Abstract: An instrument for positioning a hollow cup component of an orthopaedic joint prosthesis. The instrument includes an insertion end section, a handle end section opposite the insertion end section, and a shaft coupling the insertion end section to the handle end section. The insertion end section includes a cam wheel and a plurality of expanding pieces coupled to the cam wheel such that when the cam wheel is rotated in one direction, the expanding pieces expand out in a radial direction and frictionally engage an inner surface of the hollow cup component.

Abstract: An instrument for positioning a hollow cup component of an orthopaedic joint prosthesis. The instrument includes a longitudinal member having a first end and a second end opposite the first end. The instrument further includes a resilient cup engaging member coupled to the first end. The resilient cup engaging member has a convex outer surface adapted to engage an interior of the hollow cup component. The entire outer convex surface is manufactured of a resilient material. An actuator in fluid communication with the resilient cup engaging member is also included. When the actuator is actuated, the suction force between the resilient cup engaging member and the hollow cup increases.

Abstract: A customized patient-specific orthopaedic instrument for facilitating implantation of an acetabular cup prosthesis in a coxal bone of a patient includes a customized patient-specific acetabular reaming guide. The customized patient-specific acetabular reaming guide includes a longitudinal passageway for an acetabular reamer and a plurality of arms with attached feet. Each foot of the reaming guide is positioned relative to the body based on the contours of the coxal bone of the patient and a predetermined degree of version and inclination angles of the acetabular cup prosthesis when implanted in the patient's coxal bone.

Abstract: A method is used for aligning an acetabular cup insertion instrument by taking a single lateral view pre-operative digital x-ray of a standing patient's pelvis. The natural pelvic tilt angle is determined by locating an anterior pelvic plane (APP) which is defined by first, second and third points on the anterior of the pelvis and determining the angle between the APP and a coronal plane perpendicular to the surface on which the patient is standing. The patient is then placed on a surface of an operating room table in a supine position. A position tracking device is placed on the patient's pelvis to track movement. Thereafter an operating room navigation or orientation system is used to relocate the APP defined by the first, second and third points. A cup insertion instrument having a position tracking device thereon is oriented using the navigation or orientation system.

Abstract: An alignment system for aligning an acetabular cup insertion instrument utilizes pre-operative preferably standing x-rays and intra-operative x-rays to allow the surgeon to compensate for the position of a patient on an operating room table. The system uses a programmable computer connected to a digital x-ray system and an navigation tracking system to provide input for calculating the inclination and anteversion angles of an acetabular cup impactor based on a pre-operative plan developed from the standing x-rays. The system calculates changes in lengths and angles between anatomic landmarks on the pelvis to alter the intra-operative orientation of the acetabular reaming and impacting instruments to produce the desired inclination and anteversion angles when the pelvis is reoriented as the patient is placed on an operating table.

Abstract: A method for determining a depth of impaction of a prosthetic cup into an acetabulum using an end effector and a movable impactor shaft is provided, wherein the prosthetic cup may be positioned at a distal end of the impactor shaft. The method may position the distal end of the impactor shaft at a known pose relative to the end effector, track a spatial pose of the end effector relative to a spatial pose of the acetabulum, determine a spatial pose of the prosthetic cup based on the spatial pose of the end effector and the known pose between the distal end of the impactor shaft and the end effector, and determine the depth of impaction based on the spatial pose of the prosthetic cup and the spatial pose of the acetabulum.

Abstract: An orthopaedic prosthetic inserter used for the implantation of double mobility cup implants is described. The inserter consists of a drive train, a C-shaped housing, and a prosthetic cup engaging subassembly. The subassembly comprises an impaction plate, a grasping plate and a domed nose. When activated by the drive train, a plurality of hook ends extending from the grasping plate latch onto the cup of the prosthetic to hold and manipulate the prosthetic cup during implantation.

Abstract: A prosthetic acetabular cup inserter and impactor has an expandable annular cup engaging element to engage the inner surface of a cup to be inserted in the acetabulum. An expander is provided for expanding the cup engaging element which is connected to one end of a handle via a hollow or partly hollow extension portion. The other end of the handle is provided with an anvil. An elongate operator is located within the extension portion and connected to the cup engaging element. A device is provided for moving the elongate operator to pull the cup engaging element towards the expander.

Abstract: Methods and devices for preparing an acetabulum for receiving an acetabular component in a hip replacement procedure. The methods may include aligning a first guide in an acetabular notch of the acetabulum and determining a reference point in the acetabulum. The first guide is removed from the acetabulum and then a second guide is positioned in the acetabulum and oriented with the reference point. While the second guide is positioned in the acetabulum, the acetabular margin is reamed with a reamer. During reaming, the reamer is contacted against a rim of the second guide which prevents additional reaming of the acetabular notch below the rim of the second guide.

Abstract: An orthopedic cup impactor for use in minimally invasive hip replacement surgical procedures is described. The impactor comprises a handle, residing at a proximal end portion, and a cup engagement sub-assembly located at a distal portion. A shaft resides therebetween. The shaft portion is designed with a large radius of curvature that provides added clearance when inserting the impactor in obese patients. The cup engagement sub-assembly features a drive train that comprises a series of “U” and “H” joints deigned to provide full rotational motion. The drive train may be designed to be removable from the cup impactor to provide more efficient and thorough cleaning.

Abstract: Disclosed herein are systems and methods for performing total hip arthroplasty with patient-specific guides Pre-operative images of a pelvic region of a patient are taken in order to predefine the structure of the guides and corresponding implants. From the obtained image data an insertional vector for implanting an acetabular implant or component into an acetabulum of the patient is determined, wherein the insertional vector is coaxial with a polar axis of the acetabular component. Also from the obtained image data, a superior surface of the guides and implants can be shaped to match the acetabulum of the patient. A nub portion extending outwardly from the superior surface of the guides and implants is shaped to substantially match the shape of a fovea of the acetabulum. A guide portion of the guides forming a slot has a longitudinal axis coaxial with the determined insertional vector of a corresponding acetabular component.

Abstract: A surgical instrument for acetabular cup implantation includes an acetabular cup, a shell body and a drive shaft. The drive shaft includes a drive rod and a handle bar. The handle bar engages the pivot for angular displacement having forward position and backward position. In the forward position the drive rod rotates the acetabular cup forward, and in the backward position the drive rod shifts backward resulting in the acetabular cup engaged the extension portion. Accordingly, the operator rotates the handle bar to control the acetabular cup inserting into the position of acetabulum. The rotation of the handle bar results in the gripping or releasing of the acetabular cup or insert from the invention. Thus the invention provides a clear and ergonomic instrument for medical personnel concerning the operation of acetabular cup implantation.

Abstract: An alignment guide is described that includes a shaft having a longitudinal axis and a housing attachable to the shaft and rotatable about a first axis that is substantially perpendicular to the longitudinal axis. A guide arm the extends from the housing at a predetermined angle along a second axis. A spirit level is connected to the housing on a plane aligned with the predetermined angle.

Abstract: A method for assisting in positioning the acetabular cup comprises orienting a cup positioning instrument with a cup thereon in an initial reference orientation relative to an acetabulum of a pelvis with the cup forming a joint with the acetabulum, the cup positioning instrument comprising an inertial sensor unit with pre-planned orientation data for a desired cup orientation based on at least one landmark of the pelvis, The cup positioning instrument is rotated to a desired abduction angle as guided by an interface of the cup positioning instrument, based on movements relative to at least one landmark. The cup positioning instrument is rotated to a desired anteversion angle as guided by the interface of the cup positioning instrument, based on movements relative to the at least one landmark. Upon reaching the desired cup orientation as indicated by the interface, the cup is impacted into the acetabulum.

Abstract: An apparatus registers a patient's pelvis during surgery by establishing a patient-specific, supine pelvic reference plane. The apparatus may include an elongated support arm having three legs, at least two of which may be moveable along the arm. The first leg may contact the patient's right anterior superior iliac spines (ASIS), the second leg may contact the left ASIS, and the third leg may contact an anterior aspect of the ischium of the patient's pelvis below the acetabulum of the hip being operated on. The distances between the first leg and the second and third legs may be determined preoperatively so that the legs dock to the desired points. The apparatus may further include a direction indicator configured to point in a desired orientation for inserting an acetabular cup component in the patient's acetabulum.

Abstract: A method for inserting an acetabular cup into an acetabulum of a patient includes inspecting a preoperative plan including a three-dimensional image of a patient's acetabulum, selecting at least one of a patient-specific anteversion angle and a patient-specific abduction angle, and approving the preoperative plan. The method also includes preparing the patient's acetabulum for implantation, positioning a patient-specific first surface of an acetabular guide around a matched acetabular rim surface of the patient, and inserting an acetabular cup through an opening of the acetabular guide, the opening having a cylindrical inner surface oriented at the selected at least one of the patient-specific anteversion angle and patient-specific abduction angle.

Abstract: A prosthetic acetabular cup inserter and impactor has a body, a cup engaging element disposed at a first end of the body which is adapted to engage an inner surface of a cup with which it is used. An operating system is adapted to axially rotate the cup engaging element in relation to the body in use. An impaction plate that is adapted to engage an undulating rim of the cup is disposed between the body and the cup engaging element. The impaction plate is connected to the operating system by a linkage which acts to axially rotate the impaction plate in unison with the cup engaging element in use.

Abstract: A device for detecting and measuring a change in angular position with respect to a reference plane is useful in surgical procedures for orienting various instruments, prosthesis, and implants with respect to anatomical landmarks. One embodiment of the device uses three orthogonal rate sensors, along with integrators and averagers, to determine angular position changes using rate of change information. A display provides position changes from a reference position. Various alignment guides are useful with surgical instruments to obtain a reference plane.

Abstract: This disclosure provides an anatomic socket alignment guide set, for total hip replacement arthroplasty. The guide set is created from patient-specific medical images, allowing the guide set components to recreate the native center of rotation of a patient's hip joint, thereby permitting accurate placement of the hip replacement prosthesis.

Abstract: Systems, devices, and methods are provided for implanting and aligning orthopedic implants. A patient-matched alignment guide is used to orient tools and implants intraoperatively. In certain embodiments, the systems, devices, and methods include an orthopedic guide comprising a body having a bottom surface, wherein at least a portion of the bottom surface has predetermined surface characteristics that correspond to respective characteristics of a patient's bony anatomy, and a pliable flange that extends from the bottom surface and is shaped to be received within an undercut of an implant to releasably couple the orthopedic guide to the implant.

Abstract: Embodiments of the invention are directed to a prosthetic hip system that includes acetabular alignment structures and methods. Acetabular alignment structures and methods may include use of patient-matched components configured to reduce tissue disruption during implantation.

Abstract: An orthopedic impactor device for positioning an orthopedic prosthetic cup implant during a hip replacement surgery is described. The impactor is designed with a “one piece” elongated body portion, having a distal prosthetic cup engagement portion which is separated from a proximal strike plate by an elongated body and handle portions. A connection rod, connectable to an orthopedic prosthetic cup, is positioned longitudinally within the through-bores of the body and handle portions. A lever arm, having a linkage member, is pivotally connected to the rod such that when the lever arm is pivoted towards the exterior surface of the annular sidewall of the handle portion, the distal end of the rod moves within the body portion.

Abstract: A computer-guided system for determining the disposition of an object, the computer-guided system comprising: a platform; a compass removably and adjustably mounted to the platform, the compass comprising: a first arm having a proximal end and a distal end; a second arm having a proximal end and a distal end; the proximal end of the first arm being removably and adjustably mounted to the platform by a magnetic ball mount, wherein the magnetic ball mount comprises a spherical encoder; the proximal end of the second arm being movably mounted to the distal end of the first arm by a pivot mount, wherein the pivot mount comprises an angular sensor; and determining means for determining the disposition of the distal end of the second arm relative to the platform by using data from the spherical encoder and the angular sensor.

Abstract: A system for calculating a position and orientation of an acetabular cup in computer-assisted surgery comprises a first trackable reference secured to a pelvis, with a frame of reference being associated with the first trackable reference. A device is positionable between a femoral neck and the acetabulum of the pelvis in a known relation, the device having a second trackable reference. Sensors track the trackable references for position and orientation. A position/orientation calculator calculates a position and orientation of the frame of reference and of the device and for determining an orientation of the neck axis with respect to the frame of reference from the known relation at a desired position of the femur. An implant position/orientation calculator provides cup implanting information with respect to the orientation of said neck axis as a function of the tracking for position and orientation of at least the first trackable reference.

Abstract: An acetabular cup impactor for surgery. The impactor has a handle, a bow arm and a prehension fastener secured to the bow arm opposite the handle. An elongated spine extends within the length of the bow arm between the handle and the prehension fastener. In use, the elongated spine rotates with respect to the bow arm and causes corresponding rotation of the prehension fastener with respect to the bow arm.

Abstract: An orthopedic device includes a patient-specific acetabular guide that may be used for preparing an acetabulum of a patient to receive an acetabular implant. The acetabular guide has a body with an outer three-dimensional surface configured to match an acetabulum of a specific patient's hip joint designed from data of the patient's hip joint. The acetabular guide may further include a peripheral annular rim.

Abstract: Implementations described and claimed herein provide an arthroplasty system positioning an acetabular cup implant. In one implementation, the system includes a shape-match hip guide having a patient specific mating region that is a negative of the surface contour of the inside surface of the patient's acetabular cup, and a directional rod that extends generally along the axis of the patient's femoral head and femoral neck. They system can additionally include an outrigger or silo device to aid in the alignment of surgical tools for preparing and implanting of the prosthetic acetabular cup in the patient's acetabular cup. Related methods are also disclosed herein for generating a shape-match guide and implanting an acetabular cup with the guide.

Abstract: A patient-specific total hip arthroplasty system including surgical guide and jig instrumentation modeled by computer aided design using image data derived from a specific patient's relevant anatomy. Patient-specific jigs fit surface topography of portions of the acetabulum and femur of the patient and are designed to guide surgical implantation at very precise geometries unique to each patient. Patient-specific pin-locating jigs, pin-rail and spacer systems, acetabular reaming and impacting jigs, and femoral resection and version jigs are fabricated pre-operatively according to the models. Methods for fabricating jig components of the system and methods of performing a total hip arthroplasty utilizing the system are also disclosed.

Abstract: An orthopedic device includes a patient-specific acetabular guide that can be used for preparing an acetabulum of a patient to receive an acetabular implant and/or placement of an acetabular prosthesis. The acetabular guide has a body with an outer three-dimensional surface configured to match an acetabulum of a specific patient's hip joint designed from data of the patient's hip joint. The acetabular guide can further include a peripheral annular rim.

Abstract: Technologies for aligning an acetabular prosthetic component in a patient's surgically prepared acetabulum are disclosed. The disclosed technologies include a reference sensor module securable to the patient's bony anatomy, an inserter sensor module securable to an acetabular prosthetic component inserter, and a display module. Each sensor module generates sensor data indicative of the orientation of the sensor module and/or structures to which the sensor module is coupled. The display module receives the sensor data from the sensor modules, determines the orientation of the acetabular prosthetic component relative to the patient's bony anatomy, and displays indicia of the determined orientation on a display.

Abstract: A prosthetic acetabular cup inserter and impactor has a body, and a cup engaging element disposed at a first end of the body and adapted to engage an inner surface of a cup with which it is used via outward biasing of the cup engaging element. The cup engaging element increases in cross-sectional area from an inner end thereof to a fullest transverse section, and decreases in cross-sectional area from said fullest transverse section to an outer end thereof. The cup engaging element has a tapered central bore engaged by a conically tapered actuation element moveable in the bore. The cup engaging element has a slot therethrough allowing the element to resiliently expand on movement of the actuator in the bore.

Abstract: A device (1) for connecting to an implant (16), comprising: at least two protrusions (8, 9) connectable, in use, to at least one indentation (20) in the implant; and a mechanism for moving the protrusions between a connected and a disconnected position. An implant (16) comprising a body (17) having at least one indentation (20) disposed within the body, wherein, in use, the at least one indentation receives at least two protrusions (8, 9) of a device (1) for connecting to the implant (16) such that the implant is clamped by the device. A method of connecting an implant (16) to a device (1).

Abstract: The present disclosure provides an improved osteotome instrument for removing an acetabular cup from an acetabulum, including an explant adapter connectable to an elongated handle shaft of the instrument. The explant adapter is sized and shaped to connect any one of a set of a plurality of different sized interchangeable pivot elements, such as spherical heads, to the osteotome instrument for use in removing the acetabular cup from the acetabulum. The pivot heads may be relatively large diameter pivot heads.

Abstract: A method and an acetabular augment are disclosed for compensating for a deficiency encountered in natural bone at an implant site wherein an acetabular component of a prosthetic hip implant is to be implanted within a prepared acetabulum during a hip arthroplasty. A buttress member of an acetabular augment is placed at a selected angular position relative to an affixation member of the acetabular augment, as determined by a trialing procedure in which a trial buttress member is placed at the deficiency while a trial affixation member is placed upon natural bone at the implant site to determine a trial relative angular position between the trial buttress member and the trial affixation member of a trial acetabular augment located at the implant site. The relative angular position between the buttress member and the affixation member then is selected to mimic the trial relative angular position. The location of the trial acetabular augment is marked, and the trial acetabular augment is removed.

Abstract: Devices, systems and methods for performing arthroscopic evaluations and procedures in and near the hip joint are provided. An arthroscopic assisted arthroplasty system is useful in the treatment of arthritic hip conditions, conserving healthy tissue, and limiting iatrogenic injury associated with traditional surgical exposures. A guide wire system employing retrograde and antegrade reamers along the femoral neck is useful in anatomic placement of instrumentation without formal hip dislocation. Fluoroscopy and computer assisted navigation enhance the system, methods, and apparatus. Acetabular and femoral collapsible prosthetic forms are useful in arthroscopic assisted placement. The devices, systems, and methods are effective to assist an operating surgeon in the addressing mild to moderate arthritic conditions of the femoral head and acetabulum where tissue conservation and surgical exposure morbidities should be limited.

Abstract: An acetabular trialing system has a trial cup including a body comprising an outer surface, a part-spherical inner surface and a rim extending between the inner and outer surface with a plurality of spaced inwardly resiliently deflectable rim members each connected at a first end to the body outer surface. The part-spherical inner surface has a plurality of spaced resilient deflectable bearing members each forming part of the body part-spherical inner surface. The bearing members have a first end deflectable towards the body outer surface. Upon inward deflection, one of the plurality of deflectable rim members is capable of contacting the first end of a corresponding one of the plurality of deflectable bearing members and moving the bearing member towards the body outer surface and into contact an electrical signaling device mounted on the body intermediate the outer surface thereof and the deflectable bearing member.

Abstract: The ancillary tool according to the invention comprises a handle for manipulating an acetabulum provided, in its distal part, with a head for gripping the acetabulum and, in its proximal part, with a surface for application of a force of impaction. The tool further comprises at least one added endpiece adapted to be removably connected to the distal end of the handle. This endpiece defines both a face for wedging the acetabulum and an opposite face for interaction of the endpiece with the head of the handle, these faces both being borne by a radially deformable supple ring. The invention is particularly applicable to the positioning of an acetabular prosthesis in an anatomical or prosthetic cavity of a patient's hip.

Abstract: A system for assisting in a surgical process, comprising: (a) a surgical device taken from a group consisting of a surgical tool and a surgical implant; (b) a positional sensor carried by the surgical device, the positional sensor including a wireless transmitter and associated circuitry for transmitting sensor data from the transmitter; and (c) a computer system including a wireless receiver and signal conditioning circuitry and hardware for converting sensor data received by the wireless receiver into at least one of (i) audio feedback of positional information for the surgical device and (ii) visual feedback of positional information for the surgical device.

Abstract: An apparatus for aiding visualization of a prosthetic implant and concurrently landmarking a patient tissue includes a center post having proximal and distal post ends longitudinally separated by a post body. The post body defines a post axis coaxially therewith. An implant emulator embodies a reference feature of a prosthetic implant. The implant emulator is carried on an outer surface of the center post at a predetermined longitudinal spacing from the distal post end. A guiding device is removably attached to the implant emulator. The guiding device includes an attachment structure attached to the implant emulator. A spacing arm is connected to the attachment structure and extends laterally outward from the post axis. A landmark guiding structure is connected to the spacing arm, spaced apart from the center post, and embodies at least one of a location and a trajectory for placement of a landmark.

Abstract: Various exemplary embodiments relate to a method of performing an anterior approach hip replacement using a retractor assembly. The method may include: providing a retractor assembly including a first vertical post, a plurality of accessory arms mounted to the first post, a second vertical post, and a femur distractor mounted to the second post; exposing a surgical site including the femoral neck and acetabulum using a plurality of retractors secured to the accessory arms; cutting the femoral neck to remove the femoral head; preparing the acetabulum for insertion of an acetabular cup; preparing the femur for insertion of a femoral implant by lifting the femur using a femur hook and the femur distractor; and closing the surgical site. In various alternative embodiments, the retractors may include a lesser trochanteric retractor coming from a direct medial approach and a greater trochanteric retractor coming from a lateral, posterior, proximal approach.

Abstract: A tool for placing or removing joint sockets of an artificial joint, especially a hip joint, and a tool for placing or removing an artificial joint, has a handle, a joint socket or joint receiver or holder, and a connecting element arranged between the handle and the joint socket or joint holder. The connecting element comprises an arcuate portion in its longitudinal direction. A system for placing and removing joint sockets or joints using such a tool includes a position-determining and navigation device.

Abstract: A system for calculating a position and orientation of an acetabular cup in computer-assisted surgery comprises a first trackable reference secured to a pelvis, with a frame of reference being associated with the first trackable reference. A device is positionable between a femoral neck and the acetabulum of the pelvis in a known relation, the device having a second trackable reference. Sensors track the trackable references for position and orientation. A position/orientation calculator calculates a position and orientation of the frame of reference and of the device and for determining an orientation of the neck axis with respect to the frame of reference from the known relation at a desired position of the femur. An implant position/orientation calculator provides cup implanting information with respect to the orientation of said neck axis as a function of the tracking for position and orientation of at least the first trackable reference.

Abstract: A tool includes a housing including a receiving portion configured to receive at least a portion of an operating member so as to permit rotation of the operating member relative to the housing while constraining movement of the operating member in a radial direction of the operating member. The tool also includes a coupling device disposed on the housing and configured to couple the operating member to the housing so as to permit rotation of the operating member relative to the housing. The coupling device includes a retaining member configured to engage the operating member to constrain movement of the operating member relative to the housing in a longitudinal direction of the operating member. The retaining member is configured to rotate relative to the housing.

Abstract: An orthopedic device includes a patient-specific acetabular guide that can be used for preparing an acetabulum of a patient to receive an acetabular implant. The acetabular guide has a body with an outer three-dimensional surface configured to match an acetabulum of a specific patient's hip joint designed from data of the patient's hip joint. The acetabular guide can further include a peripheral annular rim.

Abstract: An orthopedic device includes a patient-specific acetabular guide that can be used for preparing an acetabulum of a patient to receive an acetabular implant. The acetabular guide has a dome-shaped body with a peripheral annular rim and an outer three-dimensional surface configured to match an acetabulum of a specific patient's hip joint from three-dimensional medical images of the patient's hip joint. A patient-specific registration guide is removably attached to the peripheral rim and has a longitudinal bore defining a patient-specific alignment axis with an alignment orientation configured for guiding an acetabular implant for the patient. The registration guide has a patient-specific undersurface configured to mate with a corresponding surface of periacetabular surface of the acetabulum of the patient.

Abstract: An instrument for use in a joint replacement procedure includes a trial head that corresponds to the head of an orthopaedic joint component having an upper surface defined by a curved surface and a bore formed in a lower surface and a trial connector for connecting the trial head to a stem part of the orthopaedic joint component which is intended for location in the intramedullary cavity of a bone. The trial connector can be fitted into the bore in the trial head at a variable angular orientation.

Abstract: A device for attaching to an object including a portion attached to an object, and a vacuum generating means for generating a vacuum between the object and the portion, to thereby attaching the object to the device.

Abstract: A medical device for preparing a bone of a joint of a patient includes a numerically controlled instrument having a housing including a controller, a processor and a tool driver, a patient-specific reference guide removably couplable to the housing, and a cutting tool removably coupled to the tool driver. The patient-specific reference guide has a three-dimensional inner surface preoperatively configured to mirror and mate with a corresponding surface of a bone of a joint of a patient in only one position. The patient-specific reference guide is configured to automatically register the numerically controlled instrument to the patient's bone portion intraoperatively. The cutting tool is movable along a patient-specific tool path determined during the preoperative plan for preparing a portion of the bone.

Abstract: In this invention, there is provided a system which can visually indicate to the surgeon an ideal angle for the acetabular cup during a total hip replacement procedure, wherein the system uses a robotic system which orients an elongated guide at the preferred axis for the acetabular cup.

Abstract: Disclosed is a system for engaging and holding a prosthesis both axially and rotationally relative to an inserter assembly. The inserter assembly can engage an acetabular prosthesis in a selected position, such as axially, with a first portion and then or subsequently engage the acetabular prosthesis with a second portion in a rotationally fixed manner. The acetabular prosthesis can then be inserted into a prepared acetabulum according to a disclosed method with the inserter assembly. The inserter assembly can then be removed from the acetabular prosthesis to allow for reduction of a femur.