Abstract: An implant (5) for ligament and/or bone reconstruction is composed of biodegradable material suitable to be remodeled into vital bone and having mechanical strength for securely fixing a ligament in a bore or hole in bone with a press or form fit and/or reshaping a collapsed surface of bone into original shape. A surgical instrument (9) for ligament and/or bone reconstruction can be used to insert the implant (5) into bone and has a shaft member (3) having a first end (11), a second end and a longitudinal bore (15) having an inner diameter and pushing member (4) having a first end, second end and piston (16) in turn having an outer diameter smaller than or equal to inner diameter of the bore (10) so that the piston (16) of the pushing member (4) can be slidably arranged within the longitudinal bore (10).

Abstract: A graft ligament anchor comprises a graft ligament engagement member disposed in an opening in a bone, the graft ligament engagement member being arranged to receive a graft ligament alongside the engagement member, and a locking member for disposition in the opening, and at least in part engageable with the graft ligament engagement member. Movement of the locking member in the opening causes the locking member to urge the engagement member, and the graft ligament therewith, toward a wall of the opening, to secure the graft ligament to the wall of the opening. A method for attaching a graft ligament to a bone is also provided.

Abstract: A soft tissue tensioning system comprises a manual suture tensioning device having a bar and a finger guard which is orthogonal to the bar. A lateral suture cleat is disposed on each lateral end of the bar, and a primary suture cleat extends about a top and a bottom of each of the opposed lateral ends of the bar.

Abstract: A reinforced graft construct for repairing a tendon or ligament formed by inserting a piece of material, such as suture, through the graft lengthwise. The material may be inserted along only a portion of the graft or along the entire graft. The material may be a reinforcement (reinforcing) material such as suture, tape, weave, or mesh passed lengthwise through the graft (for example, along the center of the graft). The ends of the graft may be whipstiched to provide additional fixation when implanted. The material may be bioabsorbable such that it will resorb away after a period of time in the body.

Abstract: A system and method for securing an ACL graftmay include a line routed through a plate. The plate may include an elongated body with a plurality of passageways, and a dogbone feature on at least one end of the body. The line may be routed to create at least one one-way slide so no knots are required. The line may form an adjustable loop that receives the graft. The adjustable loop is adjustable through the one-way slide feature. The plate may be configured to pass through a bone tunnel. The plate may be toggled after passage through the bone tunnel to prevent withdrawal back through the bone tunnel because the plate contact area is larger the bone tunnel area.

Abstract: A system and method for attaching soft tissue to a prosthetic implant can include a prosthetic component that defines a soft tissue attachment region having an attachment surface thereon. A first construct can be formed of porous metal and be removably coupled to the attachment surface. A second construct can be positioned outboard of the soft tissue. A fastener can be engaged to the second construct capturing the soft tissue against the first construct. The fastener can be coupled on a distal end to the first prosthetic component.

Abstract: Disclosed herein is an improved Bone Tendon Bone graft for use in orthopedic surgical procedures. Specifically exemplified herein is a Bone Tendon Bone graft comprising one or more bone blocks having a groove cut into the surface thereof, wherein said groove is sufficient to accommodate a fixation screw. Also disclosed is a porcine bone tendon bone graft for use in orthopedic procedures. Also disclosed are multiple embodiments of assembled bone tendon bone blocks for use in orthopedic surgeries. Additionally, a method of harvesting grafts that has improved efficiency, increases the quantity of extracted tissue and minimizes time required by surgeon for implantation is disclosed.

Abstract: A jamming retainer for fixing a ligament in a bone tunnel without excessive sideways pressure on the ligament that may result in tissue necrosis, the jamming retainer including a substantially rigid body with a bore or loop for receiving a ligament or tendon and a bore or ring for receiving a suture for towing the jamming retainer and ligament or tendon through a bone tunnel. Once positioned, the jamming retainer is fixed in the bone tunnel with an interference screw.

Abstract: Various methods of ligament reconstruction are provided that can include extending a filament from at least one end of a graft having at least two ends, threading the graft through a first aperture in a first bone anchor, using the filament to affix the at least two ends of the graft to a second aperture of a second bone anchor, affixing the first bone anchor in hone, and affixing the second bone anchor in bone.

Abstract: Methods for fixation of a soft tissue graft in a bone including: forming in the bone a tunnel defining an entrance opening and an exit opening at opposite ends of the tunnel, the tunnel including an anterior wall surface and a posterior wall surface opposite to the anterior wall surface; positioning the soft tissue graft within the tunnel such that the soft tissue graft extends through both the entrance opening and the exit opening of the tunnel; inserting a graft fixation apparatus into the tunnel and driving spikes of the graft fixation apparatus into the posterior wall surface to mount the graft fixation apparatus to the posterior wall surface of the tunnel such that the graft fixation apparatus is anterior to the posterior wall surface and is not recessed beneath the posterior wall surface; and securing the soft tissue graft inside the tunnel with the graft fixation apparatus.

Abstract: A prosthetic device and method to restore extraocular muscle function. The device includes a housing; a biasing component disposed in the housing; a proximal connector operatively connected to a proximal end of the biasing component; and a distal connector operatively connected to a distal end of the biasing component, wherein the proximal connector is configured for being secured with respect to an orbital bone and the distal connector adapted to be secured to the paralyzed or absent muscle stump, e.g. on the globe, or to the eyelid.

Abstract: An intervertebral connection system wherein the bone anchor has a helical configuration, and includes: a) a conformable synthetic ligament having a first end portion and an intermediate portion, b) an anchor having a central axis which is axially implantable into a bone in a patient's body, the anchor comprising: i) a distal head portion having a body portion that extends transverse to the central axis of the anchor, a proximal surface, a distal surface, and an axially extending throughhole; ii) a first helix extending axially from the body portion of the distal head portion and transversely engagable with the bone, the first helix having a proximal end, a distal end, and an intermediate portion having an opening, wherein the first end portion of the ligament extends through the throughhole of the distal head portion of the anchor, and wherein the intermediate portion of the ligament extends through the opening within the intermediate portion of the helix.

Abstract: A novel cross-pin for use in ACL reconstructive surgical procedures. The cross-pin has an elongated body having a distal tapered end. A guide wire opening in the distal end is in communication with a tunnel contained in the distal end. There is a trough extending into the outer surface of the trough for receiving a guide wire. The trough is in communication with the tunnel.

Abstract: An interarticular ligament prosthesis is formed from a plurality of high strength high modulus polymeric fibers. The fibers are independent and free from intrinsic inter-fiber shear coupling found in braided or bonded fibers. The ligament prosthesis is installed with tubular, bone screw anchors. The fibers of the ligament prosthesis pass through the central hole of the anchors and are knotted at one end. The exit holes of the anchors include ceramic eyelets with polished edges. The edges are rounded to a defined radius for desired fatigue life of the prosthesis.

Abstract: A method for fixing a bone block in a bone tunnel comprising the steps of placing the bone block in the bone tunnel, advancing spaced-apart first and second metal wires through the bone, transversely of the bone tunnel, so as to intersect the bone block and extend through the bone block, removing one of the wires and replacing the one removed wire with a first absorbable rod, and removing the other of the wires and replacing the other removed wire with a second absorbable rod, whereby to retain the bone block in the bone tunnel with the absorbable rods.

Abstract: An anchor assembly for retaining a graft in an anatomy. The anchor assembly includes an anchor body, a flexible connector, and a graft holding member. The anchor body includes a first connector bore defined by the anchor body. The flexible connector extends through the first connector bore. The graft holding member is attached to the flexible connector and is configured to hold the graft.

Abstract: Disclosed herein is processed dermis graft for use in orthopedic surgical procedures. Specifically exemplified herein is a processed dermis graft comprising one or more bone blacks having a groove cut into the surface thereof, wherein said groove is sufficient to accommodate a fixation screw. Also disclosed is a method of processing dermis that results in a dermis derived implant suitable to replace a tendon or ligament in a recipient in need thereof. Other compositions and applications of a dermis derived implant, and methods of manufacture and use, are disclosed.

Abstract: A method for fixing a bone block in a bone tunnel comprising the steps of placing the bone block in the bone tunnel, advancing spaced-apart first and second metal wires through the bone, transversely of the bone tunnel, so as to intersect the bone block and extend through the bone block, removing one of the wires and replacing the one removed wire with a first absorbable rod, and removing the other of the wires and replacing the other removed wire with a second absorbable rod, whereby to retain the bone block in the bone tunnel with the absorbable rods.

Abstract: A method and apparatus for tendon repair includes an elongated member of a generally tubular shape having two barbed sections with oppositely directed barbs and a middle portion between the barbed sections. The barbs are cut from the tubular body leaving a mesh-like body of interconnected struts. The middle portion is also formed of interconnected struts. A needle and suture is connected at both opposite ends of the elongated member and used to pull the barbed sections into respective ends of a severed tendon. The barbs bite into the tendon tissue to hold the ends together. The sutures are preferably cut off at the tendon surface at a location spaced from the rejoined ends. One or more of the tendon repair devices may be used to repair each tendon, optionally with perimeter stitching at the rejoined ends.

Abstract: A method of replacing an ACL with a graft. The method provides for the drilling bone tunnels in a femur and a tibia. A replacement graft is provided having first and second ends. A biodegradable composite screw is provided. The screw is made from a biodegradable polymer and a bioceramic or a bioglass. At least one end of the graft is secured in a bone tunnel using the biodegradable composite screw.

Abstract: A material fixation system is particularly adapted to improve the tendon-to-bone fixation of hamstring autografts, as well as other soft tissue ACL reconstruction techniques. The system is easy to use, requires no additional accessories, uses only a single drill hole, and can be implanted by one person. Additionally, it replicates the native ACL by compressing the tendons against the aperture of the tibial tunnel, which leads to a shorter graft and increased graft stiffness. It is adapted to accommodate single or double tendon bundle autografts or allografts. It also provides pull out strength measured to be greater than 1000 N.

Abstract: The present invention is directed towards a prosthetic anchor (36) including a central layer (1) through which embedded fibers (2), such as artificial tendons, pass in defined pathways (4), a ‘deep’ surface membrane (7) which interfaces with a hard structure, whether that is a prosthesis, a bone, or other hard tissue, and a ‘superficial’ surface membrane (8) which interfaces adjacent tissue and may be configured to adhere or not to adhere to that tissue. The central layer (1) is positioned intermediate the surface membranes (7, 8) which are mechanically and/or adherently attached thereto. Also, non-limiting examples of methods of fabrication and of affixing the anchor (36) to a relatively rigid structure, natural or prosthetic, in a human or animal body with improved stress distribution in the fixed tension member end are taught.

Abstract: A graft ligament anchor comprises a graft ligament engagement member disposed in an opening in a bone, the graft ligament engagement member being arranged to receive a graft ligament alongside the engagement member, and a locking member for disposition in the opening, and at least in part engageable with the graft ligament engagement member. Movement of the locking member in the opening causes the locking member to urge the engagement member, and the graft ligament therewith, toward a wall of the opening, to secure the graft ligament to the wall of the opening.

Abstract: A system for use in reconstructing a ligament is provided. The system includes a graft ligament support block and an installation tool. The support block includes a body having a distal and proximal ends and a longitudinal axis extending therebetween, the proximal end being tapered so as to facilitate withdrawal of the support block through a bone tunnel, a graft hole extending through the body transverse to the longitudinal axis and configured to receive a graft ligament therein and a transverse fixation pin hole extending through the body transverse to the longitudinal axis and configured to receive a transverse fixation pin therein. The installation tool includes a holder having a shaft with distal and proximal ends and longitudinal axis extending therebetween, the proximal end of the shaft including at least one finger for engagement in the opening and a handle mounted to the proximal end of the shaft.

Abstract: A graft ligament anchor includes a tubular body having a bore therethrough and proximal and distal ends. A flange is attached to the tubular body at the proximal end thereof and extends radially outwardly beyond the tubular body. A deformable wall is disposed in the tubular body bore and defines, at least in part, a chamber for retaining the graft ligament therein. An expansion device is configured for insertion into the tubular body axially of the tubular body, and for impinging upon the deformable wall to press the deformable wall, and hence the graft ligament received in the chamber, toward a wall of the bore, whereby to fix the graft ligament in the tubular body.

Abstract: A method for securing a graft to a bone includes forming a tunnel in the bone, positioning the graft in the tunnel, and securing the graft in the tunnel with an anchor. The method also includes attaching a distal end of an elongated anchor sleeve to a proximal end of the anchor and inserting a pre-compressed harvested bone material having a cruciate cross-section through the anchor sleeve into to a bore defined in the anchor. The bore has a mating cruciate cross-section. The method also includes removing the anchor sleeve after inserting the bone material into the anchor.

Abstract: A method for securing first and second tissues with a suture anchor. The method includes forming a borehole in the first tissue; threading a suture through the second tissue forming a loop in the suture with the tissue thereby secured in the loop, the loop defining two suture portions; attaching the two suture portions to the anchor whereby the two suture portions are threaded through the anchor and initially movable with respect to the anchor; and providing a force to a shaft of the anchor, the force causing clamping of the two suture portions in the anchor and deformation of a deformable portion of the anchor to cause the deformable portion to engage a wall of the borehole thereby to secure the suture anchor in the first tissue and the loop holding the second tissue to the suture anchor.

Abstract: A method of replacing an ACL with a graft. The method provides for the drilling bone tunnels in a femur and a tibia. A replacement graft is provided having first and second ends. A biodegradable composite screw is provided. The screw is made from a biodegradable polymer and a bioceramic or a bioglass. At least one end of the graft is secured in a bone tunnel using the biodegradable composite screw.

Abstract: A system for use in graft fixation in a knee reconstruction procedure can include a first femoral fixation member adapted to be retained relative to a first end of a femoral tunnel and a first self-locking adjustable flexible member construct having a passage portion with a pair of free ends and a pair of self-locking adjustable loops. The first flexible member construct can be interconnected to the first femoral fixation member. A second femoral fixation member can be coupled to the first flexible member construct and can be adapted to be positioned in the femoral tunnel relative to a second end of the femoral tunnel adjacent a joint space between the femur and a tibia. A second self-locking adjustable flexible member construct having a passage portion with a pair of free ends and a pair of self-locking adjustable loops can be interconnected to the second femoral fixation member.

Abstract: The present technology is related to the field of bone-tendon-bone implants, grafts, and components thereof, for implantation in mammals, particularly for implantation in humans. More particularly, the present technology relates to assembled implants that comprise a length of tendon and at least two bone components or intermediate bone blocks that are assembled to form a bone-tendon-bone implant, and methods of making such implants. In some embodiments, implants of the present technology provide a first grip on the tendon prior to implantation and a second grip during or after implantation. In some embodiments, bone block assemblies or intermediate bone blocks of the present technology have a first geometric configuration prior to implantation and a second geometric configuration during or after implantation.

Abstract: A solid implantable bone construct (12) shaped like a cylinder, a cone, or a frustum, for anchoring ligament implants. The bone construct (12) can include a bone component and a biocompatible solid component. The bone component can include particulate bone of between 75 and 600 microns, powdered bone of 75 microns or smaller in size, or both. The biocompatible solid component can include calcium sulfate hemihydrate, a calcium phosphate product, or both. The bone component can be between 5 and 50 wt-% of the construct (12) and the biocompatible solid component can be at least 50 wt-% of the construct (12). Also disclosed is a composite graft (10) comprising a first bone dowel (12) and a ligament (20) and a method of securing one bone to another using the composite graft (10).

Abstract: A method for securing a soft tissue replacement in a bone tunnel includes forming a first and second tunnel in the bone. The second tunnel intersects the first tunnel and defines a first and second access passage. A first flexible member is passed through the tunnel and includes a first end extending out of the first passage, an intermediate portion supporting the soft tissue replacement and a second end extending out of the second passage. The first end of the first flexible member is fastened to an insertion member. A crosspin is positioned between the first passage and the insertion member. The second end of the first flexible member is advanced until a distal portion of the crosspin advances into the first access passage. The insertion member is impacted thereby pushing the crosspin into an engaged position with the bone.

Abstract: Anterior cruciate ligament reconstruction methods and devices are designed to achieve an anatomically accurate double bundle anterior cruciate ligament reconstruction by using a single femoral and tibial tunnel. The method and devices reconstruct the two bundles of the anterior cruciate ligament in a single femoral and tibial tunnel using a bone-patellar tendon-bone graft. The methods and devices enable an accurate anatomical reconstruction of the anteromedial and posterolateral bundles by creating a single femoral and tibial tunnel as opposed to creating two tunnels in the tibia and femur.

Abstract: Methods and devices may be used to compress and fix soft tissue to bone. Exemplary embodiments described including methods of fixing tendon to bone in an anterior cruciate ligament replacement surgery. Through compressing tendon in situ within bone, tendons may be fixed to bone while limiting axial movement of tendons and adverse effects on tendon tension.

Abstract: A soft tissue fixation system, most typically applicable to orthopedic joint repairs, such as anterior cruciate ligament (ACL) knee repair procedures, comprises an implant which is placeable in a tunnel disposed in a portion of bone, wherein the tunnel is defined by walls comprised of bone. A first member is deployable outwardly to engage the tunnel walls for anchoring the implant in place in the tunnel, and a second member is deployable outwardly to engage tissue material to be fixed within the tunnel. The second member also functions to move the tissue material outwardly into contact with the tunnel walls to promote tendon-bone fixation. Extra graft length is eliminated by compression of the tendon against the bone at the aperture of the femoral tunnel, which more closely replicates the native ACL and increases graft stiffness. The inventive device provides high fixation of tendon to bone and active tendon-bone compression.

Abstract: A soft tissue fixation system, most typically applicable to orthopedic joint repairs, such as anterior cruciate ligament (ACL) knee repair procedures, comprises an implant which is placeable in a tunnel disposed in a portion of bone, wherein the tunnel is defined by walls comprised of bone. A first member is deployable outwardly to engage the tunnel walls for anchoring the implant in place in the tunnel, and a second member is deployable outwardly to engage tissue material to be fixed within the tunnel. The second member also functions to move the tissue material outwardly into contact with the tunnel walls to promote tendon-bone fixation. Extra graft length is eliminated by compression of the tendon against the bone at the aperture of the femoral tunnel, which more closely replicates the native ACL and increases graft stiffness. The inventive device provides high fixation of tendon to bone and active tendon-bone compression.

Abstract: A system and method for securing an ACL graft. The system may comprise a line routed through a plate, the plate may comprise an elongated body with a plurality of passageways, and a dogbone feature on one end. The line is routed such to create at least one one-way slide so no knots are required. The line may comprise an adjustable loop that receives the graft. The adjustable loop is adjustable through the one-way slide feature of the line routed around and through the plate. The plate may be configured to pass through a bone tunnel with the use of filaments routed through the passageways of the plate or around the dogbone feature of the plate. The filaments may be used to toggle the plate after passage through the bone tunnel to prevent withdrawal back through the bone tunnel because the plate contact area is larger the bone tunnel area.

Abstract: A method and apparatus for reattaching the opposed ends of a member, such as a tendon, ligament or bone, during preparing and healing of the member using a surgical repair device that can be securely attached to the member and then safely guided through tortuous anatomy for reattachment and repair. The repair device further includes structural means so as to secure opposed ends of the member against separation during healing. Devices for aiding in the positioning of the surgical repair device are provided.

Abstract: A material fixation system is particularly adapted to improve the tendon-to-bone fixation of hamstring autografts, as well as other soft tissue ACL reconstruction techniques. The system is easy to use, requires no additional accessories, uses only a single drill hole, and can be implanted by one person. Additionally, it replicates the native ACL by compressing the tendons against the aperture of the tibial tunnel, which leads to a shorter graft and increased graft stiffness. It is adapted to accommodate single or double tendon bundle autografts or allografts. It also provides pull out strength measured to be greater than 1000 N.

Abstract: An apparatus and method for performing a surgery, especially an ACL replacement surgery, where a flexible strand insertion rod co-operates with a U-Guide apparatus to insert a flexible strand into a tunnel formed in a bone portion and to guide a pair of drill points to form a pair of tunnels transversely to the tunnel of the insertion rod. The drill points are guided through the insertion rod and the flexible strand is held over the drill points as the transverse tunnels are formed. The insertion rod is then removed from the tunnels formed in the bone and the flexible strand is held looped over the second drill point. Subsequently, a soft tissue replacement is affixed to one end of the flexible strand and pulled over up to the first drill point with the other end of the flexible strand. The first drill point is then used to pull a cross pin through the transverse tunnel to hold the looped end of the soft tissue replacement in place.

Abstract: A novel fixation system for fixing a graft ligament in a bone tunnel. The fixation system comprises an interference screw comprising a body having a distal end and a proximal end, screw threads extending longitudinally along the body, and a transversely-extending region formed in the body for receiving a transverse pin therein, whereby to securely lock the interference screw, and hence the graft ligament, to the bone. In accordance with a further feature of the present invention, there is provided a method for attaching a graft ligament to a bone, the method comprising the steps of: (i) drilling a tunnel in the bone; (ii) positioning the graft ligament in the bone tunnel; (iii) placing an interference screw in the bone tunnel so as to force the graft ligament laterally against the opposite side of the bone tunnel; and (iv) advancing a transverse pin transversely through the bone and through the interference screw so as to securely lock the interference screw, and hence the graft ligament, to the bone.

Abstract: A system for single tunnel, double bundle anterior cruciate ligament reconstruction includes implant constructs and instruments. The implant constructs provide a combination of cortical fixation and bone tunnel aperture fixation. The implant constructs separate a graft into distinct bundles. The instruments are used to prepare shaped bone tunnels to receive the implant constructs and graft bundles. Methods for reconstructing the antero-medial and postero-lateral bundles of the anterior cruciate ligament may rely on single femoral and tibial tunnels and a single strand of graft.

Abstract: A system and method for sharing and absorbing energy between body parts. In one aspect, the method involves identifying link pivot locations, fixing base components and minimally invasive insertion techniques. In one particular aspect, the system facilitates absorbing energy between members forming a joint such as between articulating bones.

Abstract: System, including methods, apparatus and components thereof, and kits, for connecting to bone using an anchor element configured to be anchored in bone and having a selectively bendable hinge region. In some embodiments, the system may connect the anchor element to connective tissue, a bridge member, and/or to another anchor element by bending the hinge region while the anchor element is disposed in bone, thereby connecting bone to the connective tissue or bridge member, and/or connecting bone members.

Abstract: A placement assembly used for positioning and holding a ligament graft within a selected bone tunnel. The assembly includes a graft pulley, a surgical suture, and a graft pulley placement instrument. The graft pulley includes a pulley portion and a bone anchoring portion. The pulley portion is adapted to receive the surgical suture and for surgical suture to be drawn through it, to act as a pulley. The bone anchoring portion comprises a portion adapted to selectively fix the graft pulley within a bone tunnel. The graft instrument may be selectively attached to the graft pulley and includes a handle and elongate body, adapted to insert the graft pulley into the selected bone tunnel. Once the graft pulley is in place, the placement instrument may then be detached and withdrawn leaving the graft pulley firmly fixed within the bone tunnel and can then be used to position a ligament graft.

Abstract: A graft fixation system for fixing graft material in a bone tunnel includes an expandable fixation member having a graft receiving eyelet disposed proximate its distal end, opposed bone engaging elements disposed about its periphery, and an expansion plug receiving opening defined in its proximal end. The system also includes an expansion plug having a diameter greater than the diameter of the expansion plug receiving opening so that forcible insertion of the expansion plug into the expansion plug receiving opening causes an expansion of the expandable fixation member driving the opposed bone engaging elements apart so as to fix the bone engaging elements, as well as the graft material, in a bone tunnel.

Abstract: A graft fixation device for fixing a ligament graft to a bone, the device comprising locating means for locating the device in the bone and graft support means arranged to support the graft, wherein the graft support means is adjustable to provide adjustment of the position of the graft relative to the bone.

Abstract: A tendon anchoring device may include an implant having a pair of spaced apart legs for straddling a tendon. A push rod removably attached to the implant may be utilized to guide and push a portion of the tendon into a pre-drilled bore in a bone. A fixation member may be slid along the push rod and threadably engage an inner surface of the pre-drilled bore to thereby anchor the tendon to the bone while a force is applied to the push rod. Once the fixation member has been installed, the push rod may be disengaged from the implant and removed from the bore. The implant may remain permanently straddled over the tendon inside of the bore.

Abstract: A tendon anchoring device may include an implant having a pair of spaced apart legs for straddling a tendon. A push rod removably attached to the implant may be utilized to guide and push a portion of the tendon into a pre-drilled bore in a bone. A fixation member may be slid along the push rod and threadably engage an inner surface of the pre-drilled bore to thereby anchor the tendon to the bone while a force is applied to the push rod. Once the fixation member has been installed, the push rod may be disengaged from the implant and removed from the bore. The implant may remain permanently straddled over the tendon inside of the bore.

Abstract: A method of securing a graft in a bone tunnel, in which graft is secured within the tunnel at both the entrance and the exit ends of the tunnel to provide bicortical fixation of the graft in the bone. Interference screws or other fixation devices are used to secure the graft within the tunnel. For tibial tunnel fixation using an interference screw, the back end of the distal screw is angled so that it closely approximates the angle of the outer tibial tunnel rim. The distal screw is non-cannulated to prevent hematomas from being formed by blood flowing from the tibial tunnel into the surrounding soft tissue. The proximal screw has a restricted cannula to minimize the flow of synovial fluid entering the tibial tunnel. Advantageously, the space between the two screws fills with blood to promote faster healing and incorporation of the graft in the tibial tunnel.