Implants and procedures for joint fusion make use of implants comprising cortical bone. The implants have lamellae that are generally aligned. In some embodiments, the implants can have indicia that indicate the alignment of the lamellae within the joint. In some embodiments, the implants comprise a plurality of implant elements, with the implant elements oriented so that the lamellae of the elements are aligned with each other. The implants can be inserted into a joint with the lamellae aligned across the joint to resist compression or deforming forces of the joint and to provide for improved implant strength. In some embodiments, the implants can be inserted into a joint over a pin and/or through a cannula to help guide the implant to the implant site within the joint. In some embodiments, the implants can be desirably formed from bone plugs harvested from long bones.
