, the surgeon may bend the flexible elongated shaft 40 significantly as the shaft 40 is advanced "close" and into the proximal end 28 of the patient's femur 26 as a result of the lack of line-of-sight access to the intramedullary canal 24 during direct anterior approach hip arthroplasty.

[0034] The surgeon continues to advance the handle 30 (and thus the cement restrictor trial component 16) distally toward the proximal guide instrument 14 until the depth stop 44 engages the upper end 54 of the proximal guide instrument 14, thus preventing further advancement of the flexible elongate shaft 40 (and thus the cement restrictor trial component 16). Engagement of the depth stop 44 with the proximal guide instrument 14 provides an indication to the surgeon that the cement restrictor trial component 16 has reached the desired depth.

[0035] Once the cement restrictor trial component 16 reaches the desired depth, the surgeon verifies that the cement restrictor trial component 16 is securely seated within the intramedullary canal 24. When the surgeon is satisfied with the fit of the cement restrictor trial component 16 within the intramedullary canal 24, the surgeon pulls or otherwise urges the handle 30 and flexible elongate shaft 40 away from the proximal guide instrument 14, thereby advancing the cement restrictor trial component 16 proximally within the intramedullary canal 24 toward the proximal guide instrument 14. When the cement restrictor trial component 16 reaches the proximal guide instrument 14, the surgeon removes the proximal guide instrument 14 (and thus the insertion instrument 12 and cement restrictor trial component 16) from the surgically-prepared proximal end 24 of the patient's femur.

[0036] The surgeon then removes the cement restrictor trial component 16 from the threaded distal tip 34 of the insertion instrument 12 and replaces it with the cement restrictor implant component 18 by threading the implant component 18 onto the threaded distal tip 34 .

[0037] The surgeon then utilizes the insertion instrument 12 and proximal guide instrument 14 to place the cement restrictor implant component 18 to a desired depth within the intramedullary canal 24 of the patient's femur 26 in a manner identical to that discussed above with respect to the cement restrictor trial component 16 and illustrated in FIGS. 4-7. However, once the cement restrictor implant component 18 has been advanced to the desired depth within the intramedullary canal 24 of the patient's femur 26, the surgeon rotates the handle 30 of the insertion instrument 12 in a direction (e.g., counterclockwise) that disengages the distal tip 34 from the cement restrictor implant component 18, thereby unlocking the insertion instrument 12 from the implanted cement restrictor implant component 18. The surgeon then pulls or otherwise urges the handle 30 and flexible elongate shaft 40 away from the proximal guide instrument 14, thereby advancing the released threaded distal tip 34 proximally within the intramedullary canal 24 toward the proximal guide instrument 14. The surgeon then removes the insertion instrument 12 and proximal guide instrument 14 from the patient's femur 26 to complete the hip replacement procedure.

[0038] While the present disclosure has been illustrated and described in detail in the drawings and foregoing description, it is understood that such illustration and description is merely exemplary in nature and should not be regarded as restrictive, and that merely exemplary embodiments have been shown and described, and that all changes and modifications that come within the spirit of the disclosure are desired to be protected.

[0039] The present disclosure has multiple advantages based on various features of the methods, apparatus, and systems described herein. It should be noted that alternative embodiments of the methods, apparatus, and systems of the present disclosure may not include all of the described features, but still benefit from at least some of the advantages of such features. Those skilled in the art will readily be able to independently implement methods, apparatus, and systems that incorporate one or more of the features of the present invention and are within the spirit and scope of the present disclosure as defined in the appended claims.

[0040] [Embodiment] (1) A method of installing a cement restrictor component during a direct anterior approach orthopaedic hip replacement procedure on a patient's femur, comprising: sliding an elongated shaft of an insertion instrument through an elongated bore of a proximal guide instrument, the insertion instrument having a handle at its proximal end, the proximal guide instrument having an elongated post with the bore extending therethrough and a neck extending inwardly from the elongated post; securing the cement restrictor component onto the distal end of the insertion tool so as to slidably capture the proximal guide instrument on the elongate shaft between the handle of the insertion tool and the cement restrictor component; advancing the cement restrictor component through the surgically-prepared proximal end of the patient's femur and into the intramedullary canal of the patient's femur; sliding the proximal guide instrument along the shaft of the insertion instrument such that the post and neck of the proximal guide instrument are frictionally secured within the surgically-prepared proximal end of the patient's femur; and sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument so that the cement restrictor component is advanced distally into the intramedullary canal of the patient's femur to a desired depth. (2) unlocking the cement restrictor component from the distal end of the insertion instrument once the cement restrictor component has been advanced to the desired depth; 2. The method of claim 1, further comprising: sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument such that the distal end of the insertion instrument advances proximally out of the intramedullary canal of the patient's femur. (3) The method of embodiment 1, wherein securing the cement restrictor component onto the distal end of the insertion instrument comprises threading the cement restrictor component onto a threaded end of the shaft of the insertion instrument. (4) an upper end of the post of the proximal guide instrument defines a plane; the shaft of the insertion tool has a depth stop secured to the shaft at a location between the handle of the insertion tool and the distal end of the insertion tool; a distal surface of the depth stop defines a plane; 2. The method of claim 1, wherein sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument so that the cement restrictor component advances distally to the desired depth into the intramedullary canal of the patient's femur comprises sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument until the flat surface of the depth stop engages the flat surface of the proximal guide instrument. (5) the cement restrictor component includes a cement restrictor trial component; 2. The method of claim 1, wherein sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument comprises sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument such that the cement restrictor trial component advances distally to the desired depth into the intramedullary canal of the patient's femur.

[0041] (6) the cement restrictor component comprises a cement restrictor implant component; 2. The method of claim 1, wherein sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument comprises sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument such that the cement restrictor implant component advances distally to the desired depth into the intramedullary canal of the patient's femur. (7) The method of embodiment 1, wherein sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument includes bending the shaft of the insertion instrument during advancement of the cement restrictor component. (8) A method of installing a cement restrictor implant component during a direct anterior approach orthopaedic hip replacement procedure on a patient's femur, comprising: sliding an elongated shaft of an insertion instrument through an elongated bore of a proximal guide instrument, the insertion instrument having a handle at its proximal end, the proximal guide instrument having an elongated post with the bore extending therethrough and a neck extending inwardly from the elongated post; securing the cement restrictor implant component onto the distal end of the insertion tool so as to slidably capture the proximal guide instrument on the elongate shaft between the handle of the insertion tool and the cement restrictor implant component; advancing the cement restrictor implant component through the surgically-prepared proximal end of the patient's femur and into the intramedullary canal of the patient's femur; sliding the proximal guide instrument along the shaft of the insertion instrument such that the post and neck of the proximal guide instrument are frictionally secured within the surgically-prepared proximal end of the patient's femur; sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument so that the cement restrictor implant component is advanced distally to a desired depth into the intramedullary canal of the patient's femur; and unlocking the cement restrictor implant component from the distal end of the insertion instrument once the cement restrictor implant component has advanced to the desired depth to implant the cement restrictor implant component at the desired depth. (9) The method of claim 8, further comprising sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument such that the distal end of the insertion instrument advances proximally out of the intramedullary canal of the patient's femur. (10) The method of embodiment 8, wherein securing the cement restrictor implant component onto the distal end of the insertion tool comprises threading the cement restrictor implant component onto a threaded end of the shaft of the insertion tool.

[0042] (11) The upper end of the post of the proximal guide instrument defines a plane; the shaft of the insertion tool has a depth stop secured to the shaft at a location between the handle of the insertion tool and the distal end of the insertion tool; a distal surface of the depth stop defines a plane; 9. The method of claim 8, wherein sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument so that the cement restrictor implant component advances distally to the desired depth into the intramedullary canal of the patient's femur comprises sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument until the flat surface of the depth stop engages the flat surface of the proximal guide instrument. (12) The method of embodiment 8, wherein sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument includes bending the shaft of the insertion instrument during advancement of the cement restrictor implant component. (13) An orthopedic system for use in a direct anterior approach orthopedic hip replacement procedure on a patient's femur, comprising: a proximal guide instrument comprising: (i) an elongate post having a bore formed therein, the bore extending from an upper end of the elongate post to a lower end of the elongate post and having a common diameter along its entire length; and (ii) a neck extending inwardly from the elongate post; an insertion instrument having (i) a handle at its proximal end, (ii) a threaded distal end, and (iii) a flexible elongate shaft extending distally away from the handle to the threaded distal end, the flexible elongate shaft having a diameter sized for sliding receipt within the bore of the proximal guide instrument; a cement restrictor component configured to be threaded onto the threaded distal end of the insertion instrument. (14) The orthopedic system of embodiment 13, wherein the flexible elongate shaft is constructed from a superelastic metal. (15) The orthopedic system of embodiment 13, wherein the flexible elongate shaft is constructed from a nickel-titanium alloy.

[0043] (16) The orthopedic system of embodiment 13, wherein the cement restrictor component includes a cement restrictor trial component. (17) The orthopedic system of embodiment 13, wherein the cement restrictor component comprises a cement restrictor implant component. (18) The upper end of the post of the proximal guide instrument defines a plane; the flexible elongate shaft of the insertion tool has a depth stop secured to the flexible elongate shaft at a location between the handle of the insertion tool and the threaded distal end of the insertion tool; An orthopedic system as described in embodiment 13, wherein the distal-most surface of the depth stop defines a flat annular surface having a diameter greater than the common diameter of the bore of the proximal guide instrument.

Claims

1. 1. An orthopaedic surgical system for use in a direct anterior approach orthopaedic hip replacement procedure on a patient's femur, comprising: a proximal guide instrument comprising: (i) an elongate post having a bore formed therein, the bore extending from an upper end of the elongate post to a lower end of the elongate post and having a common diameter along its entire length; and (ii) a neck extending inwardly from the elongate post; an insertion instrument having (i) a handle at its proximal end, (ii) a threaded distal end, and (iii) a flexible elongate shaft extending distally away from the handle to the threaded distal end, the flexible elongate shaft having a diameter sized for sliding receipt within the bore of the proximal guide instrument; a cement restrictor component configured to be threaded onto the threaded distal end of the insertion instrument.

2. The orthopedic system of claim 1 , wherein the flexible elongate shaft is constructed from a superelastic metal.

3. The orthopedic system of claim 1 , wherein the flexible elongate shaft is constructed from a nickel-titanium alloy.

4. The orthopedic system of claim 1 , wherein the cement restrictor component includes a cement restrictor trial component.

5. The orthopedic system of claim 1 , wherein the cement restrictor component comprises a cement restrictor implant component.

6. the upper end of the post of the proximal guide instrument defines a plane; the flexible elongate shaft of the insertion tool has a depth stop secured to the flexible elongate shaft at a location between the handle of the insertion tool and the threaded distal end of the insertion tool; The orthopedic system of claim 1 , wherein the distal-most surface of the depth stop defines a flat annular surface having a diameter greater than the common diameter of the bore of the proximal guide instrument.

7. 1. A method of installing a cement restrictor component during performance of a direct anterior approach orthopaedic hip replacement procedure on a patient's femur, comprising: sliding an elongated shaft of an insertion instrument through an elongated bore of a proximal guide instrument, the insertion instrument having a handle at its proximal end, the proximal guide instrument having an elongated post with the bore extending therethrough and a neck extending inwardly from the elongated post; securing the cement restrictor component onto the distal end of the insertion tool so as to slidably capture the proximal guide instrument on the elongate shaft between the handle of the insertion tool and the cement restrictor component; advancing the cement restrictor component through the surgically-prepared proximal end of the patient's femur and into the intramedullary canal of the patient's femur; sliding the proximal guide instrument along the shaft of the insertion instrument such that the post and neck of the proximal guide instrument are frictionally secured within the surgically-prepared proximal end of the patient's femur; and sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument so that the cement restrictor component is advanced distally into the intramedullary canal of the patient's femur to a desired depth.

8. unlocking the cement restrictor component from the distal end of the insertion instrument once the cement restrictor component has been advanced to the desired depth; 8. The method of claim 7, further comprising: sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument such that the distal end of the insertion instrument advances proximally out of the intramedullary canal of the patient's femur.

9. The method of claim 7 , wherein securing the cement restrictor component onto the distal end of the insertion instrument comprises threading the cement restrictor component onto a threaded end of the shaft of the insertion instrument.

10. an upper end of the post of the proximal guide instrument defines a plane; the shaft of the insertion tool has a depth stop secured to the shaft at a location between the handle of the insertion tool and the distal end of the insertion tool; a distal surface of the depth stop defines a plane; 8. The method of claim 7, wherein sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument so that the cement restrictor component is advanced distally to the desired depth into the intramedullary canal of the patient's femur comprises sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument until the flats of the depth stop engage the flats of the proximal guide instrument.

11. the cement restrictor component includes a cement restrictor trial component; 8. The method of claim 7, wherein sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument comprises sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument such that the cement restrictor trial component is advanced distally into the intramedullary canal of the patient's femur to the desired depth.

12. the cement restrictor component comprises a cement restrictor implant component; 8. The method of claim 7, wherein sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument comprises sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument such that the cement restrictor implant component is advanced distally into the intramedullary canal of the patient's femur to the desired depth.

13. The method of claim 7 , wherein sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument comprises bending the shaft of the insertion instrument during advancement of the cement restrictor component.

14. 1. A method of installing a cement restrictor implant component during performance of a direct anterior approach orthopaedic hip replacement procedure on a patient's femur, comprising: sliding an elongated shaft of an insertion instrument through an elongated bore of a proximal guide instrument, the insertion instrument having a handle at its proximal end, the proximal guide instrument having an elongated post with the bore extending therethrough and a neck extending inwardly from the elongated post; securing the cement restrictor implant component onto the distal end of the insertion tool so as to slidably capture the proximal guide instrument on the elongate shaft between the handle of the insertion tool and the cement restrictor implant component; advancing the cement restrictor implant component through the surgically-prepared proximal end of the patient's femur and into the intramedullary canal of the patient's femur; sliding the proximal guide instrument along the shaft of the insertion instrument such that the post and neck of the proximal guide instrument are frictionally secured within the surgically-prepared proximal end of the patient's femur; sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument so that the cement restrictor implant component is advanced distally to a desired depth into the intramedullary canal of the patient's femur; and unlocking the cement restrictor implant component from the distal end of the insertion instrument once the cement restrictor implant component has advanced to the desired depth to implant the cement restrictor implant component at the desired depth.

15. 15. The method of claim 14, further comprising sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument such that the distal end of the insertion instrument advances proximally out of the intramedullary canal of the patient's femur.

16. 15. The method of claim 14, wherein securing the cement restrictor implant component onto the distal end of the insertion instrument comprises threading the cement restrictor implant component onto a threaded end of the shaft of the insertion instrument.

17. an upper end of the post of the proximal guide instrument defines a plane; the shaft of the insertion tool has a depth stop secured to the shaft at a location between the handle of the insertion tool and the distal end of the insertion tool; a distal surface of the depth stop defines a plane; 15. The method of claim 14, wherein sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument so that the cement restrictor implant component is advanced distally to the desired depth into the intramedullary canal of the patient's femur comprises sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument until the flat surface of the depth stop engages the flat surface of the proximal guide instrument.

18. The method of claim 14 , wherein sliding the shaft of the insertion instrument relative to the fixed proximal guide instrument comprises bending the shaft of the insertion instrument during advancement of the cement restrictor implant component.

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