Progressive grip assembled bone-tendon-bone grafts, methods of making, and methods of use

An implant comprising:

• a tendon having a length, wherein the tendon comprises along its length at least a first end, a first intermediate section, a central section, a second intermediate section, and a second end;
• at least a first bone component having a naturally occurring attachment to the first end of the tendon;
• a bone block assembly comprising at least a first intermediate bone block and a second intermediate bone block;
• wherein the tendon is secured between the first intermediate bone block and the second intermediate bone block of the bone block assembly;
• and wherein the bone block assembly provides a first grip on the tendon prior to implantation and a second grip on the tendon after implantation;
• and
• wherein at least one of the first intermediate bone block or the second intermediate bone block comprises cancellous bone having a cortical cap or shell on at least one surface thereof;
• and
• further wherein at least one of the first intermediate bone block or the second intermediate bone block comprises a stress concentrating feature which is configured to separate in a predetermined manner during or after implantation of the implant into a patient;
• wherein the stress concentrating feature is formed by partially removing said cortical cap or shell from the center of said first intermediate bone block or said second intermediate bone block.

An assembled bone tendon bone implant comprising:

• a tendon having a length and an effective diameter;
• and
• a bone block assembly fixed along the length of the tendon, the bone block assembly comprising at least a first intermediate bone block and a second intermediate bone block, wherein the tendon is between the first intermediate bone block and the second intermediate bone block, and the first intermediate bone block and the second intermediate bone block are connected by at least one pin comprising cortical bone;
• and wherein at least one of the first intermediate bone block or the second intermediate bone block comprises cancellous bone having a cortical cap or shell on at least one surface thereof;
• and
• wherein the bone block assembly has an effective diameter of from about 9 mm to about 12 mm;
• wherein the effective diameter of the tendon is between about 80% and about 120% of the effective diameter of the bone block assembly;
• wherein the width of at least one of the first intermediate bone block or the second intermediate bone block is from about 8.5 mm to about 12 mm, the length of at least one of the first intermediate bone block or the second intermediate bone block is from about 15 mm to about 30 mm;
• and the height of at least one of the first intermediate bone block or the second intermediate bone block is from about 3 mm to about 5 mm;
• and
• further wherein at least one of the first intermediate bone block or the second intermediate bone block comprises a stress concentrating feature which is configured to separate in a predetermined manner during or after implantation of the implant into a patient;
• wherein the stress concentrating feature is formed by partially removing said cortical cap or shell from the center of said first intermediate bone block or said second intermediate bone block.