Orthopaedic surgical instruments, systems, and methods for placing cemented femoral stem components in direct anterior approach hip replacement surgical procedures

Abstract

An orthopaedic surgical system for use in a direct anterior approach orthopaedic hip replacement procedure on a patient's femur includes an insertion instrument having a depth stop with a rotatable guide arm for placing a cemented femoral stem component to a desired depth. A method for placing a cemented femoral stem 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 used in direct anterior approach hip replacement surgical procedures. [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 spherically shaped 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 install certain components, such as cemented femoral stem 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, an orthopaedic surgical instrument for implanting a cemented femoral stem component during a direct anterior approach orthopaedic hip replacement surgical procedure on a patient's femur includes a stem insertion instrument. The stem insertion instrument includes a handle positioned on a proximal end of the stem insertion instrument and an insertion prong positioned on a distal end of the stem insertion instrument. The insertion prong is sized and shaped to be received within an insertion opening formed in a lateral shoulder of the femoral stem component. The insertion instrument also includes an elongated shaft extending distally away from the handle to the insertion prong, and a depth stop rotatably secured to the elongated shaft. The depth stop includes a guide arm extending away from the elongated shaft.

[0005] In embodiments, the depth stop includes a hub rotatably coupled to the elongate shaft and an extension arm extending distally away from the hub and transitioning into an elbow. In such embodiments, the guide arm extends away from the elbow.

[0006] In embodiments, the insertion prong extends in a superior / inferior direction and the elongate shaft is angled medially relative to the insertion prong.

[0007] In another embodiment, the longitudinal axis of the insertion prong and the longitudinal axis of the elongate shaft define an offset angle, such offset angle being between 15 and 45 degrees.

[0008] In yet another embodiment, the longitudinal axis of the insertion prong and the longitudinal axis of the guide arm define a guide angle, such guide angle being between 40 and 45 degrees.

[0009] In embodiments, the depth stop includes a second guide arm extending away from the elongate shaft on an opposite side of the elongate shaft from the other guide arm, and in such embodiments, the two guide arms can rotate independently of each other relative to the elongate shaft.

[0010] According to another aspect, an orthopaedic system for use in a direct anterior approach orthopaedic hip replacement surgical procedure on a patient's femur includes a cemented femoral stem component and a stem insertion instrument. The cemented femoral stem component includes a proximal body having a lateral shoulder. The lateral shoulder has an insertion aperture formed therein. The femoral stem component also includes an elongated neck extending medially from the proximal body and a tapered stem extending downwardly away from the proximal body. The stem insertion instrument includes a handle positioned on the proximal end of the stem insertion instrument and an insertion prong positioned on the distal end of the stem insertion instrument. The insertion prong is sized and shaped to be received in the insertion aperture formed in the lateral shoulder of the femoral stem component. The insertion instrument also includes an elongated shaft extending distally away from the handle to the insertion prong and a depth stop rotatably secured to the elongated shaft. The depth stop includes a guide arm extending away from the elongated shaft. When the insertion prong of the stem insertion instrument is positioned within the insertion opening of the femoral stem component, the depth stop is rotatable between a guide position in which the guide arm is positioned in contact with the femoral stem component and an access position in which the guide arm is spaced apart from the femoral stem component.

[0011] In an embodiment, the guide arm is positioned in contact with the anterior side of the femoral stem component when the depth stop is positioned in its guide position.

[0012] In embodiments, the guide arm is positioned in contact with the anterior side of the proximal body of the femoral stem component when the depth stop is positioned in its guide position.

[0013] In embodiments, the depth stop includes a hub rotatably coupled to the elongate shaft and an extension arm extending distally away from the hub and transitioning into an elbow. In such embodiments, the guide arm extends away from the elbow.

[0014] In embodiments, the insertion prong extends in a superior / inferior direction and the elongate shaft is angled medially relative to the insertion prong.

[0015] In another embodiment, the longitudinal axis of the insertion prong and the longitudinal axis of the elongate shaft define an offset angle, such offset angle being between 15 and 45 degrees.

[0016] In yet another embodiment, the longitudinal axis of the insertion prong and the longitudinal axis of the guide arm define a guide angle, such guide angle being between 40 and 45 degrees.

[0017] In embodiments, the depth stop includes a second guide arm extending away from the elongate shaft from an opposite side of the elongate shaft from the other guide arm. In such embodiments, when the insertion prong of the stem insertion instrument is positioned within the insertion opening of the femoral stem component and the depth stop is positioned in its guide position, the first guide arm is positioned in contact with a first side of the femoral stem component and the second guide arm is positioned in contact with a second, opposite side of the femoral stem component. In a more specific example of such an embodiment, when the insertion prong of the stem insertion instrument is positioned within the insertion opening of the femoral stem component and the depth stop is positioned in its guide position, the first guide arm is positioned in contact with an anterior side of the femoral stem component and the second guide arm is positioned in contact with a posterior side of the femoral stem component.

[0018] In one embodiment, the two guide arms can rotate independently of each other relative to the elongate shaft.

[0019] According to another aspect, a method for installing a cemented femoral stem component during performance of a direct anterior approach orthopaedic hip replacement surgical procedure on a patient's femur includes surgically preparing a proximal end of the patient's femur to create a resected flat surface. To secure the femoral stem component to an insertion instrument, an insertion prong of the insertion instrument is inserted into an insertion aperture formed in a lateral shoulder of the femoral stem component. A guide arm of the insertion instrument is rotated to contact the secured femoral stem component. The distal end of the femoral stem 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 femoral stem component is then further advanced until the guide arm of the insertion instrument engages the resected flat surface of the surgically prepared proximal end of the patient's femur.

[0020] In an embodiment, the guide arm of the insertion instrument is rotated into contact with the anterior surface of the fixed femoral stem component.

[0021] In another embodiment, the anterior guide arm of the insertion instrument is rotated to contact the anterior surface of the fixed femoral stem component and the posterior guide arm of the insertion instrument is rotated to contact the posterior surface of the fixed femoral stem component.

[0022] Following engagement of the guide arm of the insertion instrument with the resected flat surface of the surgically prepared proximal end of the patient's femur, the guide arm may be rotated out of contact with the femoral stem component.

[0023] In embodiments, following engagement of the guide arm of the insertion instrument with the resected flat surface of the surgically prepared proximal end of the patient's femur, the femoral stem component is unlocked from the insertion instrument, and then the insertion prong of the insertion instrument is advanced proximally to disengage from the intramedullary canal of the patient's femur. [Brief explanation of the drawings]

[0024] The detailed description makes particular reference to the following drawings: [Figure 1] 1 is a perspective view of a stem insertion instrument of an orthopaedic surgical system for use in a direct anterior approach orthopaedic hip replacement procedure on a patient's femur. [Figure 2] FIG. 1 is a side view of a cemented femoral stem component. [Figure 3] FIG. 3 is a top elevational view of the cemented femoral stem component of FIG. 2. [Figure 4] 1 secured to the femoral stem component of FIGS. 2 and 3. FIG. [Figure 5] 1 secured to the femoral stem component of FIGS. 2 and 3. FIG. [Figure 6] 10 is a cross-sectional view of a patient's femur during a direct anterior approach hip replacement surgical procedure showing a surgeon introducing the femoral stem component of FIGS. 2 and 3 by using the stem insertion instrument of FIG. 1; [Figure 7] 7 is a view similar to FIG. 6, but showing the femoral stem component at a desired depth within the intramedullary canal of the patient's femur. [Figure 8] FIG. 8 is a view similar to FIG. 7, but showing the depth stop of the stem insertion tool rotated to its access position. [Figure 9] 6A and 6B are similar to FIGS. 4 and 5, respectively, but show a depth stop for the stem insertion tool embodied with a second guide arm. [Figure 10] 6A and 6B are similar to FIGS. 4 and 5, respectively, but show a depth stop for the stem insertion tool embodied with a second guide arm. [Figure 11] FIG. 10 is an elevational view of another embodiment of a stem insertion tool. [Figure 12] FIG. 10 is an elevational view of yet another embodiment of a stem insertion tool. DETAILED DESCRIPTION OF THE INVENTION

[0025] 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.

[0026] 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.

[0027] 1-3, an orthopaedic system 10 is illustratively embodied to include an insertion instrument 12 and a femoral stem component, specifically, a cemented femoral stem component 14. As discussed in more detail below, the insertion instrument 12 is used to install the femoral stem component 14 into the intramedullary canal of a patient's femur during a direct anterior approach hip replacement surgical procedure.

[0028] As shown in Figures 2 and 3, the femoral stem component 14 is configured to be implanted into a patient's femur 106 during a hip replacement procedure. Specifically, the femoral stem component 14 is implanted into the intramedullary canal 104 of a surgically prepared (e.g., broached) patient's femur 106. A femoral head component (not shown) is secured to a trunnion formed within the end of an elongated neck 16 of the femoral stem component 14. When installed on the femoral stem component 14, the femoral head component is positioned to rest against either the patient's natural acetabulum or a prosthetic acetabular component implanted within the patient's pelvis to replace the patient's acetabulum. In this manner, the femoral stem component 14 and the natural or prosthetic acetabulum collectively function as a system to replace the natural joint of the patient's hip joint.

[0029] The proximal body 18 defines the middle portion of the femoral stem component 14. Accordingly, an elongated neck 16 extends superiorly and medially away from the proximal body 30, and a tapered trunnion is formed within the superior / medial end of the neck 16, i.e., the end opposite the end that mates with the proximal body 18. A tapered stem 20 extends inferiorly away from the opposite end of the proximal body 18. The tapered stem 20 has a rounded distal end 22 that defines the inferior-most surface of the femoral stem component 14. As can be seen in FIGS. 2 and 3 , an insertion aperture 24 is formed within a lateral shoulder 42 of the proximal body. As discussed in more detail below, the insertion aperture 24 frictionally receives an insertion prong of an insertion instrument 12 during installation of the femoral stem component 12.

[0030] In the illustrative embodiment described herein, the femoral stem component 14 is embodied as a cemented femoral stem, i.e., a stem installed using bone cement. Thus, the femoral stem component 14 is embodied as a monolithic metal structure. The femoral stem component 14 may be constructed of an implant-grade biocompatible metal, although other materials may also be used. Examples of such metals include cobalt, including cobalt alloys such as cobalt-chromium alloys, and stainless steel.

[0031] As can be seen in FIG. 1 , the insertion instrument 12 has a handle 30 at its proximal end 32. In the illustrative embodiment of FIGS. 1-10 and 12 , the handle 30 is embodied as a generally spherically shaped knob 34 having several gripping indentations 36 formed therein. The indentations 36 facilitate the surgeon's grip on the insertion instrument 12 by defining gripping surfaces for the surgeon's individual fingers. It should be understood that the handle 30 may be embodied in numerous other configurations to meet the needs of a given design. For example, the handle 30 may be configured as a generally cylindrical grip or an elongated oval grip. The opposite distal end 38 of the insertion instrument 12 has an insertion prong 40. The insertion aperture 24 of the femoral stem component 14 is sized and shaped to frictionally receive the insertion prong 40 at the distal end 38 of the insertion instrument 12 to selectively secure the cemented femoral stem component 14 to the insertion instrument 12.

[0032] The elongate shaft 44 extends distally, away from the center of the handle 30, toward the distal end 38 of the insertion instrument 12. The handle 30, elongate shaft 44, and insertion prong 40 may be integrally formed with one another or may be provided as separate components that are welded or otherwise secured to one another.

[0033] To facilitate direct anterior approach hip arthroplasty, the elongated shaft 44 is angled medially relative to the insertion prong 40. Specifically, as best seen in FIGS. 1 and 5, the insertion prong 40 extends in a superior / inferior direction. The elongated shaft 44 is angled medially relative to the insertion prong 40. In other words, as shown in FIG. 5, the elongated shaft 44 extends medially, away from the proximal end of the insertion prong 40. As discussed below, this arrangement causes the insertion instrument 12 to extend medially when secured to the femoral stem component 14. As can be seen in FIG. 1, the longitudinal axis 46 of the insertion prong 40 and the longitudinal axis 48 of the elongated shaft 44 define an offset angle θ. In illustrative embodiments described herein, the offset angle θ of the insertion instrument 12 is between 15 and 45 degrees. In certain illustrative embodiments, the offset angle θ of the insertion instrument 12 is 30 degrees. Such medial offset of the insertion instrument 12 allows the insertion instrument 12 to facilitate placement of the femoral stem component 14 "around the corner" of the proximal end 108 of the patient's femur 106 during direct anterior approach hip arthroplasty, despite the lack of line-of-sight access to the intramedullary canal 104 (see Figures 6-8).

[0034] As can be seen in FIG. 1 , the insertion instrument 12 has a depth stop 50 rotatably secured to its elongated shaft 44 at a location between the handle 30 and the insertion prong 40. As will be described in more detail below, the depth stop 50 engages a surgically prepared resected flat 102 of the patient's femur 106 when the femoral stem component 14 is advanced to a desired depth into the intramedullary canal 104 of the patient's femur 106 during installation. The depth stop 50 includes a guide arm 52 extending away from the elongated shaft 44. As can be seen in FIGS. 1 and 5-7 , the guide arm 52 has a longitudinal axis 54 that is parallel to the resection angle of the femoral stem component 14 and, consequently, parallel to the surgically prepared resected flat 102 of the patient's femur 106 into which the femoral stem component 14 will be implanted. 7, the distal-most planar surface 56 of the guide arm 52 is oriented parallel to the surgically-prepared resected planar surface 102 of the patient's femur 106 when the femoral stem component 14 is installed within the patient's femur 106, thereby providing a blunt stop surface for engaging bone when the femoral stem component 14 is installed to the desired depth. As can be seen in FIG. 1, the longitudinal axis 46 of the insertion prong 40 and the longitudinal axis 54 of the guide arm 52 define a guide angle α. In illustrative embodiments described herein, the guide angle α is between 40 and 45 degrees. In certain illustrative embodiments, the guide angle α is 45 degrees.

[0035] The depth stop 50 includes a hub 62 having a bore 64 extending therethrough. In this manner, the hub 62 is received over the shaft 44, thereby rotatably coupling the guide arm 52 to the elongated shaft 44. An extension arm 66 extends outwardly and away from the hub 62 and transitions to an elbow 68. The guide arm 52 extends away from the elbow 68. Thus, rotation of the hub 62 relative to the shaft 44 causes rotation of the guide arm 52. This feature allows the depth stop 50 to be used to control the depth to which the femoral stem component 14 is seated, while also providing the ability to move the depth stop 50 out of the surgeon's line of sight if, for example, the surgeon needs to visualize the prepared bone to assess the position of the femoral stem component 14 within a cement mantle introduced therein. Specifically, the depth stop 50 is rotatable between a guide position (see Figures 4-7) in which the guide arm 52 is positioned in contact with the anterior side 26 of the femoral stem component 14 to function as a depth stop during installation of the femoral stem component 14, and an access position (see Figure 8) in which the guide arm 52 is spaced from the anterior side 26 of the femoral stem component 14 to allow the surgeon visual and / or physical access to the patient's surgically-prepared femur 106.

[0036] As can be seen in FIG. 1 , the elongated shaft 44 has several depth markings 72 formed thereon at locations above the insertion prong 40. Each of the depth markings 72 corresponds to a desired depth to which the femoral stem component 14 may be advanced into the intramedullary canal 104 of the patient's femur 106 during installation. The hub 62 of the depth stop 50 may be positioned on the elongated shaft 44 at a depth mark 72 corresponding to the desired implantation depth of the femoral stem component 14. The hub 62 may be configured as an open ring that allows the hub 62 to be snapped onto and off the elongated shaft 44 at the desired depth mark 72. Alternatively, the depth markings 72 may be embodied as annular grooves formed in the outer surface of the elongated shaft 44. In such an embodiment, the hub 62 may be embodied with an annular ring formed in its bore that is selectively captured in annular grooves formed in the shaft 44 to position the depth stop 50 at the desired depth mark 72.

[0037] In use, the orthopaedic system 10 can be used by a surgeon to install a cemented femoral stem component 14 within the intramedullary canal 104 of a patient's femur 106 during a direct anterior approach hip replacement surgical procedure. Prior to installing the femoral stem component 14, the surgeon performs several pre-operative and intra-operative surgical steps to prepare the patient's femur 106 to receive the femoral stem component 14. For example, the surgeon uses a bone saw to surgically resect the patient's natural femoral head, creating a surgically prepared proximal end 108 of the patient's femur 106 that includes, among other features, a resected flat 102. The surgeon also assembles and installs several trial components to trial the fit and function of the installed component before implanting the femoral stem component 14. Immediately prior to installation of the femoral stem component 14, the surgeon injects pressurized bone cement into the intramedullary canal 104 of the patient's femur 106. Once bone cement has been injected into the intramedullary canal 104 of the patient's femur 106, the surgeon places the femoral stem component 14 before the bone cement has set (ie, partially or completely).

[0038] To do so, the surgeon first selects a femoral stem component 14 having a desired size from a variety of available sizes. The surgeon then installs the insertion instrument 12 onto the selected femoral stem component 14. Accordingly, the surgeon first positions the instrument's depth stop hub 62 at a location along the elongated shaft 44 at a depth mark 72 that corresponds to the desired depth at which the femoral stem component 14 will be implanted, based on the surgeon's pre- and intraoperative analysis. The surgeon then inserts the insertion prong 40 of the instrument 12 into the stem component's insertion opening 24 (as shown in FIGS. 4 and 5 ). After doing so, the surgeon rotates the depth stop 50 of the insertion instrument 12 into its guide position, where the guide arm 52 is positioned in contact with the anterior side 26 of the femoral stem component 14 (see FIGS. 4-7 ). In such position, the guide arm 52 is positioned to function as a depth stop during installation of the femoral stem component 14.

[0039] 6 , once the insertion instrument 12 is secured to the femoral stem component 14 with its depth stop 50 positioned in its guide position, the surgeon advances the distal end 22 of the femoral stem component 14 through the surgically-prepared proximal end 108 of the patient's femur 106 and into the intramedullary canal 104. The surgeon grasps the handle 30 and urges it away from the surgically-prepared proximal end 108 of the patient's femur 106. In doing so, the femoral stem component 14 advances away from the patient, and therefore further into the intramedullary canal 104 of the patient's femur 106. As shown in FIG. 6 , during such advancement of the femoral stem component 14, the medial offset of the insertion instrument 12 (i.e., its elongated shaft 44, which is angled medially when seated on the component 14) facilitates the surgeon in advancing the femoral stem component 12 “around the corner” and into the proximal end 108 of the patient's femur 106, despite the lack of line-of-sight access to the intramedullary canal 104 during direct anterior approach hip arthroplasty.

[0040] The surgeon continues to advance the handle 30 (and thus the femoral stem component 14) distally into the intramedullary canal 104 of the patient's femur 106 until the depth stop 50 engages the bone. In particular, the surgeon continues to advance the femoral stem component 14 until the distal-most flat surface 56 of the guide arm 52 (see FIG. 7 ) engages the surgically-prepared resected flat surface 102 of the patient's femur 106, thereby preventing further advancement of the insertion instrument 12 (and thus the femoral stem component 14). Engagement of the depth stop 50 with the surgically-prepared resected flat surface 102 of the patient's femur 106 provides the surgeon with an indication that the femoral stem component 14 has reached the desired depth.

[0041] Once the femoral stem component 14 reaches the desired depth, the surgeon evaluates whether the femoral stem component 14 is properly positioned (e.g., centered) within the intramedullary canal 104. To do so, the surgeon can rotate the depth stop 50 to its access position (see FIG. 8 ), where the guide arm 52 is spaced from the anterior side 26 of the femoral stem component 14, allowing the surgeon visual and / or physical access to the patient's surgically-prepared femur 106. The surgeon can do so by simply "tapping" the guide arm 52 out with, for example, a cement curette or other instrument.

[0042] When the surgeon is satisfied that the femoral stem component 14 fits within the intramedullary canal 104, the surgeon pulls or otherwise urges the handle 30 away from the femoral stem component 14 while preventing movement of the femoral stem component 14, thereby disengaging the instrument's insertion prongs 40 from the stem component's insertion opening 24. Once so released, the surgeon removes the insertion instrument 12 from the surgically-prepared proximal end 108 of the patient's femur. The surgeon then performs the remaining steps in the surgical procedure.

[0043] As shown in FIGS. 9 and 10 , the depth stop 50 of the insertion instrument 10 may be embodied to provide depth guidance for both the anterior side 26 and the posterior side 28 of the femoral stem component 14. In particular, a second guide arm 52 (and associated hub 62 and extension arm 66) may be attached to the opposite side of the elongate shaft 44. Similar to the anterior guide arm 52 of FIGS. 1-8 , the posterior guide arm 52 extends away from the elongate shaft 44 and is therefore generally parallel to the anterior guide arm 52. The two guide arms 52 rotate independently of each other relative to the elongate shaft 44 and can therefore be independently positioned by the surgeon in either a guide position or an access position. When positioned in their respective guide positions, the anterior guide arm 52 contacts the proximal body 18 at the anterior side 26 of the stem component 14, while the posterior guide arm 52 contacts the posterior side 28 opposite the component's proximal body 18.

[0044] As shown in FIG. 11 , the insertion tool 10 may be embodied to include a pair of handles 80 pivotally coupled to one another by a pivot joint 82. In such an embodiment, the insertion prongs 40 are embodied as a pair of opposing jaws 84 that move away from one another when the handles 80 are gripped by a user, thereby enhancing mechanical retention of the femoral stem component 14 during installation thereof. While the embodiment of FIG. 11 is shown with a depth stop 50 including a single guide arm 52, it should be understood that the depth stop 50 may also be embodied with dual guide arms similar to those of FIGS. 9 and 10 .

[0045] As shown in FIG. 12 , the insertion tool 10 can be embodied to include a non-rotatable depth stop 50. In such an embodiment, the guide arm 52 is coupled to the distal end of the tool by a bracket 90 that includes a slot 92 that slides in and out on a number of elongated rails 94 formed in the distal end of the tool 10. As can be seen in FIG. 12 , the rails 94 are used to select various implantation depths, similar to the depth markings 72 on the tool of FIGS. 1-8 . While the embodiment of FIG. 12 is shown with a depth stop 50 including a single guide arm 52, it should be understood that the depth stop 50 can be embodied with dual guide arms similar to those of FIGS. 9 and 10 .

[0046] 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.

[0047] 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.

[0048] [Embodiment] (1) An orthopaedic surgical instrument for implanting a cemented femoral stem component during a direct anterior approach orthopaedic hip replacement surgical procedure on a patient's femur, comprising: a stem insertion tool, a handle positioned on the proximal end of the stem insertion instrument; an insertion prong positioned on a distal end of the stem insertion instrument, the insertion prong being sized and shaped to be received within an insertion opening formed in a lateral shoulder of the femoral stem component; an elongate shaft extending distally away from the handle to the insertion prong; a depth stop rotatably secured to the elongate shaft, the depth stop comprising a guide arm extending away from the elongate shaft. (2) the depth stop further comprises: (i) a hub rotatably coupled to the elongate shaft; and (ii) an extension arm extending distally away from the hub and transitioning into an elbow; 2. The orthopaedic surgical instrument of claim 1, wherein the guide arm extends away from the elbow. (3) the insertion prong extends in an up / down direction; 2. The orthopedic surgical instrument of claim 1, wherein the elongate shaft is angled medially relative to the insertion prong. (4) a longitudinal axis of the insertion prong and a longitudinal axis of the elongate shaft define an offset angle; 2. The orthopedic surgical instrument of claim 1, wherein the offset angle is between 15 and 45 degrees. (5) a longitudinal axis of the insertion prong and a longitudinal axis of the guide arm define a guide angle; 2. The orthopedic surgical instrument of claim 1, wherein the guide angle is 40 to 45 degrees.

[0049] (6) the guide arm includes a first guide arm; the depth stop further comprises a second guide arm extending from an opposite side of the elongate shaft from the first guide arm so as to be spaced from the elongate shaft; 2. The orthopedic surgical instrument of claim 1, wherein the first guide arm and the second guide arm rotate independently of each other relative to the elongate shaft. (7) An orthopedic system for use in a direct anterior approach orthopedic hip replacement surgical procedure on a patient's femur, comprising: a cemented femoral stem component comprising: (i) a proximal body including a lateral shoulder having an insertion opening formed therein; (ii) an elongated neck extending medially from the proximal body; and (iii) a tapered stem extending downwardly away from the proximal body; 1. An orthopedic surgical system comprising: a stem insertion instrument comprising: (i) a handle positioned on a proximal end of the stem insertion instrument; (ii) an insertion prong positioned on a distal end of the stem insertion instrument, the insertion prong being sized and shaped to be received within the insertion opening formed in the lateral shoulder of the femoral stem component; (iii) an elongate shaft extending distally away from the handle to the insertion prong; and (iv) a depth stop rotatably secured to the elongate shaft, the depth stop comprising a guide arm extending away from the elongate shaft, wherein when the insertion prong of the stem insertion instrument is positioned within the insertion opening of the femoral stem component, the depth stop is rotatable between (a) a guide position in which the guide arm is positioned in contact with the femoral stem component and (b) an access position in which the guide arm is spaced apart from the femoral stem component. (8) An orthopedic system according to embodiment 7, wherein the guide arm is positioned in contact with the anterior side of the femoral stem component when the depth stop is positioned in its guide position. (9) An orthopedic system according to embodiment 7, wherein the guide arm is positioned in contact with the anterior side of the proximal body of the femoral stem component when the depth stop is positioned in its guide position. (10) The depth stop further comprises: (i) a hub rotatably coupled to the elongate shaft; and (ii) an extension arm extending distally away from the hub and transitioning into an elbow; 8. The orthopedic system of claim 7, wherein the guide arm extends away from the elbow.

[0050] (11) The insertion prong extends in an upward / downward direction; 8. The orthopedic system of claim 7, wherein the elongate shaft is angled medially relative to the insertion prong. (12) The longitudinal axis of the insertion prong and the longitudinal axis of the elongate shaft define an offset angle; 8. The orthopedic system of claim 7, wherein the offset angle is 15 to 45 degrees. (13) The longitudinal axis of the insertion prong and the longitudinal axis of the guide arm define a guide angle; 8. The orthopedic system of claim 7, wherein the guide angle is 40 to 45 degrees. (14) The guide arm includes a first guide arm; the depth stop further comprises a second guide arm extending from an opposite side of the elongate shaft from the first guide arm so as to be spaced from the elongate shaft; the first guide arm and the second guide arm rotate independently of each other relative to the elongate shaft; An orthopedic system as described in embodiment 7, wherein when the insertion prong of the stem insertion instrument is positioned within the insertion opening of the femoral stem component and the depth stop is positioned in its guide position, the first guide arm is positioned in contact with a first side of the femoral stem component and the second guide arm is positioned in contact with a second, opposite side of the femoral stem component. (15) The guide arm includes a first guide arm; the depth stop further comprises a second guide arm extending from an opposite side of the elongate shaft from the first guide arm so as to be spaced from the elongate shaft; the first guide arm and the second guide arm rotate independently of each other relative to the elongate shaft; An orthopedic system as described in embodiment 7, wherein when the insertion prong of the stem insertion instrument is positioned within the insertion opening of the femoral stem component and the depth stop is positioned in its guide position, the first guide arm is positioned in contact with the anterior side of the femoral stem component and the second guide arm is positioned in contact with the posterior side of the femoral stem component.

[0051] (16) A method of placing a cemented femoral stem component during a direct anterior approach orthopaedic hip replacement surgical procedure on a patient's femur, comprising: surgically preparing the proximal end of the patient's femur to create a resection plane; Inserting an insertion prong of the insertion instrument into an insertion opening formed in a lateral shoulder of the femoral stem component to secure the femoral stem component to the insertion instrument; rotating the guide arm of the insertion instrument into contact with the fixed femoral stem component; advancing the distal end of the femoral stem component through the surgically-prepared proximal end of the patient's femur and into the intramedullary canal of the patient's femur; and further advancing the femoral stem component until the guide arm of the insertion instrument engages the resected flat surface of the surgically-prepared proximal end of the patient's femur. 17. The method of claim 16, wherein rotating the guide arm of the insertion instrument to contact the fixed femoral stem component comprises rotating the guide arm of the insertion instrument to contact an anterior surface of the fixed femoral stem component. (18) The method of claim 16, wherein rotating the guide arm of the insertion instrument to contact the fixed femoral stem component comprises: (i) rotating the anterior guide arm of the insertion instrument to contact the anterior surface of the fixed femoral stem component; and (ii) rotating the posterior guide arm of the insertion instrument to contact the posterior surface of the fixed femoral stem component. (19) The method of claim 16, further comprising, following engagement of the guide arm of the insertion instrument with the resected flat surface of the surgically-prepared proximal end of the patient's femur, rotating the guide arm out of contact with the femoral stem component. (20) unlocking the femoral stem component from the insertion instrument following engagement of the guide arm of the insertion instrument with the resected flat surface of the surgically-prepared proximal end of the patient's femur; 17. The method of claim 16, further comprising advancing the insertion prong of the insertion instrument proximally to remove it from the intramedullary canal of the patient's femur.

Claims

1. 1. An orthopaedic surgical instrument for implanting a cemented femoral stem component during a direct anterior approach orthopaedic hip replacement surgical procedure on a patient's femur, comprising: a stem insertion tool, a handle positioned on the proximal end of the stem insertion instrument; an insertion prong positioned on a distal end of the stem insertion instrument, the insertion prong being sized and shaped to be received within an insertion opening formed in a lateral shoulder of the femoral stem component; an elongate shaft extending distally away from the handle to the insertion prong; a depth stop rotatably secured to the elongate shaft, the depth stop comprising a guide arm extending away from the elongate shaft.

2. the depth stop further comprising: (i) a hub rotatably coupled to the elongate shaft; and (ii) an extension arm extending distally away from the hub and transitioning into an elbow; The orthopaedic surgical instrument of claim 1 , wherein the guide arm extends away from the elbow.

3. the insertion prong extends in a superior / inferior direction; The orthopaedic surgical instrument of claim 1 , wherein the elongate shaft is angled medially relative to the insertion prong.

4. a longitudinal axis of the insertion prong and a longitudinal axis of the elongate shaft define an offset angle; The orthopaedic surgical instrument of claim 1, wherein the offset angle is between 15 and 45 degrees.

5. a longitudinal axis of the insertion prong and a longitudinal axis of the guide arm define a guide angle; The orthopaedic surgical instrument of claim 1, wherein the guide angle is between 40 and 45 degrees.

6. the guide arm includes a first guide arm; the depth stop further comprises a second guide arm extending from an opposite side of the elongate shaft from the first guide arm so as to be spaced away from the elongate shaft; The orthopaedic surgical instrument of claim 1 , wherein the first guide arm and the second guide arm rotate independently of each other relative to the elongate shaft.

7. 1. An orthopaedic surgical system for use in a direct anterior approach orthopaedic hip replacement surgical procedure on a patient's femur, comprising: a cemented femoral stem component comprising: (i) a proximal body including a lateral shoulder having an insertion opening formed therein; (ii) an elongated neck extending medially from the proximal body; and (iii) a tapered stem extending downwardly away from the proximal body; 1. An orthopedic surgical system comprising: a stem insertion instrument comprising: (i) a handle positioned on a proximal end of the stem insertion instrument; (ii) an insertion prong positioned on a distal end of the stem insertion instrument, the insertion prong being sized and shaped to be received within the insertion opening formed in the lateral shoulder of the femoral stem component; (iii) an elongate shaft extending distally away from the handle to the insertion prong; and (iv) a depth stop rotatably secured to the elongate shaft, the depth stop comprising a guide arm extending away from the elongate shaft, wherein when the insertion prong of the stem insertion instrument is positioned within the insertion opening of the femoral stem component, the depth stop is rotatable between (a) a guide position in which the guide arm is positioned in contact with the femoral stem component and (b) an access position in which the guide arm is spaced apart from the femoral stem component.

8. The orthopaedic system of claim 7 , wherein the guide arm is positioned in contact with an anterior side of the femoral stem component when the depth stop is positioned in its guide position.

9. The orthopaedic system of claim 7 , wherein the guide arm is positioned in contact with an anterior side of the proximal body of the femoral stem component when the depth stop is positioned in its guide position.

10. the depth stop further comprising: (i) a hub rotatably coupled to the elongate shaft; and (ii) an extension arm extending distally away from the hub and transitioning into an elbow; The orthopedic system of claim 7 , wherein the guide arm extends away from the elbow.

11. the insertion prong extends in a superior / inferior direction; The orthopedic system of claim 7 , wherein the elongate shaft is angled medially relative to the insertion prong.

12. a longitudinal axis of the insertion prong and a longitudinal axis of the elongate shaft define an offset angle; The orthopedic system of claim 7, wherein the offset angle is between 15 and 45 degrees.

13. a longitudinal axis of the insertion prong and a longitudinal axis of the guide arm define a guide angle; The orthopedic system of claim 7, wherein the guide angle is between 40 and 45 degrees.

14. the guide arm includes a first guide arm; the depth stop further comprises a second guide arm extending from an opposite side of the elongate shaft from the first guide arm so as to be spaced away from the elongate shaft; the first guide arm and the second guide arm rotate independently of one another relative to the elongate shaft; 8. The orthopaedic system of claim 7, wherein when the insertion prong of the stem insertion instrument is positioned within the insertion opening of the femoral stem component and the depth stop is positioned in its guide position, the first guide arm is positioned in contact with a first side of the femoral stem component and the second guide arm is positioned in contact with a second, opposite side of the femoral stem component.

15. the guide arm includes a first guide arm; the depth stop further comprises a second guide arm extending from an opposite side of the elongate shaft from the first guide arm so as to be spaced away from the elongate shaft; the first guide arm and the second guide arm rotate independently of one another relative to the elongate shaft; 8. The orthopaedic system of claim 7, wherein when the insertion prong of the stem insertion instrument is positioned within the insertion opening of the femoral stem component and the depth stop is positioned in its guide position, the first guide arm is positioned in contact with an anterior side of the femoral stem component and the second guide arm is positioned in contact with a posterior side of the femoral stem component.

16. 1. A method of installing a cemented femoral stem component during performance of a direct anterior approach orthopaedic hip replacement surgical procedure on a patient's femur, comprising: surgically preparing the proximal end of the patient's femur to create a resection plane; Inserting an insertion prong of the insertion instrument into an insertion opening formed in a lateral shoulder of the femoral stem component to secure the femoral stem component to the insertion instrument; rotating the guide arm of the insertion instrument into contact with the fixed femoral stem component; advancing the distal end of the femoral stem component through the surgically-prepared proximal end of the patient's femur and into the intramedullary canal of the patient's femur; and further advancing the femoral stem component until the guide arm of the insertion instrument engages the resected flat surface of the surgically-prepared proximal end of the patient's femur.

17. 17. The method of claim 16, wherein rotating the guide arm of the insertion instrument into contact with the fixed femoral stem component comprises rotating the guide arm of the insertion instrument into contact with an anterior surface of the fixed femoral stem component.

18. 17. The method of claim 16, wherein rotating the guide arm of the insertion instrument to contact the fixed femoral stem component comprises: (i) rotating an anterior guide arm of the insertion instrument to contact an anterior surface of the fixed femoral stem component; and (ii) rotating a posterior guide arm of the insertion instrument to contact a posterior surface of the fixed femoral stem component.

19. 17. The method of claim 16, further comprising, following engagement of the guide arm of the insertion instrument with the resected flat surface of the surgically-prepared proximal end of the patient's femur, rotating the guide arm out of contact with the femoral stem component.

20. unlocking the femoral stem component from the insertion instrument following engagement of the guide arm of the insertion instrument with the resected flat surface of the surgically-prepared proximal end of the patient's femur; 17. The method of claim 16, further comprising advancing the insertion prong of the insertion instrument proximally out of the intramedullary canal of the patient's femur.

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