An impactor-extractor for inserting or extracting a stem of a prosthesis into or from a bone can include a body having a first end and a second end. The body can include an impact head located at the first end. A lever can be connected to the body and pivotable about a first pivot point distal to the first end of the body. A base can be located at the second end of the body and can include a first taper connector sized to mate with a second taper connector of the stem. A lock can be located at and pivotable about a second pivot point proximate the second end and can include an extension configured to secure the stem to the first taper connector. Linkages can connect the lever and the lock.