A
graft fixation device,
system and method are disclosed for reconstruction or replacement of a
ligament or
tendon preferably wherein a
soft tissue graft or a bone-
tendon-bone graft is received and implanted in a
bone tunnel. The
graft fixation system includes a fixation device comprising a threaded body which is rotatably connected to a graft interface member. One embodiment of the
implant / graft interface member includes an enclosed loop for holding a
soft tissue graft. Another embodiment of the interface member includes a bone cage comprising a cage bottom and removable cage top to hold a
bone block at one end of a bone-
tendon-bone (BTB) graft. An additional embodiment of the interface member includes a one-piece bone cage which may be crimped or stapled to a
bone block. The fixation device holds a graft in centered axial alignment in a
bone tunnel. The body portion of the fixation device may be turned without imparting substantial twist to a graft attached to the device, due to the rotatable
coupling between the threaded body and the interface member. The fixation device may be installed using a driver tool that has a shaft and an outer sleeve, wherein the driver may be used to twist the fixation device and independently exert a pushing or pulling force thereto. The
graft fixation method may be used to install a fixation device by pulling or pushing it into a prepared
bone tunnel while minimizing the possibility of abrasion or other damage to a graft attached to the fixation device.