Graft Preparation Board – ACL and PCL Ligament Reconstruction Graft Preparation System

The Graft Preparation Board from Peak Surgicals (SKU: PS-OP-5858, PS-100 series) is a 10-piece ligament reconstruction graft preparation system in stainless steel, designed for the complete ex-situ preparation workflow of soft-tissue and bone-tendon-bone grafts for ACL reconstruction, PCL reconstruction, multiligament repair, and other intra-articular ligament reconstruction procedures — covering graft support and organisation on a Graft Preparation Board, positional adjustment with a Graft Board Sliding Base, soft tissue control with a Graft Board Tissue Grasper, graft trimming to the correct diameter with a Graft Board Cutting Strip, graft diameter sizing with a Graft Board Slotted Sizing Block, graft loop management with a Loop Holder, suture tension application and measurement with a Suture Vise with Tensiometer, mechanical tensioning post loading with a Tensioning Post, BTB (bone-tendon-bone) graft stabilisation with a Graft Board BTB Holder, and standalone suture management with a Suture Vise, all in an aluminium box. It is used by orthopaedic surgeons and sports medicine surgeons performing arthroscopic or open ligament reconstruction in hospital operating theatres and ambulatory surgery centres where the graft is prepared on the back table while the primary surgeon performs the arthroscopic portion of the procedure.

ACL and PCL Graft Preparation: The Role of the Graft Board in Ligament Reconstruction

In ACL, PCL, and multiligament reconstruction, the graft — whether a hamstring soft-tissue autograft (semitendinosus and gracilis tendons), a bone-patellar tendon-bone (BTB) autograft, a quadriceps tendon graft, or a soft-tissue allograft — must be prepared on the back table during the arthroscopic phase of the procedure. Back-table graft preparation involves stripping the soft tissue from the harvested tendons, tubularising the graft to the correct diameter, sizing the graft diameter against the planned tunnel drill size to confirm the tunnel and graft match, applying sutures to the graft ends for graft passage and fixation, tensioning the graft at a calibrated load to remove slack from the graft collagen fibres before implantation, and holding the prepared graft at the appropriate tension until it is passed into the tunnel. The Graft Preparation Board provides the organised platform and specialised instruments for each of these preparation steps, allowing the graft preparation to proceed efficiently by the surgical assistant or scrub nurse while the primary surgeon performs the arthroscopic femoral and tibial tunnel preparation steps. Efficient graft preparation reduces total surgical time and ensures the graft is ready at the correct tension at the precise moment it is needed for passage.

Graft Board, Sliding Base, Tissue Grasper, and Cutting Strip

The Graft Preparation Board (PS-100.086) is the primary work surface — a stable flat platform with integral mounting points for the other instruments of the system, providing an organised layout that keeps each instrument in a fixed position relative to the graft during preparation. The Graft Board Sliding Base (PS-100.087) provides the adjustable positional base for the board assembly, allowing the scrub nurse to reposition the entire preparation surface relative to the back table without disturbing the instruments or the graft in preparation. The Graft Board Tissue Grasper (PS-100.088) provides the controlled grip on soft graft tissue during stripping and tubularisation — the grasper holds the tendon body under controlled tension while the surgeon or assistant strips the muscle from the tendon surface and prepares the tendon ends, providing the mechanical stability that allows uniform force to be applied along the tendon length without requiring manual grip that fatigues the holding hand. The Graft Board Cutting Strip (PS-100.089) is the calibrated trimming guide for cutting the graft tubule or graft ends to the correct diameter — the strip provides a series of calibrated apertures corresponding to common graft diameters (typically 7–10mm for ACL soft-tissue grafts) through which the tubularised graft is advanced to confirm it passes at the planned drill diameter before the tunnels are drilled, and serves as a trimming guide for removing excess tissue from the graft body to achieve the target diameter.

Slotted Sizing Block, Loop Holder, BTB Holder, and Tensioning Post

The Graft Board Slotted Sizing Block (PS-100.090) provides the precision diameter-sizing step for the prepared graft — a slotted block with calibrated slots in 0.5mm or 1mm increments through which the assembled graft (with sutures applied) is advanced to confirm the total graft diameter including all suture wraps. This is the final confirmation diameter that determines the drill bit size used for the femoral and tibial tunnels, and any discrepancy between the sizing block result and the planned tunnel diameter allows the surgeon to adjust the tunnel size before drilling rather than after, when the tunnel cannot be reduced. The Graft Board BTB Holder (PS-100.094) is the specialised stabilisation instrument for bone-patellar tendon-bone grafts, which require specific handling because the bone plugs at each end of the BTB graft must be sized and shaped to fit the cylindrical bone tunnel while the intervening patellar tendon segment must be protected from crush injury. The BTB Holder grips the bone plug sections of the graft securely while the bone plug dimensions are confirmed and the plug is shaped if needed. The Loop Holder (PS-100.091) manages the continuous-loop or closed-loop suture configurations used in soft-tissue graft fixation systems, where the graft strands are folded over a suture loop that is passed through the femoral socket and looped over the fixation button — the Loop Holder keeps the folded graft and its loops under controlled orientation during suture application. The Tensioning Post (PS-100.093) provides the fixed post around which the suture ends are wrapped after the graft is assembled, applying a calibrated tension to the graft body by loading the free suture ends with a weight or tension device while the Suture Vise with Tensiometer holds the graft at the correct cyclic pre-tension load before implantation.

Suture Vise with Tensiometer and Suture Vise

The Suture Vise with Tensiometer (PS-100.092) is the tension measurement and application instrument — it grips the suture ends at each end of the assembled graft and applies a measured tensile load to the graft body. Pre-tensioning the graft on the back table before implantation removes the initial crimp and slack from the collagen fibre bundles of the tendon graft, reducing the post-implantation graft elongation that occurs when a non-pre-tensioned graft is loaded for the first time in the tunnel after fixation. This post-implantation elongation — called creep — produces clinical graft laxity and is a recognised cause of residual instability after ACL reconstruction. The tensiometer component of the Suture Vise with Tensiometer measures the applied tension in Newtons or kilograms, allowing the preparation team to confirm that the target pre-tension load has been reached before the graft is passed. The Suture Vise (PS-100.102) is a standalone suture-gripping vise used to hold individual suture strands under tension during the suture-passing and whip-stitch application steps of graft preparation, freeing the graft preparation surgeon's hands for the suturing manoeuvre itself rather than requiring them to hold the suture end under tension while simultaneously advancing the suture needle.

CE Mark, ISO 13485, and FDA Certification for Graft Preparation Instrumentation Procurement

The Graft Preparation Board is manufactured under CE Mark, ISO 13485, and FDA compliant quality standards. ISO 13485 certification confirms Peak Surgicals operates a documented quality management system covering design control, material traceability, and production consistency for orthopaedic surgical instruments. CE Mark confirms conformity with European medical device regulations, and FDA compliance supports procurement for US-based hospitals, sports medicine surgery centres, and orthopaedic departments requiring verified regulatory documentation for ligament reconstruction graft preparation instrument purchases.

Product Specifications

Frequently Asked Questions

What graft types is this set used for?
The Graft Preparation Board set is used for the preparation of both soft-tissue grafts and bone-tendon-bone grafts for ligament reconstruction. Soft-tissue graft indications include hamstring autograft (semitendinosus and gracilis tendons, prepared as a quadruple- or double-strand graft for ACL reconstruction), quadriceps tendon autograft, and soft-tissue allograft tendons (Achilles tendon, tibialis anterior, peroneus longus) used in ACL, PCL, and multiligament reconstruction. The Graft Board Tissue Grasper, Cutting Strip, Slotted Sizing Block, Loop Holder, Suture Vise with Tensiometer, Suture Vise, and Tensioning Post address the soft-tissue graft preparation workflow. The Graft Board BTB Holder (PS-100.094) specifically addresses bone-patellar tendon-bone autograft preparation, providing the stabilisation needed while the bone plug dimensions are confirmed and the patellar tendon segment is protected from compression injury during handling.

Why is graft pre-tensioning important and how does the Suture Vise with Tensiometer contribute?
Tendon grafts used for ligament reconstruction are viscoelastic structures — when a tensile load is applied, the graft elongates over time through a phenomenon called creep, as the crimp and slack in the collagen fibre bundles is progressively removed. If a graft is implanted without pre-tensioning, the initial post-operative loading of the reconstructed ligament during rehabilitation applies these loads to the graft for the first time in situ, causing creep-related graft elongation and clinical laxity — the patient's knee remains unstable despite a technically correct reconstruction. Pre-tensioning the graft on the back table before implantation applies a controlled cyclic or sustained load to the graft to remove the initial crimp phase of the creep curve, so that when the graft is implanted and loaded in vivo, it has already traversed this initial elongation region and its response to physiological loads is stiffer and more ligament-like. The Suture Vise with Tensiometer (PS-100.092) applies a measured tension to the suture-assembled graft and confirms the applied load, ensuring consistent pre-tensioning across cases regardless of the individual preparation surgeon's tactile judgement.

What is the difference between the Slotted Sizing Block and the Cutting Strip?
The Graft Board Cutting Strip (PS-100.089) is used earlier in the preparation sequence — it provides a trimming guide for removing excess soft tissue from the graft body to achieve the target tubularised diameter, serving as a calibrated reference against which the graft body is trimmed before the final suture application. The Graft Board Slotted Sizing Block (PS-100.090) is used after sutures have been applied to the graft — it provides the final confirmation diameter of the complete assembled graft including all suture wraps and any graft diameter variations along the body length. The sizing block is the measurement that directly determines the drill bit size used for the femoral and tibial bone tunnels: the surgeon confirms the graft passes through the target slot without resistance, then drills the tunnels at the corresponding diameter. If the assembled graft is larger than expected due to suture bulk, the surgeon can adjust the tunnel size before drilling rather than discovering the mismatch at graft passage after the tunnels are complete.

Is this set used on the sterile back table or by the primary surgeon at the joint?
The Graft Preparation Board system is a back-table preparation set — it is used by the scrub nurse, surgical technician, or assistant surgeon at the sterile back table adjacent to the operating field, not at the joint by the primary surgeon. In most ACL reconstruction workflows, the graft is harvested by the primary surgeon (hamstring harvest or patellar tendon harvest), then passed to the scrub nurse or assistant who performs the back-table preparation using the Graft Preparation Board while the primary surgeon performs the arthroscopic notch preparation, notchplasty, and tibial and femoral tunnel drilling steps. The graft should be fully prepared and pre-tensioned at the Tensioning Post by the time the tunnels are drilled and the primary surgeon is ready for graft passage, minimising the time the graft is off-tension waiting for passage.

What certifications does this set carry?
The Graft Preparation Board is manufactured under CE Mark, ISO 13485, and FDA compliant quality standards. ISO 13485 certification confirms Peak Surgicals operates a documented quality management system covering design control, material traceability, and manufacturing consistency for orthopaedic surgical instruments. CE Mark confirms conformity with European medical device regulations, and FDA compliance supports procurement for US hospitals, sports medicine surgery centres, and orthopaedic departments requiring verified regulatory documentation for ligament reconstruction graft preparation instrument purchases.