Apparatus and method for use in positioning an anchor

• US 6,312,448 B1
• Filed: 01/07/2000
• Issued: 11/06/2001
• Est. Priority Date: 11/15/1996
• Status: Expired due to Term

• Current Assignee: Bonutti Skeletal Innovations LLC (Acacia Research Corporation)
• Original Assignee: Peter M. Bonutti
• Inventors: Bonutti, Peter M.
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US09/479,647
• Time in Patent Office: 669 Days
• Field of Search: 606/232, 606/104, 606/213, 606/72
• US Class Current: 606/232
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/17 Guides or aligning means for drills , mills, pins or wires
• CPC Class Codes: A61B 17/1796 for holes for sutures or flexible wires
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 2017/00455 Orientation indicators, e.g. recess on the handle
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2090/034 abutting on parts of the device itself
• CPC Class Codes: A61B 2090/062 penetration depth

Abstract

An apparatus for use in positioning an anchor includes a tubular outer member and an inner or pusher member. During use of the apparatus, a slot facilitates visualization of the position of the anchor relative to body tissue. An anchor retainer may be provided at one end of the tubular outer member to grip the anchor and hold the anchor in place during assembly. The anchor retainer also holds the anchor during movement of the apparatus from an assembly location to an operating room or other location where the apparatus is to be used. Indicia may be provided on the inner member to indicate the position of the anchor relative to body tissue. The tubular outer member may be utilized to guide a drill during formation of an opening in body tissue and may be subsequently utilized to guide movement of an anchor into the opening in the body tissue.

Claims

1. An apparatus for use in positioning an anchor relative to body tissue, said apparatus comprising a tubular member, an inner member at least partially disposed in a passage in said tubular member, said tubular member and said inner member being movable relative to each other to separate at least a trailing end portion of the anchor from at least one of said tubular and inner members, and positioner means connected with said one of said inner and tubular members for engaging an opening in the anchor to position the anchor relative to said one of said inner and tubular members to hold the anchor against movement relative to said one of said inner and tubular members under the influence of force applied to the opening in the anchor by said positioner means.

2. An apparatus as set forth in claim 1 wherein said tubular member includes a side wall having surfaces which at least partially define a slot which extends away from an open end of the passage in the tubular member, said positioner means being connected with a portion of said one of said inner and tubular members opposite from the slot.

3. An apparatus as set forth in claim 1 further including indicia disposed on said inner member adjacent to said tubular member, said indicia on said inner member cooperates with said tubular member to indicate the position of said inner member relative to said tubular member.

4. An apparatus as set forth in claim 1 further including a handle fixedly connected with said tubular member, said inner member being movable along the passage in said tubular member to effect separation of the trailing end portion of the anchor from said tubular member, said positioner means being connected with said tubular member.

5. An apparatus comprising an anchor having a recess, a tubular outer member having a passage in which at least a trailing end portion of said anchor is received, an anchor positioner connected with said tubular outer member, said anchor positioner being engageable with the recess in said anchor to position said anchor relative to said tubular outer member with the trailing end portion of said anchor in the passage in said tubular outer member, and an inner member disposed in the passage in said tubular outer member, said inner member and said tubular outer member being movable relative to each other to disengage said anchor positioner from the recess in said anchor and to separate the trailing end portion of said anchor from the passage in said tubular outer member during positioning of said anchor in body tissue.

6. An apparatus as set forth in claim 5 wherein said anchor has a passage which extends transversely to a longitudinal central axis of said suture anchor, said recess in said anchor being at least partially formed by a portion of said passage in said anchor.

7. An apparatus as set forth in claim 5 wherein said recess in said anchor is formed as a groove which extends completely around said anchor.

8. An apparatus as set forth in claim 5 wherein said anchor has a cylindrical outer side surface and said recess in said anchor has an annular configuration and projects radially inward from said cylindrical outer side surface on said anchor.

9. An apparatus as set forth in claim 5 wherein said anchor has a first portion which is disposed on one side of said anchor and is engaged by said anchor positioner, said recess in said anchor being at least partially disposed in said first portion of said anchor, said anchor having a second portion which is disposed on a side of said anchor opposite from said one side and is at least partially pressed against an inner side of the passage in said tubular outer member by said anchor positioner.

10. An apparatus as set forth in claim 5 wherein said anchor positioner is resiliently deflectable from a first position to a second position by engagement of an end portion of said anchor with said anchor positioner, said anchor positioner being resiliently deflectable from the second position toward the first position upon engagement of said anchor positioner with the recess in said anchor.

11. An apparatus as set forth in claim 5 wherein said recess in said anchor is formed as a ring which extends around said anchor, said anchor positioner being formed as a ring which engages said recess in said anchor when said anchor is disposed in a predetermined position relative to said tubular outer member.

12. An apparatus as set forth in claim 5 wherein said tubular outer member includes a slot which extends from said one end of said tubular outer member toward an opposite end of said tubular outer member.

13. An apparatus as set forth in claim 12 wherein said anchor positioner is integrally formed as one piece with said tubular member and is disposed on a portion of said tubular outer member opposite from said slot.

14. An apparatus as set forth in claim 5 wherein said tubular outer member is axially movable along an outer side surface on said inner member to disengage said anchor positioner from said recess in said anchor and to separate the trailing end portion of said anchor from the passage in said tubular outer member.

15. An apparatus as set forth in claim 5 wherein said inner member is axially movable along an inner side surface on said tubular outer member to disengage said anchor positioner from said recess in said anchor and to separate the trailing end portion of said anchor from the passage in said tubular outer member.

16. An apparatus for use in positioning an anchor relative to body tissue, said apparatus comprising a tubular outer member having a passage in which at least a trailing end portion of the anchor is received, said passage extends from an opening at one end portion of said tubular outer member toward another end portion of said tubular outer member, and an inner member at least partially disposed in the passage in said tubular outer member, said tubular outer member and said inner member being movable relative to each other to separate the trailing end portion of the anchor from the passage in said tubular outer member, at least a portion of said one end portion of said tubular outer member being resiliently deflectable from a first condition to a second condition under the influence of force applied against said one end portion of said tubular outer member by the anchor, said one end portion of said tubular outer member being effective to apply force against the anchor to retain the trailing end portion of the anchor in the passage in said tubular outer member when said tubular outer member is in the second condition, said inner member and said tubular outer member being movable relative to each other to separate the trailing end portion of the anchor from the passage in said tubular outer member.

17. An apparatus as set forth in claim 16 wherein said tubular outer member includes a slot which extends from the opening at the one end portion of said tubular outer member to an opening at the other end portion of the tubular outer member.

18. An apparatus as set forth in claim 16 wherein said inner member is effective to apply force to the anchor to effect movement of the anchor relative to said tubular outer member to deflect said one end portion of said tubular outer member from the first condition to the second condition during relative movement between said tubular outer member and said inner member.

19. An apparatus as set forth in claim 16 wherein at least a portion of the passage in said tubular outer member has a first cross sectional area when said one end portion of said tubular outer member is in the first condition and has a second cross sectional area when said one end portion of said tubular outer member is in the second condition, said second cross sectional area being greater than said first cross sectional area.

20. An apparatus as set forth in claim 16 wherein said tubular outer member includes a slot which extends from the opening at the one end portion of said tubular outer member toward the other end portion of said tubular outer member, at least a portion of the slot in said tubular outer member has a first width when said tubular outer member is in the first condition and has a second width which is larger than the first width when said tubular outer member is in the second condition.

21. An apparatus as set forth in claim 16 wherein said end portion of said tubular outer member has an inner surface area which grips a portion of the anchor to hold the anchor when said one end portion of said tubular outer member is in the second condition.

22. An apparatus as set forth in claim 16 wherein said inner member includes a surface which engages said tubular outer member to block relative movement between said inner member and said tubular outer member when the one end portion of said tubular outer member is in the second condition with the trailing end portion of the anchor in the passage in said tubular outer member and a leading end portion of the anchor extends outward from the one end portion of said tubular outer member.

23. An apparatus as set forth in claim 16 wherein said one end portion of said tubular outer member includes an inner side surface and a projection which extends from said inner side surface toward the longitudinal central axis of said tubular outer member, said projection being disposed in engagement with an outer side surface of the anchor when said one end portion of said tubular outer member is in the second condition.

24. An apparatus as set forth in claim 16 wherein said one end portion of said tubular outer member includes an inner side surface and a projection which extends from said inner side surface toward the longitudinal central axis of said tubular outer member, said projection having surface means for engaging a recess formed in the anchor when said one end portion of said tubular outer member is in the second condition.

25. An apparatus as set forth in claim 16 further including indicia disposed on said inner member adjacent to the other end portion of said tubular outer member, said indicia on said inner member cooperates with the other end portion of said tubular outer member to indicate the position of a leading end portion of said inner member relative to the one end portion of said tubular outer member.

26. An apparatus as set forth in claim 16 wherein said tubular outer member is slidable along an outer side surface on said inner member to separate the trailing end portion of the anchor from the passage in said tubular outer member.

27. An apparatus as set forth in claim 16 wherein said inner member is slidable along an inner side surface of said tubular outer member to separate the trailing end portion of the anchor from the passage in said tubular outer member.

28. A method of positioning an anchor relative to body tissue, said method comprising the steps of guiding movement of a drill relative to the body tissue by moving the drill along a passage in a tubular member during formation of an opening in the body tissue with the drill, removing the drill from the body tissue and the tubular member, inserting the anchor into the passage in the tubular member, and moving the anchor along the passage in the tubular member into the opening in the body tissue.

29. A method as set forth in claim 28 further including the steps of maintaining the tubular member in a first orientation relative to the body tissue during movement of the drill along the passage in the tubular member, and maintaining the tubular member in the first orientation relative to the body tissue during movement of the anchor along the passage in the tubular member into the opening in the body tissue.

30. A method as set forth in claim 28 further including the step of moving a thin elongated member into the body tissue, said step of guiding movement of the drill relative to the body tissue includes inserting the thin elongated member into a passage in the drill and moving the drill along the thin elongated member simultaneously with movement of the drill along the passage in the tubular member.

31. A method as set forth in claim 28 wherein said step of moving the drill along a passage in a tubular member includes moving indicia on the drill relative to the tubular member and interrupting movement of the drill along the passage in the tubular member when the indicia is in a predetermined position relative to the tubular member.

32. A method comprising the steps of providing a tubular member having a passage which extends between first and second end portions of the tubular member, moving an anchor along the passage in the tubular member in a direction away from the first end portion of the tubular member, resiliently deflecting at least a portion of the second end portion of the tubular member under the influence of force transmitted from the anchor to the second end portion of the tubular member, and retaining the anchor against movement relative to the second end portion of the tubular member under the influence of force transmitted from the resiliently deflected portion of the second end portion of the tubular member to the anchor.

33. A method as set forth in claim 32 wherein said step of retaining the anchor against movement relative to the second end portion of the tubular member is performed with a trailing end portion of the anchor in the passage in the tubular member and with a leading end portion of the suture anchor extending outward from the second end portion of the tubular member.

34. A method as set forth in claim 32 further including the step of interrupting movement of the anchor along the passage in the tubular member when the anchor is in a predetermined position relative to the tubular member, said step of resiliently deflecting at least a portion of the second end portion of the tubular member is performed prior to performance of said step of interrupting movement of the suture anchor along the passage in the tubular member.

35. A method as set forth in claim 32 wherein the second end portion of the tubular member includes a slot which extends from an opening in the second end portion of the tubular member toward the first end portion of the tubular member, said step of resiliently deflecting the second end portion of the tubular member includes expanding at least a portion of the slot.

36. A method as set forth in claim 32 wherein said step of resiliently deflecting at least a portion of the second end portion of the tubular member includes engaging a projection which extends inward from an inner side surface of the tubular member toward a longitudinal central axis of the tubular member with a leading end portion of the anchor and moving the projection outward away from the longitudinal central axis of the tubular member.

37. A method as set forth in claim 32 wherein said step of resiliently deflecting at least a portion of the second end portion of the tubular member includes engaging an inner side surface of the tubular member which at least partially defines the passage in the tubular member with a leading end portion of the anchor and moving a portion of the inner side surface of the tubular member outward away from a longitudinal central axis of the tubular member.

38. A method as set forth in claim 32 wherein said steps of moving the anchor along the passage in the tubular member and resiliently deflecting at least a portion of the tubular member include applying force against a trailing end portion of the anchor with a leading end portion of a pusher member and applying force against the tubular member with a leading end portion of the anchor.

39. A method as set forth in claim 32 wherein said step of retaining the anchor against movement relative to the second end portion of the tubular member includes applying force against one side of the anchor and pressing a side of the anchor opposite from the one side against an inner side surface on the tubular member.

40. A method as set forth in claim 32 further including the steps of moving at least a leading end portion of a first pusher member into the passage in the tubular member, said step of deflecting the second end portion of the tubular member under the influence of force transmitted from the anchor to the second end portion of the tubular member includes transmitting force from the leading end portion of the first pusher member to a trailing end portion of the anchor, moving the first pusher member out of the passage in the tubular member, moving at least a leading end portion of a second pusher member into the passage in the tubular member, and moving at least the trailing end portion of the anchor from the passage in the tubular member by transmitting force from the leading end portion of the second pusher member to the trailing end portion of the anchor.

41. A method as set forth in claim 32 wherein a recess is formed in the anchor, said step of retaining the anchor against movement relative to the second end portion of the tubular member includes engaging the recess with the second end portion of the tubular member.

42. A method of positioning an anchor for engagement with body tissue, said method comprising the steps of providing a tubular member having a passage, moving the anchor into a portion of the passage in an end portion of the tubular member, expanding the end portion of the tubular member under the influence of force transmitted from the anchor to the end portion of the tubular member as the anchor moves into the portion of the passage disposed in the end portion of the tubular member, and, thereafter, holding the anchor against movement relative to the tubular member under the influence of force transmitted from the end portion of the tubular member to the anchor.

43. A method as set forth in claim 42 wherein said step of expanding the end portion of the tubular member includes expanding the end portion of the tubular member from a first condition to a second condition, the portion of the passage in the end portion of the tubular member has a first cross sectional area in a plane extending perpendicular to a longitudinal central axis of the tubular member when the end portion of the tubular member is in the first condition, the portion of the passage in the end portion of the tubular member has a second cross sectional area in a plane extending perpendicular to the longitudinal central axis of the tubular member when the end portion of the tubular member is in the second condition, said second cross sectional area being greater than said first cross sectional area.

44. A method as set forth in claim 42 wherein said step of moving the anchor into a portion of the passage in an end portion of the tubular member includes applying force against a trailing end portion of the anchor and moving the anchor along the passage in the tubular member, said step of expanding the end portion of the tubular member includes transmitting force from the trailing end portion of the anchor through a leading end portion of the anchor to the end portion of the tubular member.

45. A method as set forth in claim 42 wherein said step of holding the anchor against movement relative to the tubular member is performed with one end portion of the anchor in the passage in the tubular member and with another end portion of the anchor extending outward from the end portion of the tubular member.

46. A method as set forth in claim 42 wherein said step of expanding the end portion of the tubular member includes resiliently deflecting at least a portion of the end portion of the tubular member.

47. A method as set forth in claim 42 wherein the end portion of the tubular member includes a slot which extends from an opening in the second end portion of the tubular member toward an opposite end portion of the tubular member, said step of expanding the end portion of the tubular member includes increasing a distance between opposite sides of at least a portion of the slot.

48. A method of positioning an anchor for engagement with body tissue, said method comprising the steps of providing a member having a passage which tapers from a first portion having a first cross sectional area in a plane perpendicular to a central axis of the passage to a second portion having a second cross sectional area in a plane perpendicular to the central axis of the passage, the second cross sectional area being smaller than the fist cross sectional area, moving the anchor into the second portion of the passage and increasing the cross sectional area of the second portion of the passage from the second cross sectional area to a cross sectional area which is greater than the second cross sectional area during performance of said step of moving the anchor into the second portion of the passage.

49. A method as set forth in claim 48 wherein said step of increasing the cross sectional area of the second portion of the passage from the second cross sectional area is performed during performance of said step of moving the anchor into the second portion of the passage.

50. A method as set forth in claim 48 wherein said step of increasing the cross sectional area of the second portion of the passage includes moving a leading end portion of the anchor from the first portion of the passage to the second portion of the passage.

51. A method as set forth in claim 48 further including the step of gripping the anchor with an inner side surface area disposed on the second portion of the passage to retain the anchor against movement relative to the member.

52. A method as set forth in claim 48 wherein the member includes a slot which has a first width when the second portion of the passage has the second cross sectional area, said step of increasing the cross sectional area of the second portion of the passage includes increasing the width of at least a portion of the slot from the first width to a second width which is greater than the first width.

53. A method of positioning an anchor for engagement with body tissue, said method comprising the steps of providing a tubular member having a passage which has a first end portion disposed in a first end portion of the tubular member and a second end portion disposed in a second end portion of the tubular member, moving an anchor into the first end portion of the passage in the tubular member through an opening in the first end portion of the tubular member, applying force against a trailing end portion of the anchor with a pusher member to move the anchor along the passage in the tubular member, and expanding the second end portion of the passage under the influence of force transmitted from the pusher member through a leading end portion of the anchor to the second end portion of the tubular member during movement of the anchor along the passage in the tubular member.

54. A method as set forth in claim 53 wherein said step of applying force against a trailing end portion of the anchor with a pusher member to move the anchor along the passage in the tubular member includes moving the pusher member relative to the tubular member.

55. A method as set forth in claim 53 wherein said step of applying force against a trailing end portion of the anchor with a pusher member to move the anchor the passage in the tubular member includes moving the tubular member relative to the pusher member.

56. A method as set forth in claim 53 wherein said step of expanding the second end portion of the passage includes deflecting at least a portion of the second end portion of the tubular member outward in a direction away from a longitudinal central axis of the tubular member.

57. A method as set forth in claim 53 wherein said step of applying force against a trailing end portion of the anchor with a pusher member to move the anchor along the passage in the tubular member includes moving a surface connected with the pusher member and a surface connected with the tubular member into engagement to block relative movement between the pusher member and tubular member when the anchor is in a predetermined position relative to the tubular member.

58. A method as set forth in claim 57 wherein a slot extends between the first and second end portions of the tubular member, said method further includes the step of rotating the pusher member relative to the tubular member to move the surface on the pusher member into alignment with the slot, and, thereafter, applying force against the trailing end portion of the anchor with the pusher member to move the anchor away from the predetermined position, said step of applying force against the trailing end portion of the anchor with the pusher member to move the anchor away from the predetermined position includes moving the surface connected with the pusher member along the slot in the tubular member.

59. A method as set forth in claim 58 wherein said step of expanding the second end portion of the passage includes increasing the width of a portion of the slot disposed in the second end portion of the tubular member.

60. A method as set forth in claim 53 further including the step of removing the pusher member from the passage in the tubular member with at least a portion of the anchor in the passage in the tubular member, applying force against the trailing end portion of the anchor with a second pusher member to move the anchor out of the passage in the tubular member.

61. A method as set forth in claim 53 further including the step of gripping the anchor with the second end portion of the tubular member during performance of said step of expanding the second end portion of the passage.

62. A method as set forth in claim 53 further including the step of engaging a recess in the anchor with the second portion of the tubular member to hold the anchor against movement relative to the tubular member.

63. A method as set forth in claim 53 wherein said step of expanding the second end portion of the tubular member includes resiliently deflecting at least a portion of the second end portion of the tubular member under the influence of force-transmitted from the anchor.

64. A method as set forth in claim 53 wherein the second end portion of the tubular member includes a slot, said step of expanding the second end portion of the tubular member includes increasing the width of at least a portion of the slot.

65. An apparatus for use in positioning an anchor relative to body tissue, said apparatus comprising a tubular member, an inner member at least partially disposed in a passage in said tubular member, said tubular member and said inner member being movable relative to each other to separate at least a trailing end portion of the anchor from at least one of said tubular and inner members, and positioner means connected with said one of said inner and tubular members for engaging an opening in the anchor to position the anchor relative to said one of said inner and tubular members to hold the anchor against movement relative to said one of said inner and tubular members under the influence of force applied to the opening in the anchor by said positioner means, said positioner means includes a surface area which is integrally formed as one piece with said one of said inner and tubular members and projects into the opening in the anchor.

66. An apparatus as set forth in claim 65 wherein said tubular member includes a side wall having surfaces which at least partially define a slot which extends away from an open end of the passage in the tubular member, said positioner means being connected with a portion of said one of said inner and tubular members opposite from the slot.

67. An apparatus as set forth in claim 66 wherein said positioner means includes a projection which extends towards the slot, said projection being movable away from the slot under the influence of force transmitted through the anchor to said projection upon relative movement between said tubular member and said inner member.

68. An apparatus as set forth in claim 66 wherein said tubular member is resiliently deflectable from a first condition in which the slot has a first width and said positioner means is effective to engage the opening in the suture anchor to retain at least a portion of the suture anchor in the passage in said tubular member to a second condition in which the slot has a second width and said positioner means is ineffective to engage the opening in the anchor to retain the anchor in the passage in said tubular member, said second width of the slot being greater than said first width of the slot.

69. An apparatus as set forth in claim 66 further including indicia disposed on said inner member adjacent to said tubular member, said indicia on said inner member cooperates with said tubular member to indicate the position of said inner member relative to said tubular member.

70. An apparatus as set forth in claim 66 further including a handle fixedly connected with said inner member, said tubular member being movable along said inner member to effect separation of the trailing end portion of the anchor from said tubular member.

71. An apparatus as set forth in claim 66 further including a handle fixedly connected with said tubular member, said inner member being movable along the passage in said tubular member to effect separation of the trailing end portion of the anchor from said tubular member, said positioner means being connected with said tubular member.

72. An apparatus as set forth in claim 65 wherein the anchor further includes a surface which is engagable by a suture to interconnect the anchor and the suture.

73. An apparatus as set forth in claim 65 wherein a suture extends into the opening in the anchor, said surface area of said positioner means being engagable with the suture.

74. An apparatus for use in positioning an anchor relative to body tissue, said apparatus comprising a tubular member, an inner member at least partially disposed in a passage in said tubular member, said tubular member and said inner member being movable relative to each other to separate at least a trailing end portion of the anchor from at least one of said tubular and inner members, and positioner means connected with said one of said inner and tubular members for engaging an opening in the anchor to position the anchor relative to said one of said inner and tubular members to hold the anchor against movement relative to said one of said inner and tubular members under the influence of force applied to the opening in the anchor by said positioner means, said tubular member includes a side wall having surfaces which at least partially define a slot which extends away from an open end of the passage in the tubular member, said positioner means being connected with a portion of said one of said inner and tubular members opposite from the slot, said positioner means includes a projection which extends towards the slot, said projection being movable away from the slot under the influence of force transmitted through the anchor to said projection upon relative movement between said tubular member and said inner member.

75. An apparatus as set forth in claim 74 further including indicia disposed on said inner member adjacent to said tubular member, said indicia on said inner member cooperates with said tubular member to indicate the position of said inner member relative to said tubular member.

76. An apparatus as set forth in claim 74 wherein said positioner means includes a spring which engages the opening in the anchor, said projection being disposed on said spring.

77. An apparatus as set forth in claim 74 wherein said projection applies force against the anchor to press the anchor against a portion of said one of said inner and tubular members.

78. An apparatus as set forth in claim 74 further including a handle fixedly connected with said inner member, said tubular member being movable along said inner member to effect separation of the trailing end portion of the anchor from said tubular member.

79. An apparatus as set forth in claim 74 further including a handle fixedly connected with said tubular member, said inner member being movable along the passage in said tubular member to effect separation of the trailing end portion of the anchor from said tubular member, said positioner means being connected with said tubular member.

80. An apparatus as set forth in claim 74 wherein the anchor further includes a surface which is engagable by a suture to interconnect the anchor and the suture.

81. An apparatus as set forth in claim 74 wherein a suture is connected with the anchor and is at least partially disposed in the slot in said tubular member.

82. An apparatus for use in positioning an anchor relative to body tissue, said apparatus comprising a tubular member, an inner member at least partially disposed in a passage in said tubular member, said tubular member and said inner member being movable relative to each other to separate at least a trailing end portion of the anchor from at least one of said tubular and inner members, and positioner means connected with said one of said inner and tubular members for engaging an opening in the anchor to position the anchor relative to said one of said inner and tubular members to hold the anchor against movement relative to said one of said inner and tubular members under the influence of force applied to the opening in the anchor by said positioner means, said tubular member includes a side wall having surfaces which at least partially define a slot which extends away from an open end of the passage in the tubular member, said positioner means being connected with a portion of said one of said inner and tubular members opposite from the slot, said tubular member is resiliently deflectable from a first condition in which the slot has a first width and said positioner means is effective to engage the opening in the anchor to retain at least a portion of the anchor in the passage in said tubular member to a second condition in which the slot has a second width and said positioner means is ineffective to engage the opening in the anchor to retain the anchor in the passage in said tubular member, said second width of the slot being greater than said first width of the slot.

83. An apparatus as set forth in claim 82 further including indicia disposed on said inner member adjacent to said tubular member, said indicia on said inner member cooperates with said tubular member to indicate the position of said inner member relative to said tubular member.

84. An apparatus as set forth in claim 82 further including a handle fixedly connected with said inner member, said tubular member being movable along said inner member to effect separation of the trailing end portion of the anchor from said tubular member, said positioner means being connected with said inner member.

85. An apparatus as set forth in claim 82 further including a handle fixedly connected with said tubular member, said inner member being movable along the passage in said tubular member to effect separation of the trailing end portion of the anchor from said tubular member, said positioner means being connected with said tubular member.

86. An apparatus as set forth in claim 82 wherein the anchor further includes a surface which is engagable by a suture to interconnect the anchor and the suture.

87. An apparatus as set forth in claim 82 wherein a suture is connected with the anchor and is at least partially disposed in the slot in said tubular member.

88. An apparatus for use in positioning an anchor relative to body tissue, said apparatus comprising a tubular member, an inner member at least partially disposed in a passage in said tubular member, said tubular member and said inner member being movable relative to each other to separate at least a trailing end portion of the anchor from at least one of said tubular and inner members, and positioner means connected with said one of said inner and tubular members for engaging an opening in the anchor to position the anchor relative to said one of said inner and tubular members to hold the anchor against movement relative to said one of said inner and tubular members under the influence of force applied to the opening in the anchor by said positioner means, said positioner means includes a spring which engages the opening in the anchor.

89. An apparatus as set forth in claim 88 wherein said tubular member includes a side wall having surfaces which at least partially define a slot which extends away from an open end of the passage in the tubular member, said positioner means being connected with a portion of said one of said inner and tubular members opposite from the slot.

90. An apparatus as set forth in claim 89 wherein said spring extends towards the slot, said projection being movable away from the slot under the influence of force transmitted through the anchor to said spring upon relative movement between said tubular member and said inner member.

91. An apparatus as set forth in claim 89 further including indicia disposed on said inner member adjacent to said tubular member, said indicia on said inner member cooperates with said tubular member to indicate the position of said inner member relative to said tubular member.

92. An apparatus as set forth in claim 88 wherein said spring includes a resiliently deflectable projection which applies force against the anchor to press the anchor against a portion of said one of said inner and tubular members.

93. An apparatus as set forth in claim 88 further including a handle fixedly connected with said inner member, said tubular member being movable along said inner member to effect separation of the trailing end portion of the anchor from said tubular member, said spring being connected with said inner member.

94. An apparatus as set forth in claim 88 further including a handle fixedly connected with said tubular member, said inner member being movable along the passage in said tubular member to effect separation of the trailing end portion of the anchor from said tubular member, said spring being connected with said tubular member.

95. An apparatus as set forth in claim 88 wherein the anchor further includes a surface which is engagable by a suture to interconnect the anchor and the suture.

96. An apparatus as set forth in claim 88 wherein a suture is connected with the anchor, said spring has a surface which engages the suture.

97. An apparatus for use in positioning an anchor relative to body tissue, said apparatus comprising a tubular member, an inner member at least partially disposed in a passage in said tubular member, said tubular member and said inner member being movable relative to each other to separate at least a trailing end portion of the anchor from at least one of said tubular and inner members, and positioner means connected with said one of said inner and tubular members for engaging an opening in the anchor to position the anchor relative to said one of said inner and tubular members to hold the anchor against movement relative to said one of said inner and tubular members under the influence of force applied to the opening in the anchor by said positioner means, said positioner means includes a resiliently deflectable projection which applies force against the anchor to press the anchor against a portion of said one of said inner and outer tubular members.

98. An apparatus as set forth in claim 97 wherein said positioner means includes a surface area which is integrally formed as one piece with said one of said inner and tubular members and projects into the opening in the anchor.

99. An apparatus as set forth in claim 97 wherein said tubular member includes a side wall having surfaces which at least partially define a slot which extends away from an open end of the passage in the tubular member, said projection being connected with a portion of said one of said inner and tubular members opposite from the slot.

100. An apparatus as set forth in claim 99 wherein said projection which extends towards the slot, said projection being movable away from the slot under the influence of force transmitted through the anchor to said projection upon relative movement between said tubular member and said inner member.

101. An apparatus as set forth in claim 99 wherein said tubular member is resiliently deflectable from a first condition in which the slot has a first width to a second condition in which the slot has a second width, said second width of the slot being greater than said first width of the slot.

102. An apparatus as set forth in claim 97 further including indicia disposed on said inner member adjacent to said tubular member, said indicia on said inner member cooperates with said tubular member to indicate the position of said inner member relative to said tubular member.

103. An apparatus as set forth in claim 97 wherein said projection engages the opening in the anchor.

104. An apparatus as set forth in claim 97 further including a handle fixedly connected with said inner member, said tubular member being movable along said inner member to effect separation of the trailing end portion of the suture anchor from said tubular member, said positioner means being connected with said inner member.

105. An apparatus as set forth in claim 97 further including a handle fixedly connected with said tubular member, said inner member being movable along the passage in said tubular member to effect separation of the trailing end portion of the anchor from said tubular member, said positioner means being connected with said tubular member.

106. An apparatus as set forth in claim 97 wherein the anchor further includes a surface which is engagable by a suture.

107. An apparatus as set forth in claim 97 wherein a suture is connected with the anchor, said projection has a surface which engages the suture.

108. An apparatus for use in positioning an anchor relative to body tissue, said apparatus comprising a tubular member, an inner member at least partially disposed in a passage in said tubular member, said tubular member and said inner member being movable relative to each other to separate at least a trailing end portion of the anchor from at least one of said tubular and inner members, positioner means connected with said one of said inner and tubular members for engaging an opening in the anchor to position the anchor relative to said one of said inner and tubular members to hold the anchor against movement relative to said one of said inner and tubular members under the influence of force applied to the opening in the anchor by said positioner means, and a handle fixedly connected with said inner member, said tubular member being movable along said inner member to effect separation of the trailing end portion of the anchor from said tubular member, said positioner means being connected with said inner member.

109. A method of positioning an anchor for engagement with body tissue, said method comprising the steps of providing a tubular member having a passage which extends between opposite end portions of the tubular member, moving the anchor to a predetermined position in which a first end portion of the anchor is disposed in the passage in the tubular member and a second end portion of the anchor extends outward from one end portion of the tubular member, and gripping the anchor with the one end portion of the tubular member to retain the anchor in the predetermined position, said step of gripping the anchor includes resiliently deflecting at least a portion of the one end portion of the tubular member under the influence of force transmitted from one of the end portions of the anchor.

110. A method as set forth in claim 109 wherein said step of gripping the anchor includes engaging a recess in the anchor with the one end portion of the tubular member.

111. A method as set forth in claim 109 wherein the one end portion of the tubular member includes a slot which extends from an opening in the one end portion of the tubular member toward an end portion of the tubular member opposite from the one end portion, said step of gripping the anchor includes moving the anchor through the opening in the one end portion of the tubular member and expanding at least a portion of the slot under the influence of force applied against the one end portion of the tubular member by the anchor.

112. A method as set forth in claim 109 wherein said step of moving the anchor to a predetermined position in which a first end portion of the anchor is disposed in the passage and the second end portion of the anchor extends outward from one end portion of the tubular member includes moving the anchor along the passage in the tubular member with the second end portion of the anchor leading, said step of gripping the anchor with the one end portion of the tubular member to retain the anchor in the predetermined position includes engaging a projection which extends inward from an inner side surface of the tubular member with the second end portion of the anchor and moving the projection outward away from a central axis of the tubular member.

113. A method as set forth in claim 109 wherein said step of moving the anchor to the predetermined position in which the first end portion of the anchor is disposed in the passage in the tubular member and the second end portion of the anchor extends outward from the one end portion of the tubular member is performed with a first leg of a suture extending from the first end portion of the anchor and a second leg of the suture extending from the second end portion of the anchor.

114. A method as set forth in claim 109 wherein said step of resiliently deflecting at least a portion of the one end portion of the tubular member includes resiliently expanding at least a portion of the passage in the tubular member from a first cross sectional area to a second cross sectional area which is greater than the first cross sectional area under the influence of force applied against the tubular member by the anchor.

115. A method of positioning an anchor for engagement with body tissue, said method comprising the steps of providing a tubular member having a passage which extends between opposite end portions of the tubular member, moving the anchor to a predetermined position in which a first end portion of the anchor is disposed in the passage in the tubular member and a second end portion of the anchor extends outward from one end portion of the tubular member, and gripping the anchor with the one end portion of the tubular member to retain the anchor in the predetermined position, said step of gripping the anchor with the one end portion of the tubular member to retain the anchor in the predetermined position includes engaging a recess in the anchor with the one end portion of the tubular member.

116. A method as set forth in claim 115 wherein said step of moving the anchor to the predetermined position in which the first end portion of the anchor is disposed in the tubular member and the second end portion of the anchor extends outward from the one end portion of the tubular member is performed with a first leg of a suture extending from the first end portion of the anchor and a second leg of the suture extending from the second end portion of the anchor.

117. A method as set forth in claim 115 wherein said step of engaging a recess in the anchor with the one end portion of the tubular member includes engaging a recess disposed between the first and second end portions of the anchor.

118. A method of positioning an anchor for engagement with body tissue, said method comprising the steps of providing a tubular member having a passage which extends between opposite end portions of the tubular member, moving the anchor to a predetermined position in which a first end portion of the anchor is disposed in the passage in the tubular member and a second end portion of the anchor extends outward from one end portion of the tubular member, and gripping the anchor with the one end portion of the tubular member to retain the anchor in the predetermined position, the one end portion of the tubular member includes a slot which extends from an opening in the one end portion of the tubular member toward an end portion of the tubular member opposite from the one end portion, said step of gripping the anchor with the one end portion of the tubular member to retain the anchor in the predetermined position includes moving the anchor through the opening in the one end portion of the tubular member and expanding at least a portion of the slot under the influence of force applied against the one end portion of the tubular member by the anchor.

119. A method as set forth in claim 118 wherein a suture is connected with the anchor, said step of expanding at least a portion of the slot is performed with at least a portion of the suture disposed in the slot.

120. A method of positioning an anchor for engagement with body tissue, said method comprising the steps of providing a tubular member having a passage which extends between opposite end portions of the tubular member, moving the anchor to a predetermined position in which a first end portion of the anchor is disposed in the passage in the tubular member and a second end portion of the anchor extends outward from one end portion of the tubular member, and gripping the anchor with the one end portion of the tubular member to retain the anchor in the predetermined position, said step of moving the anchor to a predetermined position in which a first end portion of the anchor is disposed in the passage and the second end portion of the anchor extends outward from one end portion of the tubular member includes moving the anchor along the passage in the tubular member with the second end portion of the anchor leading, said step of gripping the anchor with the one end portion of the tubular member to retain the anchor in the predetermined position includes engaging a projection which extends inward from an inner side surface of the tubular member with the second end portion of the anchor and moving the projection outward away from a central axis of the tubular member.

121. A method as set forth in claim 120 wherein said step of moving the anchor to the predetermined position in which the first end portion of the anchor is disposed in the tubular member and the second end portion of the anchor extends outward from the one end portion of the tubular member is performed with a first leg of a suture extending from the first end portion of the anchor and a second leg of the suture extending from the second end portion of the anchor.

122. A method of positioning an anchor for engagement with body tissue, said method comprising the steps of providing a tubular member having a passage, moving the anchor into a portion of the passage in an end portion of the tubular member, expanding the end portion of the tubular member under the influence of force transmitted from the anchor to the end portion of the tubular member as the anchor moves into the portion of the passage disposed in the end portion of the tubular member, said step of expanding the end portion of the tubular member includes sliding the anchor along a surface on a portion of the passage disposed in the end portion of the tubular member, and, thereafter, holding the anchor against movement relative to the tubular member under the influence of force transmitted from the end portion of the tubular member to the anchor.

123. A method as set forth in claim 122 wherein said step of expanding the end portion of the tubular member includes expanding the end portion of the tubular member from a first condition to a second condition, the portion of the passage in the end portion of the tubular member has a first cross sectional area in a plane extending perpendicular to a longitudinal central axis of the tubular member when the end portion of the tubular member is in the first condition, the portion of the passage in the end portion of the tubular member has a second cross sectional area in a plane extending perpendicular to the longitudinal central axis of the tubular member when the end portion of the tubular member is in the second condition, said second cross sectional area being greater than said first cross sectional area.

124. A method as set forth in claim 122 wherein said step of moving the anchor into a portion of the passage in an end portion of the tubular member includes applying force against a trailing end portion of the anchor and moving the anchor along the passage in the tubular member, said step of expanding the end portion of the tubular member includes transmitting force from the trailing end portion of the anchor through a leading end portion of the anchor to the surface on the portion of the passage disposed in the end portion of the tubular member.

125. A method as set forth in claim 122 wherein said step of holding the anchor against movement relative to the tubular member includes gripping the anchor with at least a portion of the surface on the portion of the passage disposed in the end portion of the tubular member.

126. A method as set forth in claim 122 wherein the surface on the portion of the passage against which the anchor slides along is skewed at an acute angle to a longitudinal central axis of the tubular member with an end portion of the anchor.

127. A method as set forth in claim 122 wherein said step of holding the anchor against movement relative to the tubular member is performed with one end portion of the anchor in the passage in the tubular member and with another end portion of the anchor extending outward from the end portion of the tubular member.

128. A method as set forth in claim 122 wherein said step of expanding the end portion of the tubular member includes resiliently deflecting at least a portion of the end portion of the tubular member as the anchor slides along the surface on a portion of the passage disposed in the end portion of the tubular member.

129. A method as set forth in claim 122 further including the step of interrupting movement of the anchor in the passage in the tubular member when the anchor is in a predetermined position relative to the tubular member, said step of expanding the end portion of the tubular member is performed prior to performance of said step of interrupting movement of the anchor in the passage in the tubular member.

130. A method as set forth in claim 122 wherein the end portion of the tubular member includes a slot which extends from an opening in the second end portion of the tubular member toward an opposite end portion of the tubular member, said step of expanding the end portion of the tubular member includes increasing a distance between opposite sides of at least a portion of the slot.

131. A method as set forth in claim 122 wherein said step of holding the anchor against movement relative to the tubular member includes applying force against one side of the anchor and pressing a side of the anchor opposite from the one side against an inner side surface on the end portion of the tubular member under the influence of force applied against the one side of the anchor.

132. A method as set forth in claim 122 further including the step of connecting a suture with the anchor.

133. A method of positioning an anchor for engagement with body tissue, said method comprising the steps of providing a tubular member having a passage, moving the anchor into a portion of the passage in an end portion of the tubular member, expanding the end portion of the tubular member under the influence of force transmitted from the anchor to the end portion of the tubular member as the anchor moves into the portion of the passage disposed in the end portion of the tubular member, and, thereafter, holding the anchor against movement relative to the tubular member under the influence of force transmitted from the end portion of the tubular member to the anchor, said step of holding the anchor against movement relative to the tubular member includes gripping the anchor with at least a portion of the passage disposed in the end portion of the tubular member.

134. A method as set forth in claim 133 wherein said step of expanding the end portion of the tubular member includes pressing the anchor against a surface on a portion of the passage disposed in the end portion of the tubular member.

135. A method as set forth in claim 133 wherein said step of expanding the end portion of the tubular member includes expanding the end portion of the tubular member from a first condition to a second condition, the portion of the passage in the end portion of the tubular member has a first cross sectional area in a plane extending perpendicular to a longitudinal central axis of the tubular member when the end portion of the tubular member is in the first condition, the portion of the passage in the end portion of the tubular member has a second cross sectional area in a plane extending perpendicular to the longitudinal central axis of the tubular member when the end portion of the tubular member is in the second condition, said second cross sectional area being greater than said first cross sectional area.

136. A method as set forth in claim 133 wherein said step of moving the anchor into a portion of the passage in an end portion of the tubular member includes applying force against a trailing end portion of the anchor and moving the anchor along the passage in the tubular member, said step of expanding the end portion of the tubular member includes transmitting force from the trailing end portion of the anchor through a leading end portion of the anchor to the end portion of the tubular member.

137. A method as set forth in claim 133 wherein said step of gripping the anchor with at least a portion of a surface of a portion of the passage disposed in the end portion of the tubular member includes gripping a leading end portion of the anchor.

138. A method as set forth in claim 133 wherein said step of expanding the end portion of the tubular member includes applying force against a surface which is skewed at an acute angle to a longitudinal central axis of the tubular member with an end portion of the anchor.

139. A method as set forth in claim 133 wherein said step of holding the anchor against movement relative to the tubular member is performed with one end portion of the anchor in the passage in the tubular member and with another end portion of the anchor extending outward from the end portion of the tubular member.

140. A method as set forth in claim 133 wherein said step of expanding the end portion of the tubular member includes resiliently deflecting at least a portion of the end portion of the tubular member in which the portion of the passage with which the anchor is gripped is disposed.

141. A method as set forth in claim 133 further including the step of interrupting movement of the anchor in the passage in the tubular member when the anchor is in a predetermined position relative to the tubular member, said step of expanding the end portion of the tubular member is performed prior to performance of said step of interrupting movement of the anchor in the passage in the tubular member.

142. A method as set forth in claim 133 wherein the end portion of the tubular member includes a slot which extends from an opening in the second end portion of the tubular member toward an opposite end portion of the tubular member, said step of expanding the end portion of the tubular member includes increasing a distance between opposite sides of at least a portion of the slot.

143. A method as set forth in claim 133 wherein said step of holding the anchor against movement relative to the tubular member includes applying force against one side of the anchor and pressing a side of the anchor opposite from the one side against an inner side surface on the end portion of the tubular member under the influence of force applied against the one side of the anchor.

144. A method as set forth in claim 133 further including the step of connecting a suture with the anchor.

145. A method of positioning an anchor for engagement with body tissue, said method comprising the steps of providing a tubular member having a passage, moving the anchor into a portion of the passage in an end portion of the tubular member, expanding the end portion of the tubular member under the influence of force transmitted from the anchor to the end portion of the tubular member as the anchor moves into the portion of the passage disposed in the end portion of the tubular member, said step of expanding the end portion of the tubular member includes applying force against a surface which is skewed at an acute angle to a longitudinal central axis of the tubular member with an end portion of the anchor, and, thereafter, holding the anchor against movement relative to the tubular member under the influence of force transmitted from the end portion of the tubular member to the anchor.

146. A method as set forth in claim 145 wherein said step of expanding the end portion of the tubular member includes sliding the anchor along the surface which is skewed at an acute angle to the longitudinal central axis of the tubular member.

147. A method as set forth in claim 145 wherein said step of expanding the end portion of the tubular member includes expanding the end portion of the tubular member from a first condition to a second condition, the portion of the passage in the end portion of the tubular member has a first cross sectional area in a plane extending perpendicular to the longitudinal central axis of the tubular member when the end portion of the tubular member is in the first condition, the portion of the passage in the end portion of the tubular member has a second cross sectional area in a plane extending perpendicular to the longitudinal central axis of the tubular member when the end portion of the tubular member is in the second condition, said second cross sectional area being greater than said first cross sectional area.

148. A method as set forth in claim 145 wherein said step of moving the anchor into a portion of the passage in an end portion of the tubular member includes applying force against a trailing end portion of the anchor and moving the anchor along the passage in the tubular member, said step of expanding the end portion of the tubular member includes transmitting force from the trailing end portion of the anchor through a leading end portion of the anchor to the surface which is skewed at an acute angle to the longitudinal central axis of the tubular member.

149. A method as set forth in claim 145 wherein said step of holding the anchor against movement relative to the tubular member includes gripping the anchor with at least a portion of a surface of the surface which is skewed at an acute angle to the longitudinal central axis of the tubular member.

150. A method as set forth in claim 145 wherein said step of expanding the end portion of the tubular member includes sliding a leading end portion of the anchor along the surface which is skewed at an acute angle to a longitudinal central axis of the tubular member.

151. A method as set forth in claim 145 wherein said step of holding the anchor against movement relative to the tubular member is performed with one end portion of the anchor in the passage in the tubular member and with another end portion of the anchor extending outward from the end portion of the tubular member.

152. A method as set forth in claim 145 wherein said step of expanding the end portion of the tubular member includes resiliently deflecting at least a portion of the end portion of the tubular member on which the surface which is skewed at an acute angle to the longitudinal central axis of the tubular member is disposed.

153. A method as set forth in claim 145 further including the step of interrupting movement of the anchor in the passage in the tubular member when the anchor is in a predetermined position relative to the tubular member, said step of expanding the end portion of the tubular member is performed prior to performance of said step of interrupting movement of the anchor in the passage in the tubular member.

154. A method as set forth in claim 145 wherein the end portion of the tubular member includes a slot which extends from an opening in the second end portion of the tubular member toward an opposite end portion of the tubular member, said step of expanding the end portion of the tubular member includes increasing a distance between opposite sides of at least a portion of the slot.

155. A method as set forth in claim 145 wherein said step of holding the anchor against movement relative to the tubular member includes applying force against one side of the anchor with the surface which is skewed at an acute angle to a longitudinal central axis of the tubular member and pressing a side of the anchor opposite from the one side against an inner side surface on the end portion of the tubular member under the influence of force applied against the one side of the anchor.

156. A method as set forth in claim 145 further including the step of connecting a suture with the anchor.

157. A method of positioning an anchor for engagement with body tissue, said method comprising the steps of providing a tubular member having a passage, moving the anchor into a portion of the passage in an end portion of the tubular member, expanding the end portion of the tubular member under the influence of force transmitted from the anchor to the end portion of the tubular member as the anchor moves into the portion of the passage disposed in the end portion of the tubular member, interrupting movement of the anchor in the passage in the tubular member when the anchor is in a predetermined position relative to the tubular member, said step of expanding the end portion of the tubular member is performed prior to performance of said step of interrupting movement of the anchor in the passage in the tubular member, and, thereafter, holding the anchor against movement relative to the tubular member under the influence of force transmitted from the end portion of the tubular member to the anchor.

158. A method as set forth in claim 157 wherein said step of expanding the end portion of the tubular member includes pressing a leading end portion of the anchor against a surface on a portion of the passage disposed in the end portion of the tubular member prior to moving the anchor to the predetermined position relative to the tubular member.

159. A method as set forth in claim 157 wherein said step of expanding the end portion of the tubular member includes expanding the end portion of the tubular member from a first condition to a second condition, the portion of the passage in the end portion of the tubular member has a first cross sectional area in a plane extending perpendicular to a longitudinal central axis of the tubular member when the end portion of the tubular member is in the first condition, the portion of the passage in the end portion of the tubular member has a second cross sectional area in a plane extending perpendicular to the longitudinal central axis of the tubular member when the end portion of the tubular member is in the second condition, said second cross sectional area being greater than said first cross sectional area.

160. A method as set forth in claim 157 wherein said step of moving the anchor into a portion of the passage in an end portion of the tubular member includes applying force against a trailing end portion of the anchor and moving the anchor along the passage in the tubular member, said step of expanding the end portion of the tubular member includes transmitting force from the trailing end portion of the anchor through a leading end portion of the anchor to the end portion of the tubular member.

161. A method as set forth in claim 157 wherein said step of holding the anchor against movement relative to the tubular member includes gripping the anchor with the tubular member while the anchor is in the predetermined position relative to the tubular member.

162. A method as set forth in claim 157 wherein said step of expanding the end portion of the tubular member includes applying force against the tubular member with the anchor as the anchor moves to the predetermined position relative to the tubular member.

163. A method as set forth in claim 157 wherein said step of holding the anchor against movement relative to the tubular member is performed with the anchor in the predetermined position and with one end portion of the anchor in the passage in the tubular member and with another end portion of the anchor extending outward from the end portion of the tubular member.

164. A method as set forth in claim 157 wherein said step of expanding the end portion of the tubular member includes resiliently deflecting at least a portion of the end portion of the tubular member.

165. A method as set forth in claim 157 wherein the end portion of the tubular member includes a slot which extends from an opening in the second end portion of the tubular member toward an opposite end portion of the tubular member, said step of expanding the end portion of the tubular member includes increasing a distance between opposite sides of at least a portion of the slot.

166. A method as set forth in claim 157 wherein said step of holding the anchor against movement relative to the tubular member includes applying force against one side of the anchor and pressing a side of the anchor opposite from the one side against an inner side surface on the end portion of the tubular member under the influence of force applied against the one side of the anchor.

167. A method as set forth in claim 157 further including the step of connecting a suture with the anchor.

168. A method of positioning an anchor for engagement with body tissue, said method comprising the steps of providing a tubular member having a passage, moving the anchor into a portion of the passage in an end portion of the tubular member, expanding the end portion of the tubular member under the influence of force transmitted from the anchor to the end portion of the tubular member as the anchor moves into the portion of the passage disposed in the end portion of the tubular member, and, thereafter, holding the anchor against movement relative to the tubular member under the influence of force transmitted from the end portion of the tubular member to the anchor, step of holding the anchor against movement relative to the tubular member includes applying force against one side of the anchor and pressing a side of the anchor opposite from the one side against an inner side surface on the end portion of the tubular member under the influence of force applied against the one side of the anchor.

169. A method as set forth in claim 168 further including the step of connecting a suture with the anchor.