A prosthetic acetabular cup inserter and impactor comprising a body, a cup engaging means disposed at a first end of said body and adapted to engage an inner surface of a cup with which it is used, and operating means adapted to axially rotate said cup engaging means in relation to said body in use, in which an impaction plate adapted to engage a rim of said cup is disposed between said body and said cup engaging means, and in which said impaction plate is connected to said operating means by linkage means which act to axially rotate said impaction plate in unison with said cup engaging means in use.
