A system includes an ultrasonic instrument and a bone insertion element. The instrument includes an ultrasonic transducer and an ultrasonic blade. The ultrasonic transducer is operable to convert electrical power into ultrasonic vibrations. The ultrasonic blade is in acoustic communication with the ultrasonic transducer such that the ultrasonic transducer drives the ultrasonic blade to vibrate ultrasonically to form an opening within bone. The bone insertion element is configured to be inserted within the opening formed by the ultrasonic blade.
