The present invention has multiple aspects relating to assembled self fixing bone-
tendon-bone (BTB) grafts and BTB implants. A preferred application in which self fixing assembled bone-
tendon-bone (BTB) grafts and implants of the present technology can be used is for ACL repairs in a
human patient. In one embodiment, a self fixing BTB graft is characterized by the presence of threads along at least a portion of the exterior surface of one or both bone blocks. In another embodiment, a self fixing assembled bone-
tendon-
bone implant comprises a removable tendon tensioner which imparts a predetermined tension on the tendon of the BTB graft. In this embodiment, the tensioner can be narrower than the
diameter of the bone blocks or can be threaded such that the threads are continuous with the threads of at least one of the bone blocks. The threads facilitate the simultaneous implantation of the leading and trailing bone blocks of the BTB graft in tapped (threaded) holes in the
tibia and the
femur of a recipient patient. The tensioner maintains the tension on the tendon and the spacing between the bone blocks until the leading
bone block is fixed (threaded) in the tapped hole in the
femur and the trailing
bone block is fixed (threaded) into the tapped
tibial bone tunnel. Once the bone blocks are substantially in their fixed positions, the tensioner is removed arthroscopically in the joint space between the
tibia and the
femur.