Method and apparatus for coupling anatomical features

A method of coupling a first portion of an anatomy to a second portion of the anatomy comprising:

• forming a tibial bore in a tibial bone of the anatomy;
• forming a femoral bore in a femoral bone of the anatomy;
• coupling the tibial and femoral bones with a bone-tendon-bone implant, wherein the bone-tendon-bone implant has tibial bone end, a femoral bone end and a replacement tendon between the tibial and femoral bone ends;
• positioning the tibial bone end in the tibial bore;
• securing the tibial bone end with an interference anchor in the tibial bone;
• positioning the femoral bone end in the femoral bore;
• passing a toggle anchor coupled to the bone-tendon-bone implant through and outside the femoral bore in a first orientation substantially aligned with the femoral bore, the toggle anchor coupled to an adjustable suture construct having a first end and a second end, wherein the adjustable suture construct includes a passage portion defined by a body of a suture used to form the adjustable suture construct and first and second adjustable loops slidable relative to the passage portion;
• rotating the toggle anchor to a second orientation transverse to the first orientation outside the femoral bore;
• and
• tensioning at least one of the first and second ends of the adjustable suture construct to adjust a size of the first and second adjustable loops to tension the replacement tendon and position the tibial bone relative to the femoral bone.

A method of coupling a first portion of an anatomy to a second portion of the anatomy comprising:

• forming a first bore in a first bone of the anatomy;
• forming a second bore in a second bone of the anatomy;
• positioning a first bone end of a bone-tendon-bone implant in the first bore;
• positioning a second bone end of the bone-tendon-bone implant in the second bore, wherein a replacement tendon is between the first and second bone ends;
• securing the first bone end in the first bore with a first anchor and the second bone end in the second bore with a second anchor, wherein the second anchor is positioned outside the second bore and is coupled to an adjustable suture construct having a passage portion defined by a body of a suture used to form first and second adjustable loops that pass through the passage portion;
• pulling a first end and a second end of the suture construct to adjust a size of the first and second adjustable loops and position the first bone relative to the second bone.