Apparatus for and methods of inserting implants are disclosed wherein the apparatus includes a handle portion and a body portion attached to the handle portion and defining a longitudinal axis. The body portion includes an outer tubular member fixed relative to the handle portion for rotation therewith about the longitudinal axis. The outer tube member has first implant engaging structure adjacent a distal end. An inner tubular member is disposed at least partially within the outer tubular member and is mounted for longitudinal motion relative to the outer tubular member. Second implant engaging structure is positioned adjacent a distal end of the inner tubular member. The body portion further includes an inner shaft, coaxially mounted at least partially within the inner tubular member for independent rotation relative to the inner and outer tubular members, the inner shaft having third implant engaging structure adjacent a distal end. In a method for inserting an implant having a hollow portion with a closed distal end and a removable cap, the first, second and third implant engaging structures are attached to the implant with at least one of the engaging structure attached to the removable cap and another of the engaging structure attached to the hollow portion. The implant is preferably preloaded with bone chips and/or bone growth inducing substances prior to attachment. Thereafter, the preloaded implant is inserted into the desired surgical location.