Sacroiliac joint fusion implants, insertion instruments, and methods

An insertion system for inserting a lateral sacroiliac (SI) joint implant, comprising:

• a guidewire;
• and
• an insertion instrument, comprising:
• a distal end for coupling to the lateral SI joint implant;
• and
• a proximal end comprising a ratcheting handle subassembly, the ratcheting handle subassembly comprising:
• an inner shaft having an inner shaft distal end comprising a plurality of recesses around a circumference of the inner shaft;
• a rotatable grip portion surrounding the inner shaft and comprising a plurality of retaining surfaces;
• a plurality of rollers received within the plurality of retaining surfaces and configured to be in contact with the plurality of recesses,
• wherein, when the rotatable grip portion is rotated in a first direction, the plurality of retaining surfaces moves the plurality of rollers to engage a recess of the plurality of recesses such that the inner shaft rotates with rotation of the rotatable grip portion,
• wherein rotation of the rotatable grip portion in a second direction opposite the first direction is impeded by a geometry of the plurality of retaining surfaces,
• wherein rotation of the rotatable grip portion in the first direction rotates the lateral SI joint implant.