Abstract: A pneumatically driven orthopedic broach inserter comprising a continuously reciprocating piston which strikes a proximal anvil during each cycle. The impact of the piston with the proximal anvil drives the broach out of a bone. To drive the broach into the bone, a surgeon pushes on the power broach inserter, bringing a distal anvil into the path of the piston, and creating a forward action which dominates over the on-going reverse action produced by the piston striking the proximal anvil. The piston is provided with a low-friction sleeve so that completely oilless operation is possible. A fast-acting chuck having a key and a wedge is provided whereby broaches of different size can be quickly attached to the power broach inserter.