A tensioner for a tightening a surgical knot has a squeeze handle and a pair of jaw arms that pivot from a common point behind the handle. The jaw arms have a jaw clamp at the distal tip to clamp onto the suture material, and a release handle at the proximal or butt end. A spreader or distractor mechanism may be a pantographic arrangement of struts joined to anchor points on the jaw arms. This converts axial motion of an actuator rod into a lateral distractive force. A tension gauge in the handle indicates the amount of tension being applied to the suture material.