Method and apparatus for tibial fixation of an ACL graft

A tensioner system for use in graft strand tensioning and fixation in a knee reconstruction procedure, comprising:

• a handle assembly including a hollow outer handle body and an inner handle body slidably received within the outer handle body, an arm support member rotatably coupled to a distal end of the inner handle body;
• a tensioner assembly coupled relative to the handle assembly;
• a ratcheting member slidably received in the outer handle body and including a plurality of ratchet teeth in selective engagement with a pawl carried by the outer handle body, the ratchet teeth configured to maintain a position of the outer handle body relative to the ratcheting member upon movement of the outer handle body relative to the ratcheting member;
• and
• a drive shaft slidably received through and supported by the handle assembly such that proximal and distal ends of the drive shaft extend beyond respective proximal and distal ends of the handle assembly;
• wherein the ratcheting member includes a throughbore slidably receiving a portion of the drive shaft and a C-shaped distal end adapted to be aligned with a tibial bone tunnel and receive the drive shaft therethrough.

A tensioner system for use in graft strand tensioning and fixation in a knee reconstruction procedure, comprising:

• a handle assembly including a hollow outer handle body and an inner handle body slidably received within the outer handle body, an arm support member rotatably coupled to a distal end of the inner handle body;
• a tensioner assembly coupled relative to the handle assembly, the tensioner assembly including first and second arm members each rotatably coupled to lateral sides of the arm support member;
• a ratcheting member slidably received in the outer handle body and including a plurality of ratchet teeth in selective engagement with a pawl carried by the outer handle body, the ratchet teeth configured to maintain a position of the outer handle body relative to the ratcheting member upon movement of the outer handle body relative to the ratcheting member;
• and
• a drive shaft slidably received through and supported by the handle assembly such that proximal and distal ends of the drive shaft extend beyond respective proximal and distal ends of the handle assembly;
• wherein when the arm support member and arms are biased against the outer handle body, the arm support member and arms are locked in a non-deployed or deployed position;
• and
• wherein when tension is applied to the tensioner assembly such that the outer handle body moves apart from the arms and arm support member, the arms and arm support member are free to independently rotate about each of their respective axes.

A tensioner system for use in graft strand tensioning and fixation in a knee reconstruction procedure, comprising:

• a handle assembly including a hollow outer handle body and an inner handle body slidably received within the outer handle body, an arm support member rotatably coupled to a distal end of the inner handle body;
• a tensioner assembly coupled relative to the handle assembly, the tensioner assembly including first and second arm members each rotatably coupled to lateral sides of the arm support member;
• a ratcheting member slidably received in the outer handle body and including a plurality of ratchet teeth in selective engagement with a pawl carried by the outer handle body, the ratchet teeth configured to maintain a position of the outer handle body relative to the ratcheting member upon movement of the outer handle body relative to the ratcheting member;
• a drive shaft slidably received through and supported by the handle assembly;
• a self-locking adjustable flexible member construct having a pair of adjustable loops adapted to be coupled to graft strands;
• and
• a fixation member coupled to the adjustable flexible member construct;
• wherein the fixation member is adapted to fix the adjustable flexible member construct relative to a bone tunnel.