Method of securing tissue

• US 6,447,516 B1
• Filed: 08/09/1999
• Issued: 09/10/2002
• Est. Priority Date: 08/09/1999
• 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): Robert, Eduardo C.
• Application Number:
  US09/370,865
• Time in Patent Office: 1,128 Days
• Field of Search: 606/72, 606/76, 606/60, 623/13.11, 623/13.14, 623/13.15, 623/13.17, 623/13.12, 623/13.13, 623/13.16
• 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 17/68 Internal fixation devices , including fasteners and spinal fixators, even if a part thereof projects from the skin bone staples A61B17/0642
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61F 2/0805 Implements for inserting tendons or ligaments
• CPC Class Codes: A61F 2/0811 Fixation devices for tendons or ligaments
• CPC Class Codes: Y10S 606/902 Cortical plate specifically adapted for a particular bone

Abstract

A retainer member formed of bone secures tissue against movement relative to a portion of a bone in a patient'"'"'s body. The retainer member is utilized to form an opening in a compact outer layer of a portion of the bone in the patient'"'"'s body. The retainer member formed of bone is advantageously enclosed in a tubular member or sleeve to prevent breaking of the retainer member during the forming of the opening in the bone. The extent of movement of the retainer member into the bone in the patient'"'"'s body is determined as the retainer member is moved into the bone. A suture may be connected with the retainer member and used to connect tissue with the bone. The retainer member may be positioned across a fracture in a bone to hold portions of the bone on opposite sides of the fracture against movement relative to each other. The retainer member may be used at a joint between end portions of bones to immobilize the joint. The joint may be released for movement by breaking the retainer member formed of bone.

Claims

1. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with the tissue to be secured, said step of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes positioning the retainer member formed of bone in a tubular member, applying force against a trailing end portion of the retainer member formed of bone while the retainer member is at least partially enclosed by the tubular member, and forming an opening in the portion of the bone in the patient'"'"'s body under the influence of force transmitted from the retainer member formed of bone to the portion of the bone in the patient'"'"'s body while the retainer member is at least partially enclosed by the tubular member, said step of forming an opening in the bone in the patient'"'"'s body includes moving at least a portion of the retainer member formed of bone out of the end portion of the tubular member into the portion of the bone in the patient'"'"'s body.

2. A method as set forth in claim 1 wherein said step of forming an opening in the portion of the bone in the patient'"'"'s body includes pushing material forming a compact outer layer of the portion of the bone in the patient'"'"'s body aside under the influence of the force transmitted from a leading end portion of the retainer member formed of bone to the compact outer layer.

3. A method as set forth in claim 1 wherein said step of forming an opening in the portion of the bone in the patient'"'"'s body includes moving the leading end portion of the retainer member formed of bone through a compact outer layer of the portion of the bone in the patient'"'"'s body into cancellous bone.

4. A method as set forth in claim 1 wherein said step of connecting the retainer member formed of bone with tissue to be secured includes moving a portion of the retainer member formed of bone through the tissue to be secured, separating the tubular member from the retainer member formed of bone, and transmitting force between an outer side surface area on the retainer member formed of bone and the tissue to be secured after performing said step of moving a portion of the retainer member formed of bone through the tissue to be secured.

5. A method as set forth in claim 1 wherein said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through the portion of the bone in the patient'"'"'s body into the tissue to be secured.

6. A method as set forth in claim 1 wherein said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through a first portion of the bone in the patient'"'"'s body into a second portion of the bone in the patient'"'"'s body.

7. A method as set forth in claim 1 wherein the bone in the patient'"'"'s body is divided into a first portion and a second portion by a fracture and the tissue to be secured is the second portion of the bone, said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member formed of bone through the first portion of the bone into the second portion of the bone.

8. A method as set forth in claim 1 wherein the bone in the patient'"'"'s body is a first bone and the tissue to be secured is a second bone in the patient'"'"'s body, said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured includes moving a portion of the retainer member through the first bone into the second bone to prevent relative movement between the first and second bones.

9. A method as set forth in claim 8 further including the step of breaking the retainer member formed of bone to enable relative movement to occur between the first and second bones.

10. A method as set forth in claim 1 wherein said step of positioning the retainer member formed of bone in the patient'"'"'s body includes moving the retainer member formed of bone through a compact outer layer into cancellous, said step of connecting the retainer member formed of bone with the tissue to be secured includes transmitting force between the tissue to be secured and the retainer member through a suture.

11. A method as set forth in claim 10 wherein said step of positioning the retainer member formed of bone in the patient'"'"'s body includes changing the orientation of the retainer member formed of bone relative to the compact outer layer of bone after performing said step of moving the retainer member formed of bone through the compact outer layer into cancellous bone.

12. A method as set forth in claim 11 wherein said step of transmitting force between the tissue to be secured and the retainer member through a suture includes maintaining the retainer member in a spaced apart relationship with the compact outer layer of the bone in the patient'"'"'s body under the influence of force applied against the retainer member formed of bone by the cancellous bone.

13. A method as set forth in claim 1 wherein said step of applying force against a trailing end portion of the retainer member formed of bone while the retainer member formed of bone is enclosed by the tubular member includes engaging the trailing end portion of the retainer member with a pusher member, said step of moving the leading end portion of the retainer member formed of bone out of the end portion of the tubular member being interrupted when the pusher member is in a predetermined position relative to the tubular member.

14. A method as set forth in claim 1 further including the step of forming an initial opening in the portion of the bone in the patient'"'"'s body, said step of forming an opening in the portion of the bone in the patient'"'"'s body under the influence of force transmitted from a leading end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body includes enlarging the initial opening in the portion of the bone in the patient'"'"'s body.

15. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with the tissue to be secured, said steps of positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include engaging a portion of the tissue to be secured, tensioning at least a portion of the tissue to be secured by moving the engaged portion of the tissue to be secured from a first location relative to the portion of the bone in the patient'"'"'s body to a second location relative to the portion of the bone in the patient'"'"'s body, and utilizing the retainer member formed of bone to hold the tissue at the second location by engaging the tissue and an opening formed in the portion of the bone in the patient'"'"'s body with the retainer member formed of bone.

16. A method as set forth in claim 15 wherein said step of engaging a portion of the tissue to be secured includes engaging the portion of the tissue to be secured at the first location with the retainer member formed of bone, said step of tensioning the tissue to be secured includes moving the engaged portion of the tissue and the retainer member formed of bone together from the first location to the second location.

17. A method as set forth in claim 15 further including the step of utilizing the retainer member formed of bone to form the opening at the second location prior to performance of said step of moving the engaged portion of the tissue to be secured from the first location to the second location.

18. A method as set forth;

in claim 15 wherein said step of tensioning the tissue to be secured includes transmitting force from the retainer member formed of bone to the tissue to be secured.

19. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of removing a hard surface area from a location on the portion of the bone in the patient'"'"'s body, positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with the tissue to be secured, said step of positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body, said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes transmitting force from an end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body at the location where the hard surface area was removed.

20. A method as set forth in claim 19 wherein said step of transmitting force from an end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body includes rotating the retainer member formed of bone about a central axis of the retainer member formed of bone.

21. A method as set forth in claim 19 wherein said step of transmitting force from an end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body includes applying an axially directed force against the retainer member formed of bone and pushing material of the portion of the bone in the patient'"'"'s body aside under the influence of the axially directed force.

22. A method as set forth in claim 19 wherein said step of utilizing the retainer member to form an opening in the portion of the bone in the patient'"'"'s body includes moving at least a portion of the retainer member through a compact outer layer of the portion of the bone into cancellous bone enclosed by the compact outer layer.

23. A method as set forth in claim 19 wherein said step of connecting the retainer member formed of bone with tissue to be secured includes moving a portion of the retainer member formed of bone into the tissue to be secured and transmitting force between an outer side surface area on the retainer member formed of bone and the tissue to be secured.

24. A method as set forth in claim 19 wherein said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through the portion of the bone in the patient'"'"'s body into the tissue to be secured.

25. A method as set forth in claim 19 wherein said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through a first portion of the bone in the patient'"'"'s body into a second portion of the bone in the patient'"'"'s body.

26. A method as set forth in claim 19 wherein the bone in the patient'"'"'s body is divided into a first portion and a second portion by a fracture and the tissue to be secured is the second portion of the bone, said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through the first portion of the bone into the second portion of the bone.

27. A method as set forth in claim 19 wherein the portion of a bone in the patient'"'"'s body is a first bone and the tissue to be secured is a second bone in the patient'"'"'s body, said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured includes moving a portion of the retainer member through the first bone into the second bone to prevent relative movement between the first and second bones.

28. A method as set forth in claim 27 further including the step of breaking the retainer member formed of bone to enable relative movement to occur between the first and second bones.

29. A method as set forth in claim 19 wherein said step of positioning the retainer member formed of bone in the patient'"'"'s body includes moving the retainer member formed of bone through a compact outer layer of bone into cancellous bone, said step of connecting the retainer member formed of bone with the tissue to be secured includes transmitting force between the tissue to be secured and the retainer member through a suture.

30. A method as set forth in claim 29 wherein said step of positioning the retainer member formed of bone in the patient'"'"'s body includes changing the orientation of the retainer member formed of bone relative to the compact outer layer of bone after performing said step of moving the retainer member formed of bone through the compact outer layer into cancellous bone.

31. A method as set forth in claim 29 wherein said step of transmitting force between the tissue to be secured and the retainer member through a suture includes maintaining the retainer member in a spaced apart relationship with the compact outer layer of the bone in the patient'"'"'s body under the influence of force applied against the retainer member formed of bone by the cancellous bone.

32. A method as set forth in claim 19 wherein said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes enclosing the retainer member formed of bone with a sleeve, and applying force against a trailing end portion of the retainer member formed of bone to move a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body.

33. A method as set forth in claim 19 wherein said step positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body and interrupting movement of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body when the leading end portion of the retainer member formed of bone has moved a predetermined distance into the portion of the bone disposed in the patient'"'"'s body.

34. A method as set forth in claim 19 wherein the retainer member formed of bone includes a shank portion and a head end portion which projects radially outward from the shank portion, said step of connecting the retainer member formed of bone with the tissue to be secured includes pressing the head end portion of the retainer member formed of bone against the tissue to be secured.

35. A method as set forth in claim 19 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes engaging a portion of the tissue to be secured, tensioning at least a portion of the tissue to be secured by moving the engaged portion of the tissue to be secured from a first location relative to the portion of the bone in the patient'"'"'s body to a second location relative to the portion of the bone in the patient'"'"'s body, said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes utilizing the retainer member to form the opening at the second location.

36. A method as set forth in claim 35 wherein said step of engaging a portion of the tissue to be secured includes engaging the portion of the tissue to be secured with the retainer member formed of bone prior to performing said step of utilizing the retainer member to form the opening at the second location.

37. A method as set forth in claim 35 wherein said step of utilizing the retainer member formed of bone to form the opening at the second location is performed prior to performance of said step of moving the engaged portion of the tissue to be secured from the first location to the second location.

38. A method as set forth in claim 19 wherein said step of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes moving a member into the portion of the bone in the patient'"'"'s body to form an opening of a first size, said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes increasing the size of the opening formed in the bone in the patient'"'"'s body from the first size to a second size which is larger than the first size.

39. A method as set forth in claim 19 wherein said step of positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes moving a thin elongated member into the portion of the bone in the patient'"'"'s body, said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes guiding movement of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body with the thin elongated member.

40. A method as set forth in claim 19 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes moving the retainer member formed of bone into the tissue to be secured and applying force to the retainer member to tension the tissue to be secured, said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body is performed while maintaining the tension in the tissue to be secured.

41. A method as set forth in claim 19 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes moving a tubular member into the tissue to be secured, applying force to the tubular member to tension the tissue to be secured, and positioning the retainer member formed of bone in the tubular member, said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes moving at least a portion of the retainer member formed of bone from the tubular member into the portion of the bone in the patient'"'"'s body.

42. A method as set forth in claim 41 further including the step of disengaging the tubular member from the tissue to be secured and the retainer member formed of bone after performing said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body.

43. A method as set forth in claim 19 wherein said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving the retainer member formed of bone through the tissue to be secured and into the portion of the bone in the patient'"'"'s body with a first end portion of the retainer member formed of bone leading and a second end portion of the retainer member formed of bone trailing, and interrupting movement of the retainer member formed of bone relative to the portion of the bone in the patient'"'"'s body and to the tissue to be secured with the first end portion of the retainer member formed of bone disposed in engagement with the portion of the bone in the patient'"'"'s body and with the second end portion of the retainer member formed of bone disposed in engagement with the tissue to be secured.

44. A method as set forth in claim 43 wherein said step of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes enclosing the retainer member formed of bone with a sleeve, applying force against a trailing end portion of the retainer member formed of bone, and moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body under the influence of force applied against the trailing end portion of the retainer member formed of bone while the retainer member formed of bone is enclosed by the sleeve.

45. A method as set forth in claim 44 further including the step of interrupting movement of the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body when the leading end portion of the retainer member formed of bone has moved a predetermined distance into the portion of the bone disposed in the patient'"'"'s body.

46. A method as set forth in claim 43 further including the step of tensioning the tissue to be secured prior to moving the retainer member formed of bone into the portion of the bone in the patient'"'"'s body.

47. A method as set forth in claim 19 wherein said step of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes positioning the retainer member formed of bone in a tubular member, applying force against a trailing end portion of the retainer member formed of bone while the retainer member is at least partially enclosed by the tubular member, and forming an opening in the portion of the bone in the patient'"'"'s body under the influence of force transmitted from the retainer member formed of bone to the portion of the bone in the patient'"'"'s body while the retainer member is at least partially enclosed by the tubular member, said step of forming an opening in the bone in the patient'"'"'s body includes moving at least a portion of the retainer member formed of bone out of the end portion of the tubular member into the portion of the bone in the patient'"'"'s body.

48. A method as set forth in claim 47 wherein said step of forming an opening in the portion of the bone in the patient'"'"'s body includes pushing material forming a compact outer layer of the portion of the bone in the patient'"'"'s body aside under the influence of the force transmitted from a leading end portion of the retainer member formed of bone to the compact outer layer.

49. A method as set forth in claim 47 wherein said step of forming an opening in the portion of the bone in the patient'"'"'s body includes moving the leading end portion of the retainer member formed of bone through a compact outer layer of the portion of the bone in the patient'"'"'s body into cancellous bone.

50. A method as set forth in claim 47 wherein said step of connecting the retainer member formed of bone with tissue to be secured includes moving a portion of the retainer member formed of bone through the tissue to be secured, separating the tubular member from the retainer member formed of bone, and transmitting force between an outer side surface area on the retainer member formed of bone and the tissue to be secured after performing said step of moving a portion of the retainer member formed of bone through the tissue to be secured.

51. A method as set forth in claim 47 wherein said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through the portion of the bone in the patient'"'"'s body into the tissue to be secured.

52. A method as set forth in claim 47 wherein said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through a first portion of the bone in the patient'"'"'s body into a second portion of the bone in the patient'"'"'s body.

53. A method as set forth in claim 47 wherein the bone in the patient'"'"'s body is divided into a first portion and a second portion by a fracture and the tissue to be secured is the second portion of the bone, said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member formed of bone through the first portion of the bone into the second portion of the bone.

54. A method as set forth in claim 47 wherein the bone in the patient'"'"'s body is a first bone and the tissue to be secured is a second bone in the patient'"'"'s body, said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured includes moving a portion of the retainer member through the first bone into the second bone to prevent relative movement between the first and second bones.

55. A method as set forth in claim 54 further including the step of breaking the retainer member formed of bone to enable relative movement to occur between the first and second bones.

56. A method as set forth in claim 47 wherein said step of positioning the retainer member formed of bone in the patient'"'"'s body includes moving the retainer member formed of bone through a compact outer layer into cancellous bone, said step of connecting the retainer member formed of bone with the tissue to be secured includes transmitting force between the tissue to be secured and the retainer member through a suture.

57. A method as set forth in claim 56 wherein said step of positioning the retainer member formed of bone in the patient'"'"'s body includes changing the orientation of the retainer member formed of bone relative to the compact outer layer of bone after performing said step of moving the retainer member formed of bone through the compact outer layer into cancellous bone.

58. A method as set forth in claim 57 wherein said step of transmitting force between the tissue to be secured and the retainer member through a suture includes maintaining the retainer member in a spaced apart relationship with the compact outer layer of the bone in the patient'"'"'s body under the influence of force applied against the retainer member formed of bone by the cancellous bone.

59. A method as set forth in claim 47 wherein said step of applying force against a trailing end portion of the retainer member formed of bone while the retainer member formed of bone is enclosed by the tubular member includes engaging the trailing end portion of the retainer member with a pusher member, said step of moving the leading end portion of the retainer member formed of bone out of the end portion of the tubular member being interrupted when the pusher member is in a predetermined position relative to the tubular member.

60. A method as set forth in claim 47 further including the step of forming an initial opening in the portion of the bone in the patient'"'"'s body, said step of forming an opening in the portion of the bone in the patient'"'"'s body under the influence of force transmitted from a leading end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body includes enlarging the initial opening in the portion of the bone in the patient'"'"'s body.

61. A method as set forth in claim 19 wherein said method further includes the steps of connecting a suture with a retainer member formed of bone, said step of connecting the retainer member formed of bone with the tissue to be secured includes engaging the tissue to be secured with the suture, said step of positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes moving the retainer member into the opening in the portion of the bone in the patient'"'"'s body with the suture extending from the retainer member formed of bone.

62. A method as set forth in claim 61 wherein said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes inserting the retainer member into a tubular member, positioning an end portion of the tubular member adjacent to the portion of the bone in the patient'"'"'s body, and applying force against a trailing end portion of the retainer member formed of bone while the retainer member is at least partially enclosed by the tubular member.

63. A method as set forth in claim 61 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes tensioning the suture, said step of positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes retaining the retainer member formed of bone against movement relative to the portion of the bone in the patient'"'"'s body under the influence of force transmitted from the suture to the retainer member formed of bone by transmitting force between the retainer member formed of bone and cancellous bone in the portion of the bone in the patient'"'"'s body while the retainer member formed of bone is spaced from a compact outer layer of the portion of the bone in the patient'"'"'s body.

64. A method as set forth in claim 61 further including the step of changing the orientation of the retainer member formed of bone relative to the portion of the bone in the patient'"'"'s body after performing said step of moving the retainer member formed of bone into the opening in the portion of the bone in the patient'"'"'s body.

65. A method as set forth in claim 61 wherein said step of connecting the retainer member formed of bone with the tissue to be secured by engaging the tissue to be secured with the suture includes pulling on first and second sections of the suture which extend from the retainer member formed of bone.

66. A method as set forth in claim 19 wherein said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes engaging a compact outer layer of a portion of the bone disposed on a first side of a fracture with a leading end portion of the retainer member formed of bone, said step of positioning the retainer member formed of bone in the patient'"'"'s body includes moving the leading end portion of the retainer member formed of bone across the fracture, engaging the compact layer of a portion of the bone disposed on a second side of the fracture with the leading end portion of the retainer member formed of bone, and utilizing the leading end portion of the retainer member formed of bone to form an opening in the compact outer layer of the portion of the bone disposed on the second side of the fracture.

67. A method as set forth in claim 66 further including the steps of positioning the retainer member formed of bone in a tubular member, and positioning an end portion of the tubular member adjacent to the compact outer layer of the portion of the bone disposed on a first side of the fracture, said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes applying force against a trailing end portion of the retainer member formed of bone while the retainer member formed of bone is at least partially enclosed by the tubular member.

68. A method as set forth in claim 67 wherein said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes applying force against the trailing end portion of the retainer member formed of bone while the retainer member formed of bone is at least partially enclosed by the tubular member.

69. A method as set forth in claim 66 wherein said step of utilizing the leading end portion of the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes moving the leading end portion of the retainer member through an outer area on the compact outer layer of the portion of the bone disposed on the first side of the fracture and subsequently moving the leading end portion of the retainer member through an inner area on the compact outer layer of the portion of the bone disposed on the first side of the fracture, said step of positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes moving the leading end portion of the retainer member through an inner area on the compact outer layer of the portion of the bone disposed on the second side of the fracture.

70. A method as set forth in claim 19 wherein said step of positioning the retainer member formed of bone in the portion of the bone in the patient body includes moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body, determining an extent of movement of the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body, and interrupting said step of moving the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body upon determining that the extent of movement of the leading end portion of the retainer member formed of bone corresponds to a predetermined extent of movement.

71. A method as set forth in claim 19 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes moving a shank portion of the retainer member formed of bone through the tissue to be secured, said step of positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes moving the shank portion of the retainer member formed of bone into a the portion of the bone in the patient'"'"'s body, and pressing a head end portion of the retainer member formed of bone against the tissue to be secured while the shank portion of the retainer member formed of bone extends into the portion of the bone in the patient'"'"'s body.

72. A method as set forth in claim 71 wherein said step of pressing the head end portion of the retainer member formed of bone against the tissue to be secured includes engaging a first side of the tissue to be secured with the head end portion of the retainer member formed of bone and pressing a second side of the tissue to be secured against the portion of the bone in the patient'"'"'s body under the influence of force transmitted from the head end portion of the retainer member formed of bone.

73. A method as set forth in claim 19 wherein said step of positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes moving the retainer member formed of bone through a portion of a first bone and into a second bone, and holding the first and second bones against movement relative to each other with the retainer member formed of bone.

74. A method as set forth in claim 73 further including the step of releasing the first and second bones for movement relative to each other by breaking the retainer member formed of bone.

75. A method as set forth in claim 73 further including the step of positioning tissue at a joint between the first and second bones prior to performing said step of moving a retainer member formed of bone through a portion of the first bone and into the second bone, said step of moving the retainer member formed of bone through a portion of the first bone into the second bone includes moving the retainer member through the tissue at the joint between the first and second bones.

76. A method as set forth in claim 73 further including the step of determining the extent of movement of a leading end portion of the retainer member formed of bone relative to the first bone and interrupting said step of moving the retainer member formed of bone through a portion of the first bone and into the second bone upon determining that the extent of movement of the leading end portion of the retainer member formed of bone corresponds to a predetermined extent of movement.

77. A method as set forth in claim 73 further including the step of inserting the retainer member formed of bone into a tubular member, and positioning the tubular member adjacent to the first bone, said step of moving a retainer member formed of bone through a portion of the first bone and into the second bone is at least partially performed with a portion of the retainer member formed of bone disposed in the tubular member.

78. A method as set forth in claim 77 wherein said step of moving a retainer member formed of bone through a portion of the first bone and into the second bone includes applying force against a trailing end portion of the retainer member formed of bone while the trailing end portion of the retainer member formed of bone is enclosed by the tubular member.

79. A method as set forth in claim 19 wherein said step of positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes moving a thin elongated member into the portion of the bone in the patient'"'"'s body and moving the retainer member formed of bone along the thin elongated member into the portion of the bone in the patient'"'"'s body.

80. A method as set forth in claim 79 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes moving the thin elongated member into the tissue to be secured and moving the retainer member formed of bone along the thin elongated member into the tissue to be secured.

81. A method as set forth in claim 79 wherein said step of moving a thin elongated member into the portion of the bone in the patient'"'"'s body includes moving the thin elongated member into the portion of the bone in the patient'"'"'s body at the location where the hard surface area on the portion of the bone in the patient'"'"'s body was removed, said step of moving the retainer member formed of bone along the thin elongated member includes moving a leading end portion of the retainer member formed of bone into engagement with the portion of the bone in the patient'"'"'s body at the location where the hard surface area on the portion of the bone in the patient'"'"'s body was removed.

82. A method as set forth in claim 79 wherein said steps of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body and moving the retainer member formed of bone along the thin elongated member include utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body by pushing material forming the portion of the bone in the patient'"'"'s body aside under the influence of force transmitted through the retainer member formed of bone as the retainer member formed of bone moves along the thin elongated member.

83. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with the tissue to be secured, said step of positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body, said step of connecting the retainer member formed of bone with the tissue to be secured includes engaging a portion of the tissue to be secured, tensioning at least a portion of the tissue to be secured by moving the engaged portion of the tissue to be secured from a first location relative to the portion of the bone in the patient'"'"'s body to a second location relative to the portion of the bone in the patient'"'"'s body, said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes utilizing the retainer member to form the opening at the second location, said step of utilizing the retainer member formed of bone to form the opening at the second location is performed prior to performance of said step of moving the engaged portion of the tissue to be secured from the first location to the second location.

84. A method as set forth in claim 83 wherein said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes enclosing the retainer member formed of bone with a sleeve, and applying force against a trailing end portion of the retainer member formed of bone to move a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body.

85. A method as set forth in claim 83 wherein said step positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body and interrupting movement of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body when the leading end portion of the retainer member formed of bone has moved a predetermined distance into the portion of the bone disposed in the patient'"'"'s body.

86. A method as set forth in claim 83 wherein the retainer member formed of bone includes a shank portion and a head end portion which projects radially outward from the shank portion, said step of connecting the retainer member formed of bone with the tissue to be secured includes pressing the head end portion of the retainer member formed of bone against the tissue to be secured.

87. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with the tissue to be secured, said step of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes moving a member into the portion of the bone in the patient'"'"'s body to form an opening of a first size, said step of positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body further includes utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body by utilizing the retainer member formed of bone to increase the size of the opening formed in the bone in the patient'"'"'s body from the first size to a second size which is larger than the first size.

88. A method as set forth in claim 87 wherein said step of moving a member into the portion of the bone in the patient'"'"'s body to form an opening of a first size includes moving a drill into the portion of the bone in the patient'"'"'s body to form the opening of a first size.

89. A method as set forth in claim 87 wherein said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes moving the retainer member formed of bone into the portion of the bone in the patient'"'"'s body without rotating the retainer member formed of bone about its central axis.

90. A method as set forth in claim 87 further including the step of transmitting force from an end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body, said step of transmitting force from an end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body includes rotating the retainer member formed of bone about a central axis of the retainer member formed of bone.

91. A method as set forth in claim 87 further including the step of transmitting force from an end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body, said step of transmitting force from an end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body includes applying an axially directed force against the retainer member formed of bone and pushing material of the portion of the bone in the patient'"'"'s body aside under the influence of the axially directed force.

92. A method as set forth in claim 87 wherein said step of utilizing the retainer member to form an opening in the portion of the bone in the patient'"'"'s body includes moving at least a portion of the retainer member through a compact outer layer of the portion of the bone into cancellous bone enclosed by the compact outer layer.

93. A method as set forth in claim 87 wherein said step of connecting the retainer member formed of bone with tissue to be secured includes moving a portion of the retainer member formed of bone into the tissue to be secured and transmitting force between an outer side surface area on the retainer member formed of bone and the tissue to be secured.

94. A method as set forth in claim 87 wherein said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through the portion of the bone in the patient'"'"'s body into the tissue to be secured.

95. A method as set forth in claim 87 wherein said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through a first portion of the bone in the patient'"'"'s body into a second portion of the bone in the patient'"'"'s body.

96. A method as set forth in claim 87 wherein the bone in the patient'"'"'s body is divided into a first portion and a second portion by a fracture and the tissue to be secured is the second portion of the bone, said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through the first portion of the bone into the second portion of the bone.

97. A method as set forth in claim 87 wherein the portion of a bone in the patient'"'"'s body is a first bone and the tissue to be secured is a second bone in the patient'"'"'s body, said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured includes moving a portion of the retainer member through the first bone into the second bone to prevent relative movement between the first and second bones.

98. A method as set forth in claim 97 further including the step of breaking the retainer member formed of bone to enable relative movement to occur between the first and second bones.

99. A method as set forth in claim 87 wherein said step of positioning the retainer member formed of bone in the patient'"'"'s body includes moving the retainer member formed of bone through a compact outer layer of bone into cancellous bone, said step of connecting the retainer member formed of bone with the tissue to be secured includes transmitting force between the tissue to be secured and the retainer member through a suture.

100. A method as set forth in claim 99 wherein said step of positioning the retainer member formed of bone in the patient'"'"'s body includes changing the orientation of the retainer member formed of bone relative to the compact outer layer of bone after performing said step of moving the retainer member formed of bone through the compact outer layer into cancellous bone.

101. A method as set forth in claim 99 wherein said step of transmitting force between the tissue to be secured and the retainer member through a suture includes maintaining the retainer member in a spaced apart relationship with the compact outer layer of the bone in the patient'"'"'s body under the influence of force applied against the retainer member formed of bone by the cancellous bone.

102. A method as set forth in claim 87 wherein said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes enclosing the retainer member formed of bone with a sleeve, and applying force against a trailing end portion of the retainer member formed of bone to move a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body.

103. A method as set forth in claim 87 wherein said step positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body and interrupting movement of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body when the leading end portion of the retainer member formed of bone has moved a predetermined distance into the portion of the bone disposed in the patient'"'"'s body.

104. A method as set forth in claim 87 wherein the retainer member formed of bone includes a shank portion and a head end portion which projects radially outward from the shank portion, said step of connecting the retainer member formed of bone with the tissue to be secured includes pressing the head end portion of the retainer member formed of bone against the tissue to be secured.

105. A method as set forth in claim 87 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes engaging a portion of the tissue to be secured, tensioning at least a portion of the tissue to be secured by moving the engaged portion of the tissue to be secured from a first location relative to the portion of the bone in the patient'"'"'s body to a second location relative to the portion of the bone in the patient'"'"'s body, said step of moving a member into the portion of the bone in the patient'"'"'s body to form an opening of the first size is performed at the second location.

106. A method as set forth in claim 105 wherein said step of engaging a portion of the tissue to be secured includes engaging the portion of the tissue to be secured with the retainer member formed of bone prior to performing said step of utilizing the retainer member formed of bone to form the opening.

107. A method as set forth in claim 105 wherein said step of utilizing the retainer member formed of bone to form an opening is performed at the second location prior to performance of said step of moving the engaged portion of the tissue to be secured from the first location to the second location.

108. A method as set forth in claim 87 wherein said step of moving a member into the portion of the bone in the patient'"'"'s body to form an opening of a first size includes moving a thin elongated member into the portion of the bone in the patient'"'"'s body, said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes guiding movement of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body with the thin elongated member.

109. A method as set forth in claim 87 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes moving the retainer member formed of bone into the tissue to be secured and applying force to the retainer member to tension the tissue to be secured, said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body is performed while maintaining the tension in the tissue to be secured.

110. A method as set forth in claim 87 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes moving a tubular member into the tissue to be secured, applying force to the tubular member to tension the tissue to be secured, and positioning the retainer member formed of bone in the tubular member, said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes moving at least a portion of the retainer member formed of bone from the tubular member into the portion of the bone in the patient'"'"'s body.

111. A method as set forth in claim 87 further including the step of disengaging the tubular member from the tissue to be secured and the retainer member formed of bone after performing said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body.

112. A method as set forth in claim 87 wherein said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving the retainer member formed of bone through the tissue to be secured and into the portion of the bone in the patient'"'"'s body with a first end portion of the retainer member formed of bone leading and a second end portion of the retainer member formed of bone trailing, and interrupting movement of the retainer member formed of bone relative to the portion of the bone in the patient'"'"'s body and to the tissue to be secured with the first end portion of the retainer member formed of bone disposed in engagement with the portion of the bone in the patient'"'"'s body and with the second end portion of the retainer member formed of bone disposed in engagement with the tissue to be secured.

113. A method as set forth in claim 87 wherein said step of increasing the size of the opening formed in the bone includes increasing the size of an opening formed in a compact outer layer of the portion of the bone in the patient'"'"'s body.

114. A method as set forth in claim 87 wherein said step of increasing the size of the opening formed in the portion of the bone in the patient'"'"'s body includes enclosing the retainer member formed of bone with a sleeve, aligning the sleeve with the opening formed in the portion of the bone in the patient'"'"'s body, applying force against a trailing end portion of the retainer member formed of bone while the sleeve is aligned with the opening in the portion of the bone in the patient'"'"'s body, and moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body under the influence of force applied against the trailing end portion of the retainer member formed of bone while the retainer member formed of bone is enclosed by the sleeve.

115. A method as set forth in claim 114 further including the step of interrupting movement of the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body when the leading end portion of the retainer member formed of bone has moved a predetermined distance into the portion of the bone disposed in the patient'"'"'s body.

116. A method as set forth in claim 87 further including the step of tensioning the tissue to be secured prior to moving the retainer member formed of bone into the portion of the bone in the patient'"'"'s body.

117. A method as set forth in claim 87 wherein said step of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes positioning the retainer member formed of bone in a tubular member, and applying force against a trailing end portion of the retainer member formed of bone while the retainer member is at least partially enclosed by the tubular member, said step of increasing the size of the opening formed in the bone in the patient'"'"'s body from the first size to a second size is performed under the influence of force transmitted from the retainer member formed of bone to the portion of the bone in the patient'"'"'s body while the retainer member is at least partially enclosed by the tubular member and moving at least a portion of the retainer member formed of bone out of the end portion of the tubular member into the portion of the bone in the patient'"'"'s body.

118. A method as set forth in claim 87 wherein said step of increasing the size of the opening formed in the portion of the bone in the patient'"'"'s body includes pushing material forming a compact outer layer of the portion of the bone in the patient'"'"'s body aside under the influence of the force transmitted from a leading end portion of the retainer member formed of bone to the compact outer layer.

119. A method as set forth in claim 87 wherein said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes moving the leading end portion of the retainer member formed of bone through a compact outer layer of the portion of the bone in the patient'"'"'s body into cancellous bone.

120. A method as set forth in claim 87 wherein the bone in the patient'"'"'s body is divided into a first portion and a second portion by a fracture and the tissue to be secured is the second portion of the bone, said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member formed of bone through the first portion of the bone into the second portion of the bone, said step of increasing the size of the opening formed in the bone in the patient'"'"'s body is at least partially performed in the first portion of the bone.

121. A method as set forth in claim 87 wherein the bone in the patient'"'"'s body is a first bone and the tissue to be secured is a second bone in the patient'"'"'s body, said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured includes moving a portion of the retainer member through the first bone into the second bone to prevent relative movement between the first and second bones.

122. A method as set forth in claim 121 further including the step of breaking the retainer member formed of bone to enable relative movement to occur between the first and second bones.

123. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with the tissue to be secured, said step of positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body, said step of connecting the retainer member formed of bone with the tissue to be secured includes moving a tubular member into the tissue to be secured, applying force to the tubular member to tension the tissue to be secured, and positioning the retainer member formed of bone in the tubular member, said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes moving at least a portion of the retainer member formed of bone from the tubular member into the portion of the bone in the patient'"'"'s body.

124. A method as set forth in claim 123 wherein said step of transmitting force from an end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body includes rotating the retainer member formed of bone about a central axis of the retainer member formed of bone.

125. A method as set forth in claim 123 wherein said step of transmitting force from an end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body includes applying an axially directed force against the retainer member formed of bone while the retainer member formed of bone is at least partially disposed in the tubular member and pushing material of the portion of the bone in the patient'"'"'s body aside under the influence of the axially directed force.

126. A method as set forth in claim 123 wherein said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes moving at least a portion of the retainer member through a compact outer layer of the portion of the bone into cancellous bone enclosed by the compact outer layer while the retainer member is partially disposed in the tubular member.

127. A method as set forth in claim 123 further including the step of disengaging the tubular member from the tissue to be secured and the retainer member formed of bone after performing said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body.

128. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of removing a hard surface area from a location on a compact outer layer of the portion of the bone in the patient'"'"'s body, positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with the tissue to be secured, said step of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes positioning the retainer member formed of bone in a tubular member, applying force against a trailing end portion of the retainer member formed of bone while the retainer member is at least partially enclosed by the tubular member, and forming an opening in the portion of the bone in the patient'"'"'s body under the influence of force transmitted from the retainer member formed of bone to the portion of the bone in the patient'"'"'s body while the retainer member is at least partially enclosed by the tubular member, said step of forming an opening in the bone in the patient'"'"'s body includes transmitting force from an end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body at the location where the hard surface area on the compact outer layer was removed and moving at least a portion of the retainer member formed of bone out of the end portion of the tubular member into the portion of the bone in the patient'"'"'s body.

129. A method as set forth in claim 128 wherein said step of forming an opening in the portion of the bone in the patient'"'"'s body includes pushing material forming a compact outer layer of the portion of the bone in the patient'"'"'s body aside under the influence of the force transmitted from a leading end portion of the retainer member formed of bone to the compact outer layer.

130. A method as set forth in claim 128 wherein said step of forming an opening in the portion of the bone in the patient'"'"'s body includes moving the leading end portion of the retainer member formed of bone through a compact outer layer of the portion of the bone in the patient'"'"'s body into cancellous bone.

131. A method as set forth in claim 128 wherein said step of connecting the retainer member formed of bone with tissue to be secured includes moving a portion of the retainer member formed of bone through the tissue to be secured, separating the tubular member from the retainer member formed of bone, and transmitting force between an outer side surface area on the retainer member formed of bone and the tissue to be secured after performing said step of moving a portion of the retainer member formed of bone through the tissue to be secured.

132. A method as set forth in claim 128 wherein said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through the portion of the bone in the patient'"'"'s body into the tissue to be secured.

133. A method as set forth in claim 128 wherein said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through a first portion of the bone in the patient'"'"'s body into a second portion of the bone in the patient'"'"'s body.

134. A method as set forth in claim 128 wherein the bone in the patient'"'"'s body is divided into a first portion and a second portion by a fracture and the tissue to be secured is the second portion of the bone, said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member formed of bone through the first portion of the bone into the second portion of the bone.

135. A method as set forth in claim 128 wherein the bone in the patient'"'"'s body is a first bone and the tissue to be secured is a second bone in the patient'"'"'s body, said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured includes moving a portion of the retainer member through the first bone into the second bone to prevent relative movement between the first and second bones.

136. A method as set forth in claim 135 further including the step of breaking the retainer member formed of bone to enable relative movement to occur between the first and second bones.

137. A method as set forth in claim 128 wherein said step of positioning the retainer member formed of bone in the patient'"'"'s body includes moving the retainer member formed of bone through a compact outer layer into cancellous, said step of connecting the retainer member formed of bone with the tissue to be secured includes transmitting force between the tissue to be secured and the retainer member through a suture.

138. A method as set forth in claim 137 wherein said step of positioning the retainer member formed of bone in the patient'"'"'s body includes changing the orientation of the retainer member formed of bone relative to the compact outer layer of bone after performing said step of moving the retainer member formed of bone through the compact outer layer into cancellous bone.

139. A method as set forth in claim 138 wherein said step of transmitting force between the tissue to be secured and the retainer member through a suture includes maintaining the retainer member in a spaced apart relationship with the compact outer layer of the bone in the patient'"'"'s body under the influence of force applied against the retainer member formed of bone by the cancellous bone.

140. A method as set forth in claim 128 wherein said step of applying force against a trailing end portion of the retainer member formed of bone while the retainer member formed of bone is enclosed by the tubular member includes engaging the trailing end portion of the retainer member with a pusher member, said step of moving the leading end portion of the retainer member formed of bone out of the end portion of the tubular member being interrupted when the pusher member is in a predetermined position relative to the tubular member.

141. A method as set forth in claim 128 further including the step of forming an initial opening in the portion of the bone in the patient'"'"'s body, said step of forming an opening in the portion of the bone in the patient'"'"'s body under the influence of force transmitted from a leading end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body includes enlarging the initial opening in the portion of the bone in the patient'"'"'s body.

142. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of removing a hard surface area from a location on the compact outer layer of the portion of the bone in the patient'"'"'s body, positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with tissue to be secured, said step of positioning the retainer member formed of bone in the portion of the bone in the patient body includes moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body, step of moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes utilizing the retainer member formed of bone to form an opening in the compact outer layer of the portion of the bone in the patient'"'"'s body, said step of utilizing the retainer member formed of bone to form an opening includes transmitting force from the leading end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body at the location where the hard surface area on the compact outer layer was removed, determining an extent of movement of the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body, and interrupting said step of moving the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body upon determining that the extent of movement of the leading end portion of the retainer member formed of bone corresponds to a predetermined extent of movement.

143. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with the tissue to be secured, said step of positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes initiating formation of an opening in the portion of the bone in the patient'"'"'s body by pushing material of the portion of the bone in the patient'"'"'s body aside under the influence of force applied against the portion of the bone in the patient'"'"'s body by the retainer member formed of bone.

144. A method as set forth in claim 143 wherein said step of initiating formation of an opening in the portion of the bone in the patient'"'"'s body includes applying an axially directed force against the retainer member formed of bone and pushing material of the portion of the bone in the patient'"'"'s body aside under the influence of the axially directed force without rotating the retainer member formed of bone.

145. A method as set forth in claim 143 wherein said step of positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes moving at least a portion of the retainer member through a compact outer layer of the portion of the bone into cancellous bone enclosed by the compact outer layer.

146. A method as set forth in claim 143 wherein said step of connecting the retainer member formed of bone with tissue to be secured includes moving a portion of the retainer member formed of bone into the tissue to be secured and transmitting force between an outer side surface area on the retainer member formed of bone and the tissue to be secured.

147. A method as set forth in claim 143 wherein said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through the portion of the bone in the patient'"'"'s body into the tissue to be secured.

148. A method as set forth in claim 143 wherein said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through a first portion of the bone in the patient'"'"'s body into a second portion of the bone in the patient'"'"'s body.

149. A method as set forth in claim 143 wherein the bone in the patient'"'"'s body is divided into a first portion and a second portion by a fracture and the tissue to be secured is the second portion of the bone, said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through the first portion of the bone into the second portion of the bone.

150. A method as set forth in claim 143 wherein the portion of a bone in the patient'"'"'s body is a first bone and the tissue to be secured is a second bone in the patient'"'"'s body, said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured includes moving a portion of the retainer member through the first bone into the second bone to prevent relative movement between the first and second bones.

151. A method as set forth in claim 150 further including the step of breaking the retainer member formed of bone to enable relative movement to occur between the first and second bones.

152. A method as set forth in claim 143 wherein said step of positioning the retainer member formed of bone in the patient'"'"'s body includes moving the retainer member formed of bone through a compact outer layer of bone into cancellous bone, said step of connecting the retainer member formed of bone with the tissue to be secured includes transmitting force between the tissue to be secured and the retainer member through a suture.

153. A method as set forth in claim 152 wherein said step of positioning the retainer member formed of bone in the patient'"'"'s body includes changing the orientation of the retainer member formed of bone relative to the compact outer layer of bone after performing said step of moving the retainer member formed of bone through the compact outer layer into cancellous bone.

154. A method as set forth in claim 152 wherein said step of transmitting force between the tissue to be secured and the retainer member through a suture includes maintaining the retainer member in a spaced apart relationship with the compact outer layer of the bone in the patient'"'"'s body under the influence of force applied against the retainer member formed of bone by the cancellous bone.

155. A method as set forth in claim 143 further including the step of enclosing the retainer member formed of bone with a sleeve, said step of initiating formation of an opening in the portion of the bone in the patient'"'"'s body includes applying force against a trailing end portion of the retainer member formed of bone to move a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body.

156. A method as set forth in claim 143 wherein said step positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body and interrupting movement of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body when the leading end portion of the retainer member formed of bone has moved a predetermined distance into the portion of the bone disposed in the patient'"'"'s body.

157. A method as set forth in claim 143 wherein the retainer member formed of bone includes a shank portion and a head end portion which projects radially outward from the shank portion, said step of connecting the retainer member formed of bone with the tissue to be secured includes pressing the head end portion of the retainer member formed of bone against the tissue to be secured.

158. A method as set forth in claim 143 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes engaging a portion of the tissue to be secured, tensioning at least a portion of the tissue to be secured by moving the engaged portion of the tissue to be secured from a first location relative to the portion of the bone in the patient'"'"'s body to a second location relative to the portion of the bone in the patient'"'"'s body, said step of initiating formation of an opening in the portion of the bone in the patient'"'"'s body includes initiating formation of the opening at the second location.

159. A method as set forth in claim 158 wherein said step of engaging a portion of the tissue to be secured includes engaging the portion of the tissue to be secured with the retainer member formed of bone prior to performing said step of initiating formation of the opening at the second location.

160. A method as set forth in claim 158 wherein said step of initiating formation of the opening at the second location is performed prior to performance of said step of moving the engaged portion of the tissue to be secured from the first location to the second location.

161. A method as set forth in claim 143 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes moving the retainer member formed of bone into the tissue to be secured and applying force to the retainer member to tension the tissue to be secured, said step of initiating formation of an opening in the portion of the bone in the patient'"'"'s body is performed while maintaining the tension in the tissue to be secured.

162. A method as set forth in claim 143 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes moving a tubular member into the tissue to be secured, and positioning the retainer member formed of bone in the tubular member, said step of initiating formation of an opening in the portion of the bone in the patient'"'"'s body includes moving at least a portion of the retainer member formed of bone from the tubular member into the portion of the bone in the patient'"'"'s body.

163. A method as set forth in claim 162 further including the step of disengaging the tubular member from the tissue to be secured and the retainer member formed of bone after performing said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body.

164. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of tensioning the tissue to be secured, said step of tensioning the tissue to be secured includes moving a retainer member formed of bone and at least a portion of the tissue to be secured from a first location relative to the portion of the bone in the patient'"'"'s body to a second location relative to the portion of the bone in the patient'"'"'s body, and moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body at the second location by applying force against a trailing end portion of the retainer member formed of bone, said step of moving the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body is performed while maintaining tension in at least a portion of the tissue to be secured.

165. A method as set forth in claim 164 wherein said step of moving the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes forming an opening at the second location in the portion of the bone in the patient'"'"'s body by transmitting an axially directed force applied against the trailing end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body without rotating the retainer member formed of bone about a central axis of the retainer member formed of bone, and utilizing the retainer member formed of bone to hold the portion of the tissue to be secured at the second location by engaging the portion of the tissue to be secured with the trailing end portion of the retainer member formed of bone while the leading end portion of the retainer member formed of bone is disposed in the portion of the bone in the patient'"'"'s body at the second location.

166. A method as set forth in claim 164 further including the step of positioning at least a portion of the retainer member formed of bone in a tubular member, said step of applying force against a trailing end portion of the retainer member formed of bone is performed with at least a portion of the retainer member formed of bone disposed in the tubular member.

167. A method as set forth in claim 164 wherein said step of moving the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes initiating formation of an opening by pushing material of the portion of the bone in the patient'"'"'s body aside under the influence of the axially directed force applied against the trailing end portion of the retainer member formed of bone.

168. A method as set forth in claim 164 further including the step of moving a member into the portion of the bone in the patient'"'"'s body at the second location to form an opening of a first size, said step of forming an opening at the second location includes increasing the size of the opening formed in the bone in the patient'"'"'s body from the first size to a second size which is larger than the first size.

169. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of forming an initial opening in the portion of the bone in the patient'"'"'s body, moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body at a location where the initial opening is formed in the portion of the bone in the patient'"'"'s body, said step of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes engaging the initial opening in the portion of the bone in the patient'"'"'s body with a leading end portion of the retainer member formed of bone and enlarging the initial opening formed in the portion of the bone in the patient'"'"'s body by applying an axially directed force against a trailing end portion of the retainer member formed of bone and pushing aside material forming the portion of the bone in the patient'"'"'s body under the influence of the axially directed force which is transmitted to the portion of the bone in the patient'"'"'s body by the leading end portion of the retainer member formed of bone at the location where the initial opening was formed in the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with the tissue to be secured.

170. A method as set forth in claim 169 wherein said step of pushing aside material forming the portion of the bone in the patient'"'"'s body is performed without rotating the retainer member formed of bone about a central axis of the retainer member formed of bone.

171. A method as set forth in claim 169 wherein said step of moving the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes positioning the retainer member formed of bone in a tubular member, said step of enlarging the initial opening formed in the portion of the bone in the patient'"'"'s body is performed while the retainer member formed of bone is at least partially positioned in the tubular member and includes moving the retainer member formed of bone relative to the tubular member.

172. A method as set forth in claim 169 further including the step of interrupting movement of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body when the leading end portion of the retainer member formed of bone has moved a predetermined distance into the portion of the bone disposed in the patient'"'"'s body.

173. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with tissue to be secured, said step of moving the retainer member formed of bone into the portion of the bone in the patient body includes moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body and forming an opening in he portion of the bone in the patient'"'"'s body with the leading end portion of the retainer member formed of bone as the leading end portion of the retainer member formed of bone moves into the portion of the bone in the patient'"'"'s body, determining an extent of movement of the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body by viewing indicia indicative of the extent of movement of the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body, and interrupting said step of moving the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body when the indicia indicates that the extent of movement of the leading end portion of the retainer member formed of bone corresponds to a predetermined extent of movement.

174. A method as set forth in claim 173 wherein said step of moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body and forming an opening in the portion of the bone in the patient'"'"'s body with the leading end portion of the retainer member formed of bone include deflecting material of the portion of the bone in the patient'"'"'s body with the leading end portion of the retainer member without rotating the retainer member.

175. A method as set forth in claim 173 further including the step of removing a hard surface area from a location on the compact outer layer of the portion of the bone in the patient'"'"'s body, said step of moving the retainer member formed of into the portion of the bone in the patient'"'"'s body includes moving the retainer member formed of bone into the portion of the bone in the patient'"'"'s body at the location where the hard surface area on the compact outer layer was removed.

176. A method as set forth in claim 173 wherein said step of connecting the retainer member formed of bone with tissue to be secured includes moving a portion of the retainer member formed of bone through the tissue to be secured and transmitting force between an outer side surface area on the retainer member formed of bone and the tissue to be secured after performing said step of moving a portion of the retainer member formed of bone through the tissue to be secured.

177. A method as set forth in claim 173 wherein said steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through the portion of the bone in the patient'"'"'s body into the tissue to be secured.

178. A method as set forth in claim 173 wherein said steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through the portion of the bone in the patient'"'"'s body into a second portion of the bone in the patient'"'"'s body.

179. A method as set forth in claim 173 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes transmitting force between the tissue to be secured and the retainer member through a suture.

180. A method as set forth in claim 173 wherein said step of moving the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes enclosing the retainer member formed of bone with a tubular member, and applying force against a trailing end portion of said retainer member formed of bone to move the leading end portion of the retainer member formed of bone into a compact outer layer of the portion of the bone in the patient'"'"'s body.

181. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with the tissue to be secured, said step of positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body and forming an opening in the portion of the bone in the patient'"'"'s body with the leading end portion of the retainer member formed of bone as the leading end portion of the retainer member formed of bone moves into the portion of the bone in the patient'"'"'s body, said step of moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body is performed without rotating the retainer member formed of bone about a central axis of the retainer member formed of bone.

182. A method as set forth in claim 181 wherein said step of forming an opening in the portion of the bone in the patient'"'"'s body includes initiating formation of an opening in the portion of the bone in the patient'"'"'s body by transmitting force from the leading end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body.

183. A method as set forth in claim 181 wherein said step of forming an opening in the portion of the bone in the patient'"'"'s body includes enlarging an initial opening formed in the portion of the bone in the patient'"'"'s body prior to engagement of the portion of the bone in the patient'"'"'s body with the leading end portion of the retainer member formed of bone.

184. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with the tissue to be secured, said step of positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body, said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes enclosing the retainer member formed of bone with a sleeve, and applying force against a trailing end portion of the retainer member formed of bone to move a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body.

185. A method as set forth in claim 184 further including the step of removing a hard surface area from a location on the portion of the bone in the patient'"'"'s body, said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes transmitting force from the leading end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body at the location where the hard surface area was removed while the retainer member formed of bone is enclosed by the sleeve.

186. A method as set froth in claim 184 wherein said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes initiating formation of an opening in the portion of the bone in the patient'"'"'s body while the retainer member formed of bone is enclosed by the sleeve.

187. A method as set forth in claim 184 wherein said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes pushing material of the portion of the bone in the patient'"'"'s body aside under the influence of the force applied to the trailing end portion of the retainer member formed of bone.

188. A method as set forth in claim 184 wherein said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes moving at least a portion of the retainer member through a compact outer layer of the portion of the bone in the patient'"'"'s body into cancellous bone enclosed by the compact outer layer.

189. A method as set forth in claim 184 wherein said step of connecting the retainer member formed of bone with tissue to be secured includes moving a portion of the retainer member formed of bone into the tissue to be secured and transmitting force between an outer side surface area on the retainer member formed of bone and the tissue to be secured.

190. A method as set forth in claim 184 wherein said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through the portion of the bone in the patient'"'"'s body into the tissue to be secured.

191. A method as set forth in claim 184 wherein said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through a first portion of the bone in the patient'"'"'s body into a second portion of the bone in the patient'"'"'s body.

192. A method as set forth in claim 184 wherein the bone in the patient'"'"'s body is divided into a first portion and a second portion by a fracture and the tissue to be secured is the second portion of the bone, said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through the first portion of the bone into the second portion of the bone.

193. A method as set forth in claim 184 wherein the portion of a bone in the patient'"'"'s body is a first bone and the tissue to be secured is a second bone in the patient'"'"'s body, said steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured includes moving a portion of the retainer member through the first bone into the second bone to prevent relative movement between the first and second bones.

194. A method as set forth in claim 193 further including the step of breaking the retainer member formed of bone to enable relative movement to occur between the first and second bones.

195. A method as set forth in claim 184 wherein said step of positioning the retainer member formed of bone in the patient'"'"'s body includes moving the retainer member formed of bone through a compact outer layer of bone into cancellous bone, said step of connecting the retainer member formed of bone with the tissue to be secured includes transmitting force between the tissue to be secured and the retainer member through a suture.

196. A method as set forth in claim 195 wherein said step of positioning the retainer member formed of bone in the patient'"'"'s body includes changing the orientation of the retainer member formed of bone relative to the compact outer layer of bone after performing said step of moving the retainer member formed of bone through the compact outer layer into cancellous bone.

197. A method as set forth in claim 195 wherein said step of transmitting force between the tissue to be secured and the retainer member through a suture includes maintaining the retainer member in a spaced apart relationship with the compact outer layer of the bone in the patient'"'"'s body under the influence of force applied against the retainer member formed of bone by the cancellous bone.

198. A method as set forth in claim 184 wherein said step positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body and interrupting movement of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body when the leading end portion of the retainer member formed of bone has moved a predetermined distance into the portion of the bone disposed in the patient'"'"'s body.

199. A method as set forth in claim 184 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes engaging a portion of the tissue to be secured, tensioning at least a portion of the tissue to be secured by moving the engaged portion of the tissue to be secured from a first location relative to the portion of the bone in the patient'"'"'s body to a second location relative to the portion of the bone in the patient'"'"'s body, said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes utilizing the retainer member to form the opening at the second location.

200. A method as set forth in claim 199 wherein said step of engaging a portion of the tissue to be secured includes engaging the portion of the tissue to be secured prior to performing said step of utilizing the retainer member formed of bone to form the opening at the second location.

201. A method as set forth in claim 199 wherein said step of utilizing the retainer member formed of bone to form the opening at the second location is performed prior to performance of said step of moving the engaged portion of the tissue to be secured from the first location to the second location.

202. A method as set forth in claim 184 wherein said step of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes forming an opening of a first size in the portion of the bone in the patient'"'"'s body, said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes increasing the size of the opening formed in the bone in the patient'"'"'s body from the first size to a second size which is larger than the first size.

203. A method as set forth in claim 184 wherein said step of positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes moving a thin elongated member into the portion of the bone in the patient'"'"'s body, said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes guiding movement of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body with the thin elongated member.

204. A method as set forth in claim 184 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes moving the retainer member formed of bone into the tissue to be secured and tensioning the tissue to be secured, said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body is performed while maintaining the tension in the tissue to be secured.

205. A method as set forth in claim 184 further including the step of disengaging the sleeve from the retainer member formed of bone after performing said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body.

206. A method as set forth in claim 184 wherein said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes moving a leading end portion of the sleeve into engagement with the portion of the bone in the patient'"'"'s body, said step of applying force against a trailing end portion of the retainer member formed of bone is performed with the leading end portion of the sleeve in engagement with the portion of the bone in the patient'"'"'s body.

207. A method as set forth in claim 184 wherein said step of applying force against a trailing end portion of the retainer member includes moving a portion of a pusher member into the sleeve and transmitting force from the pusher member to the retainer member formed of bone.

208. A method as set forth in claim 184 further including the step of moving the sleeve at least part way through tissue to be secured and transmitting force between the tissue to be secured and the sleeve.

209. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with the tissue to be secured, said step of positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body, said step of connecting the retainer member formed of bone with the tissue to be secured includes engaging a portion of the tissue to be secured, tensioning at least a portion of the tissue to be secured by moving the engaged portion of the tissue to be secured from a first location relative to the portion of the bone in the patient'"'"'s body to a second location relative to the portion of the bone in the patient'"'"'s body, said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes utilizing the retainer member to form the opening at the second location.

210. A method as set forth in claim 209 wherein said step of engaging the portion of the tissue to be secured includes engaging the portion of the tissue to be secured with the retainer member formed of bone.

211. A method as set forth in claim 210 wherein said step of tensioning at least a portion of the tissue to be secured includes transmitting force from the retainer member formed of bone to the tissue to be secured.

212. A method as set forth in claim 209 wherein said step of engaging the portion of the tissue to be secured includes engaging the portion of the tissue to be secured with a tubular member, said step of utilizing the retainer member to form the opening at the second location includes moving a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body.

213. A method as set forth in claim 212 wherein said step of tensioning at least a portion of the tissue to be secured includes transmitting force from the tubular member to the tissue to be secured.

214. A method as set forth in claim 209 wherein said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body is performed with the retainer member formed of bone extending at least part way through the tissue to be secured.

215. A method as set forth in claim 209 wherein the retainer member formed of bone includes a shank portion and a head end portion which projects outward from the shank portion, said step of connecting the retainer member formed of bone with the tissue to be secured includes transmitting force from the head end portion of the retainer member formed of bone to the tissue to be secured.

216. A method as set forth in claim 215 wherein said step of engaging the portion of the tissue to be secured includes engaging the portion of the tissue to be secured with the shank portion of the retainer member formed of bone.

217. A method as set forth in claim 216 wherein said step of tensioning at least a portion of the tissue to be secured includes transmitting force from the shank portion of the retainer member formed of bone to the tissue to be secured.

218. A method as set forth in claim 216 wherein said step of engaging a portion of the tissue to be secured includes piercing the tissue to be secured with the retainer member formed of bone.

219. A method as set forth in claim 209 wherein said step of engaging a portion of the tissue to be secured includes engaging the portion of the tissue to be secured with the retainer member formed of bone prior to performing said step of utilizing the retainer member to form the opening at the second location.

220. A method as set forth in claim 209 further including the step of removing a hard surface area from the second location on the portion of the bone in the patient'"'"'s body, said step of utilizing the retainer member formed of bone to form an opening at the second location on the portion of the bone in the patient'"'"'s body includes transmitting force from an end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body at the second location where the hard surface area was removed.

221. A method as set forth in claim 209 wherein said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes initiating formation of an opening in the portion of the bone in the patient'"'"'s body at the second location with the retainer member formed of bone.

222. A method as set forth in claim 209 wherein said step of utilizing the retainer member formed of bone to form an opening at the second location in the portion of the bone in the patient'"'"'s body includes enclosing the retainer member formed of bone with a sleeve, and applying force against a trailing end portion of the retainer member formed of bone to move a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body at the second location.

223. A method as set forth in claim 209 wherein said step utilizing the retainer member formed of bone to form an opening at the second location in the portion of the bone in the patient'"'"'s body includes moving a leading end portion of the retainer member formed of bone into the portion of the bone at the second location and interrupting movement of the retainer member formed of bone into the portion of the bone at the second location when the leading end portion of the retainer member formed of bone has moved a predetermined distance into the portion of the bone disposed in the patient'"'"'s body.

224. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of positioning a retainer member formed of bone in the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with the tissue to be secured, said step of positioning the retainer member formed of bone in the portion of the bone in the patient'"'"'s body includes utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body, said step of connecting the retainer member formed of bone with the tissue to be secured includes moving the retainer member formed of bone into the tissue to be secured and applying force to the retainer member to tension the tissue to be secured, said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body is performed while maintaining the tension in the tissue to be secured.

225. A method as set forth in claim 224 further including the step of removing a hard surface area from a location on the portion of the bone in the patient'"'"'s body, said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body includes transmitting,force from an end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body at the location where the hard surface area was removed while maintaining the tension in the tissue to be secured.

226. A method as set forth in claim 225 wherein said step of transmitting force from an end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body includes rotating the retainer member formed of bone about a central axis of the retainer member formed of bone while maintaining the tension in the tissue to be secured.

227. A method as set forth in claim 226 wherein said step of transmitting force from an end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body includes applying an axially directed force against the retainer member formed of bone and pushing material of the portion of the bone in the patient'"'"'s body aside under the influence of the axially directed force while maintaining the tension in the tissue to be secured.

228. A method as set forth in claim 224 wherein said step of utilizing the retainer member to form an opening in the portion of the bone in the patient'"'"'s body includes moving at least a portion of the retainer member through a compact outer layer of the portion of the bone into the patient'"'"'s body into cancellous bone enclosed by the compact outer layer while maintaining the tension in the tissue to be secured.

229. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of positioning at least a portion of a retainer member formed of bone in a tubular member, moving at least a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with the tissue to be secured, said step of connecting the retainer member formed of bone with tissue to be secured includes moving a portion of the retainer member formed of bone into the tissue to be secured while the retainer member formed of bone is at least partially disposed in the tubular member.

230. A method as set forth in claim 229 wherein said step of moving a portion of the retainer member formed of bone into the tissue to be secured includes contemporaneously moving the tubular member and the retainer member formed of bone into the tissue to be secured.

231. A method as set forth in claim 229 wherein said step of moving a portion of the retainer member formed of bone into the tissue to be secured includes initiating formation of an opening in the tissue to be secured with an end portion of the retainer member formed of bone.

232. A method as set forth in claim 229 wherein said step of moving a portion of the retainer member formed of bone into the tissue to be secured includes initiating formation of an opening in the tissue to be secured with an end portion of the retainer member formed of bone and moving the tubular member into the opening in the tissue to be secured.

233. A method as set forth in claim 229 wherein said step of moving at least a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body includes forming an opening in the portion of the bone in the patient'"'"'s body with a leading end portion of the retainer member formed of bone.

234. A method as set forth in claim 229 wherein said step of moving at least a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body includes initiating formation of an opening in the portion of the bone in the patient'"'"'s body.

235. A method as set forth in claim 229 further including the step of removing a hard surface area from a location on the portion of the bone in the patient'"'"'s body, said step of moving at least a portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes transmitting force from an end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body at the location where the hard surface area was removed.

236. A method as set forth in claim 229 wherein said step of moving at least a portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes rotating the retainer member formed of bone about a central axis of the retainer member formed of bone.

237. A method as set forth in claim 229 wherein said step of moving at least a portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes applying force against the retainer member formed of bone and pushing material of the portion of the bone in the patient'"'"'s body aside under the influence of the force applied against the retainer member formed of bone without rotating the retainer member formed of bone about a central axis of the retainer member formed of bone.

238. A method as set forth in claim 229 wherein said step of moving at least a portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes moving at least a portion of the retainer member through a compact outer layer of the portion of the bone in the patient'"'"'s body into cancellous bone enclosed by the compact outer layer.

239. A method as set forth in claim 229 wherein said steps of moving at least a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member formed of bone through the portion of the bone in the patient'"'"'s body into the tissue to be secured.

240. A method as set forth in claim 229 wherein said steps of moving at least a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member formed of bone through a first portion of the bone in the patient'"'"'s body into a second portion of the bone in the patient'"'"'s body.

241. A method as set forth in claim 229 wherein the bone in the patient'"'"'s body is divided into a first portion and a second portion by a fracture and the tissue to be secured is the second portion of the bone, said steps of moving at least a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through the first portion of the bone into the second portion of the bone.

242. A method as set forth in claim 229 wherein the portion of a bone in the patient'"'"'s body is a first bone and the tissue to be secured is a second bone in the patient'"'"'s body, said steps of moving at least a portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured includes moving a portion of the retainer member through the first bone into the second bone to prevent relative movement between the first and second bones.

243. A method as set forth in claim 242 further including the step of breaking the retainer member formed of bone to enable relative movement to occur between the first and second bones.

244. A method as set forth in claim 229 wherein said step of moving at least a portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes moving the retainer member formed of bone through a compact outer layer of bone into cancellous bone, said step of connecting the retainer member formed of bone with the tissue to be secured includes transmitting force between the tissue to be secured and the retainer member through a suture.

245. A method as set forth in claim 244 wherein said step of moving at least a portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes changing the orientation of the retainer member formed of bone relative to the compact outer layer of bone after performing said step of moving the retainer member formed of bone through the compact outer layer into cancellous bone.

246. A method as set forth in claim 244 wherein said step of transmitting force between the tissue to be secured and the retainer member through a suture includes maintaining the retainer member in a spaced apart relationship with the compact outer layer of the bone in the patient'"'"'s body under the influence of force applied against the retainer member formed of bone by the cancellous bone.

247. A method as set forth in claim 229 wherein said step moving at least a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body includes moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body and interrupting movement of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body when the leading end portion of the retainer member formed of bone has moved a predetermined distance into the portion of the bone disposed in the patient'"'"'s body.

248. A method as set forth in claim 247 wherein said step of utilizing the retainer member formed of bone to form the opening at the second location is performed prior to performance of said step of moving the engaged portion of the tissue to be secured from the first location to the second location.

249. A method as set forth in claim 229 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes engaging a portion of the tissue to be secured, tensioning at least a portion of the tissue to be secured by moving the engaged portion of the tissue to be secured from a first location relative to the portion of the bone in the patient'"'"'s body to a second location relative to the portion of the bone in the patient'"'"'s body, said step of moving at least a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body includes utilizing the retainer member to form an opening at the second location.

250. A method as set forth in claim 249 wherein said step of engaging a portion of the tissue to be secured includes engaging the portion of the tissue to be secured with the retainer member formed of bone prior to performing said step of utilizing the retainer member to form the opening at the second location.

251. A method as set forth in claim 229 further including the step of moving a member into the portion of the bone in the patient'"'"'s body to form an opening of a first size, said step of moving at least a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body includes increasing the size of the opening formed in the bone in the patient'"'"'s body from the first size to a second size which is larger than the first size.

252. A method as set forth in claim 229 wherein said step of moving at least a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body includes moving a thin elongated member into the portion of the bone in the patient'"'"'s body and guiding movement of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body with the thin elongated member.

253. A method as set forth in claim 229 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes moving the retainer member formed of bone into the tissue to be secured and tensioning the tissue to be secured, said step of moving at least a portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body is performed while maintaining the tension in the tissue to be secured.

254. A method as set forth in claim 229 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes moving the tubular member into the tissue to be secured and tensioning the tissue to be secured, said step of moving at least a portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body is performed while continuing to tension the tissue to be secured.

255. A method as set forth in claim 254 further including the step of disengaging the tubular member from the tissue to be secured and the retainer member formed of bone after performing said step of moving at least a portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body.

256. A method as set forth in claim 229 wherein said step of moving at least a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body is at least partially performed with the tubular member in engagement with the tissue to be secured, said method further includes the step of disengaging the tubular member from the tissue to be secured after performing said step of moving at least a portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body.

257. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of positioning at least a portion of a retainer member formed of bone in a tubular member, moving at least a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with the tissue to be secured, said step of connecting the retainer member formed of bone with the tissue to be secured includes engaging a portion of the tissue to be secured, tensioning at least a portion of the tissue to be secured by moving the engaged portion of the tissue to be secured from a first location relative to the portion of the bone in the patient'"'"'s body to a second location relative to the portion of the bone in the patient'"'"'s body, said step of moving at least a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body includes utilizing the retainer member to form an opening at the second location.

258. A method as set forth in claim 257 wherein said step of engaging the portion of the tissue to be secured includes engaging the portion of the tissue to be secured with the retainer member formed of bone.

259. A method as set forth in claim 258 wherein said step of tensioning at least a portion of the tissue to be secured includes transmitting force from the retainer member formed of bone to the tissue to be secured.

260. A method as set forth in claim 257 wherein said step of engaging the portion of the tissue to be secured includes engaging the portion of the tissue to be secured with the tubular member.

261. A method as set forth in claim 260 wherein said step of tensioning at least a portion of the tissue to be secured includes transmitting force from the tubular member to the tissue to be secured.

262. A method as set forth in claim 257 wherein said step of utilizing the retainer member formed of bone to form an opening in the portion of the bone in the patient'"'"'s body is performed with the retainer member formed of bone extending at least part way through the tissue to be secured.

263. A method as set forth in claim 257 wherein said step of engaging a portion of the tissue to be secured includes piercing the tissue to be secured with the retainer member formed of bone.

264. A method as set forth in claim 257 wherein said step of engaging a portion of the tissue to be secured includes engaging the portion of the tissue to be secured with the retainer member formed of bone prior to performing said step of utilizing the retainer member to form the opening at the second location.

265. A method as set forth in claim 257 wherein said step of utilizing the retainer member formed of bone to form the opening at the second location is performed prior to performance of said step of moving the engaged portion of the tissue to be secured from the first location to the second location.

266. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of positioning at least a portion of a retainer member formed of bone in a tubular member, moving at least a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body, connecting the retainer member formed of bone with the tissue to be secured, and moving a member into the portion of the bone in the patient'"'"'s body to form an opening of a first size, said step of moving at least a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body includes increasing the size of the opening formed in the bone in the patient'"'"'s body from the first size to a second size which is larger than the first size.

267. A method as set forth in claim 266 wherein said step of moving at least a portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes rotating the retainer member formed of bone about a central axis of the retainer member formed of bone.

268. A method as set forth in claim 266 wherein said step of moving at least a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body includes applying force against the retainer member formed of bone and pushing material of the portion of the bone in the patient'"'"'s body aside under the influence of the force applied against the retainer member formed of bone.

269. A method as set forth in claim 266 wherein said step of moving at least a portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes moving at least a portion of the retainer member through a compact outer layer of the portion of the bone in the patient'"'"'s body into cancellous bone enclosed by the compact outer layer.

270. A method as set forth in claim 266 wherein said steps of moving at least a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member formed of bone through the portion of the bone in the patient'"'"'s body into the tissue to be secured.

271. A method as set forth in claim 266 wherein said steps of moving at least a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member formed of bone through a first portion of the bone in the patient'"'"'s body into a second portion of the bone in the patient'"'"'s body.

272. A method as set forth in claim 266 wherein said step of moving at least a portion of the retainer member formed of bone into the patient'"'"'s body includes moving the retainer member formed of bone through a compact outer layer of bone into cancellous bone, said step of connecting the retainer member formed of bone with the tissue to be secured includes transmitting force between the tissue to be secured and the retainer member through a suture.

273. A method as set forth in claim 272 wherein said step of positioning the retainer member formed of bone in the patient'"'"'s body includes changing the orientation of the retainer member formed of bone relative to the compact outer layer of bone after performing said step of moving the retainer member formed of bone through the compact outer layer into cancellous bone.

274. A method as set forth in claim 272 wherein said step of transmitting force between the tissue to be secured and the retainer member through a suture includes maintaining the retainer member in a spaced apart relationship with the compact outer layer of the bone in the patient'"'"'s body under the influence of force applied against the retainer member formed of bone by the cancellous bone.

275. A method as set forth in claim 266 wherein said step moving at least a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body includes moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body and interrupting movement of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body when the leading end portion of the retainer member formed of bone has moved a predetermined distance into the portion of the bone disposed in the patient'"'"'s body.

276. A method as set forth in claim 266 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes engaging a portion of the tissue to be secured, tensioning at least a portion of the tissue to be secured by moving the engaged portion of the tissue to be secured from a first location relative to the portion of the bone in the patient'"'"'s body to a second location relative to the portion of the bone in the patient'"'"'s body, said step of moving at least a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body includes moving the retainer member into engagement with bone at the second location.

277. A method as set forth in claim 276 wherein said step of engaging a portion of the tissue to be secured includes engaging the portion of the tissue to be secured with the retainer member formed of bone prior to performing said step of moving the retainer member into engagement with bone at the second location.

278. A method as set forth in claim 276 wherein said step of moving the retainer member formed of bone into engagement with bone at the second location is performed prior to performance of said step of moving the engaged portion of the tissue to be secured from the first location to the second location.

279. A method as set forth in claim 266 wherein said step of moving a member into the portion of the bone in the patient'"'"'s body to form an opening of a first size includes moving a thin elongated member into the portion of the bone in the patient'"'"'s body, said step of increasing the size of the opening formed in the bone in the patient'"'"'s body includes guiding movement of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body with the thin elongated member.

280. A method as set forth in claim 266 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes moving the retainer member formed of bone into the tissue to be secured and applying force to the retainer member to tension the tissue to be secured, said step of moving at least a portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body is performed while maintaining the tension in the tissue to be secured.

281. A method as set forth in claim 266 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes moving the tubular member into the tissue to be secured, and applying force to the tubular member to tension the tissue to be secured, said step of moving at least a portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body is performed while continuing to tension the tissue to be secured.

282. A method as set forth in claim 281 further including the step of disengaging the tubular member from the tissue to be secured and the retainer member formed of bone after performing said step of moving at least a portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body.

283. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of positioning at least a portion of a retainer member formed of bone in a tubular member, moving at least a portion of the retainer member formed of bone out of the tubular member into the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with the tissue to be secured, said step of connecting the retainer member formed of bone with the tissue to be secured includes moving the retainer member formed of bone into the tissue to be secured and applying force to the retainer member to tension the tissue to be secured, said step of moving at least a portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body is performed while maintaining the tension in the tissue to be secured.

284. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body under the influence of force applied against a trailing end portion of the retainer member formed of bone, said step of moving the retainer member formed of bone into the portion of the bone in the patient'"'"'s body under the influence of force applied against the trailing end portion of the retainer member formed of bone includes initiating formation of an opening in the portion of the bone in the patient'"'"'s body by transmitting force from a leading end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body and enlarging the opening by continuing to transmit force from the leading end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with the tissue to be secured, said step of transmitting force from the leading end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body is performed without rotating the retainer member formed of bone about a central axis of the retainer member formed of bone.

285. A method as set forth in claim 284 further including the step of removing a hard surface area from a location on the portion of the bone in the patient'"'"'s body, said step of initiating formation of an opening in the portion of the bone in the patient'"'"'s body includes transmitting force from the leading end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body at the location where the hard surface area was removed.

286. A method as set forth in claim 284 wherein said step of transmitting force from the leading end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body includes pushing material of the portion of the bone in the patient'"'"'s body aside.

287. A method as set forth in claim 284 wherein said step of moving the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes moving at least a portion of the retainer member through a compact outer layer of the portion of the bone into cancellous bone enclosed by the compact outer layer.

288. A method as set forth in claim 284 wherein said step of connecting the retainer member formed of bone with tissue to be secured includes moving a portion of the retainer member formed of bone into the tissue to be secured and transmitting force between an outer side surface area on the retainer member formed of bone and the tissue to be secured.

289. A method as set forth in claim 284 wherein said step of moving the retainer member formed of bone in the portion of the bone into the patient'"'"'s body includes positioning the retainer member formed of bone in a tubular member, said steps of initiating formation of an opening in the portion of the bone in the patient'"'"'s body and enlarging the opening are performed while the retainer member formed of bone is at least partially positioned in the tubular member and include moving the retainer member formed of bone relative to the tubular member.

290. A method as set forth in claim 284 further including the step of interrupting movement of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body when the leading end portion of the retainer member formed of bone has moved a predetermined distance into the portion of the bone disposed in the patient'"'"'s body.

291. A method as set forth in claim 284 wherein said steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through the portion of the bone in the patient'"'"'s body into the tissue to be secured.

292. A method as set forth in claim 284 wherein said steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through a first portion of the bone in the patient'"'"'s body into a second portion of the bone in the patient'"'"'s body.

293. A method as set forth in claim 284 wherein the bone in the patient'"'"'s body is divided into a first portion and a second portion by a fracture and the tissue to be secured is the second portion of the bone, said steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through the first portion of the bone into the second portion of the bone.

294. A method as set forth in claim 284 wherein the portion of a bone in the patient'"'"'s body is a first bone and the tissue to be secured is a second bone in the patient'"'"'s body, said steps of moving a retainer member formed of bone in the portion of the bone into the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured includes moving a portion of the retainer member through the first bone into the second bone to prevent relative movement between the first and second bones.

295. A method as set forth in claim 294 further including the step of breaking the retainer member formed of bone to enable relative movement to occur between the first and second bones.

296. A method as set forth in claim 284 wherein said step of moving the retainer member formed of bone into the patient'"'"'s body includes moving the retainer member formed of bone through a compact outer layer of bone into cancellous bone, said step of connecting the retainer member formed of bone with the tissue to be secured includes transmitting force between the tissue to be secured and the retainer member through a suture.

297. A method as set forth in claim 296 wherein said step of moving the retainer member formed of bone into the patient'"'"'s body includes changing the orientation of the retainer member formed of bone relative to the compact outer layer of bone after performing said step of moving the retainer member formed of bone through the compact outer layer into cancellous bone.

298. A method as set forth in claim 297 wherein said step of transmitting force between the tissue to be secured and the retainer member through a suture includes maintaining the retainer member in a spaced apart relationship with the compact outer layer of the bone in the patient'"'"'s body under the influence of force applied against the retainer member formed of bone by the cancellous bone.

299. A method as set forth in claim 284 wherein said step of initiating formation of an opening in the portion of the bone in the patient'"'"'s body includes enclosing the retainer member formed of bone with a sleeve and moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body while a portion of the retainer member formed of bone is enclosed by the sleeve.

300. A method as set forth in claim 284 wherein the retainer member formed of bone includes a shank portion and a head end portion which projects radially outward from the shank portion, said step of connecting the retainer member formed of bone with the tissue to be secured includes pressing the head end portion of the retainer member formed of bone against the tissue to be secured.

301. A method as set forth in claim 284 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes engaging a portion of the tissue to be secured, tensioning at least a portion of the tissue to be secured by moving the engaged portion of the tissue to be secured from a first location relative to the portion of the bone in the patient'"'"'s body to a second location relative to the portion of the bone in the patient'"'"'s body, said step of initiating formation of an opening in the portion of the bone in the patient'"'"'s body includes utilizing the retainer member to form the opening at the second location.

302. A method as set forth in claim 301 wherein said step of engaging a portion of the tissue to be secured includes engaging the portion of the tissue to be secured with the retainer member formed of bone prior to performing said step of initiating formation of the opening at the second location.

303. A method as set forth in claim 301 wherein said step of initiating formation of the opening at the second location is performed prior to performance of said step of moving the engaged portion of the tissue to be secured from the first location to the second location.

304. A method as set forth in claim 284 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes moving the retainer member formed of bone into the tissue to be secured and applying force to the retainer member to tension the tissue to be secured, said step of initiating formation of an opening in the portion of the bone in the patient'"'"'s body is performed while maintaining the tension in the tissue to be secured.

305. A method as set forth in claim 284 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes moving a tubular member into the tissue to be secured, applying force to the tubular member to tension the tissue to be secured, and positioning the retainer member formed of bone in the tubular member, said step of initiating formation of an opening in the portion of the bone in the patient'"'"'s body includes moving at least a portion of the retainer member formed of bone from the tubular member into the portion of the bone in the patient'"'"'s body.

306. A method as set forth in claim 305 further including the step of disengaging the tubular member from the tissue to be secured and the retainer member formed of bone after performing said step of initiating formation of an opening in the portion of the bone in the patient'"'"'s body.

307. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body under the influence of force applied against a trailing end portion of the retainer member formed of bone, said step of moving the retainer member formed of bone into the portion of the bone in the patient'"'"'s body under the influence of force applied against the trailing end portion of the retainer member formed of bone includes initiating formation of an opening in the portion of the bone in the patient'"'"'s body by transmitting force from a leading end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body and enlarging the opening by continuing to transmit force from the leading end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with the tissue to be secured, said step of transmitting force from the leading end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body includes pushing material of the portion of the bone in the patient'"'"'s body aside under the influence of force applied against the trailing end portion of the retainer member formed of bone.

308. A method as set forth in claim 307 further including the step of removing a hard surface area from a location on the portion of the bone in the patient'"'"'s body, said step of initiating formation of an opening in the portion of the bone in the patient'"'"'s body includes transmitting force from the leading end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body at the location where the hard surface area was removed.

309. A method as set forth in claim 307 wherein said step of moving the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes moving at least a portion of the retainer member through a compact outer layer of the portion of the bone into cancellous bone enclosed by the compact outer layer.

310. A method as set forth in claim 307 wherein said step of connecting the retainer member formed of bone with tissue to be secured includes moving a portion of the retainer member formed of bone into the tissue to be secured and transmitting force between an outer side surface area on the retainer member formed of bone and the tissue to be secured.

311. A method as set forth in claim 307 wherein said step of moving the retainer member formed of bone in the portion of the bone into the patient'"'"'s body includes positioning the retainer member formed of bone in a tubular member, said steps of initiating formation of an opening in the portion of the bone in the patient'"'"'s body and enlarging the opening are performed while the retainer member formed of bone is at least partially positioned in the tubular member and include moving the retainer member formed of bone relative to the tubular member.

312. A method as set forth in claim 307 further including the step of interrupting movement of the retainer member formed of bone into the portion of the bone in the patients body when the leading end portion of the retainer member formed of bone has moved a predetermined distance into the portion of the bone disposed in the patient'"'"'s body.

313. A method as set forth in claim 307 wherein said step of transmitting force from an end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body includes rotating the retainer member formed of bone about a central axis of the retainer member formed of bone.

314. A method as set forth in claim 307 wherein said steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through the portion of the bone in the patient'"'"'s body into the tissue to be secured.

315. A method as set forth in claim 307 wherein said steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through a first portion of the bone in the patient'"'"'s body into a second portion of the bone in the patient'"'"'s body.

316. A method as set forth in claim 307 wherein the bone in the patient'"'"'s body is divided into a first portion and a second portion by a fracture and the tissue to be secured is the second portion of the bone, said steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through the first portion of the bone into the second portion of the bone.

317. A method as set forth in claim 307 wherein the portion of a bone in the patient'"'"'s body is a first bone and the tissue to be secured is a second bone in the patient'"'"'s body, said steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured includes moving a portion of the retainer member through the first bone into the second bone to prevent relative movement between the first and second bones.

318. A method as set forth in claim 317 further including the step of breaking the retainer member formed of bone to enable relative movement to occur between the first and second bones.

319. A method as set forth in claim 307 wherein said step of moving the retainer member formed of bone into the patient'"'"'s body includes moving the retainer member formed of bone through a compact outer layer of bone into cancellous bone, said step of connecting the retainer member formed of bone with the tissue to be secured includes transmitting force between the tissue to be secured and the retainer member through a suture.

320. A method as set forth in claim 319 wherein said step of moving the retainer member formed of bone into the patient'"'"'s body includes changing the orientation of the retainer member formed of bone relative to the compact outer layer of bone after performing said step of moving the retainer member formed of bone through the compact outer layer into cancellous bone.

321. A method as set forth in claim 319 wherein said step of transmitting force between the tissue to be secured and the retainer member through a suture includes maintaining the retainer member in a spaced apart relationship with the compact outer layer of the bone in the patient'"'"'s body under the influence of force applied against the retainer member formed of bone by the cancellous bone.

322. A method as set forth in claim 307 wherein said step of moving the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes enclosing the retainer member formed of bone with a sleeve and moving a portion of the retainer member formed of bone out of the sleeve into the portion of the bone in the patient'"'"'s body.

323. A method as set forth in claim 307 wherein the retainer member formed of bone includes a shank portion and a head end portion which projects radially outward from the shank portion, said step of connecting the retainer member formed of bone with the tissue to be secured includes pressing the head end portion of the retainer member formed of bone against the tissue to be secured.

324. A method as set forth in claim 307 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes engaging a portion of the tissue to be secured, tensioning at least a portion of the tissue to be secured by moving the engaged portion of the tissue to be secured from a first location relative to the portion of the bone in the patient'"'"'s body to a second location relative to the portion of the bone in the patient'"'"'s body, said step of initiating formation of an opening in the portion of the bone in the patient'"'"'s body includes utilizing the retainer member to form the opening at the second location.

325. A method as set forth in claim 324 wherein said step of engaging a portion of the tissue to be secured includes engaging the portion of the tissue to be secured with the retainer member formed of bone prior to performing said step of utilizing the retainer member to form the opening at the second location.

326. A method as set forth in claim 324 wherein said step of utilizing the retainer member formed of bone to form the opening at the second location is performed prior to performance of said step of moving the engaged portion of the tissue to be secured from the first location to the second location.

327. A method as set forth in claim 307 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes moving the retainer member formed of bone into the tissue to be secured and applying force to the retainer member to tension the tissue to be secured, said step of moving the retainer member formed of bone into the portion of the bone in the patient'"'"'s body is performed while maintaining the tension in the tissue to be secured.

328. A method as set forth in claim 307 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes moving a tubular member into the tissue to be secured, applying force to the tubular member to tension the tissue to be secured, and positioning the retainer member formed of bone in the tubular member, said step of moving the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes moving at least a portion of the retainer member formed of bone from the tubular member into the portion of the bone in the patient'"'"'s body.

329. A method as set forth in claim 328 further including the step of disengaging the tubular member from the tissue to be secured and the retainer member formed of bone after performing said step of moving the retainer member formed of bone into the portion of the bone in the patient'"'"'s body.

330. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body under the influence of force applied against a trailing end portion of the retainer member formed of bone, said step of moving the retainer member formed of bone into the portion of the bone in the patient'"'"'s body under the influence of force applied against the trailing end portion of the retainer member formed of bone includes initiating formation of an opening in the portion of the bone in the patient'"'"'s body by transmitting force from a leading end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body and enlarging the opening by continuing to transmit force from the leading end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with the tissue to be secured, said step of moving the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes positioning the retainer member formed of bone in a tubular member, said steps of initiating formation of an opening in the portion of the bone in the patient'"'"'s body and enlarging the opening are performed while the retainer member formed of bone is at least partially positioned in the tubular member and include moving the retainer member formed of bone relative to the tubular member.

331. A method as set forth in claim 330 further including the step of removing a hard surface area from a location on the portion of the bone in the patient'"'"'s body, said step of initiating formation of an opening in the portion of the bone in the patient'"'"'s body includes transmitting force from the leading end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body at the location where the hard surface area was removed.

332. A method as set forth in claim 330 wherein said step of moving the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes moving at least a portion of the retainer member through a compact outer layer of the portion of the bone into cancellous bone enclosed by the compact outer layer.

333. A method as set forth in claim 330 wherein said step of connecting the retainer member formed of bone with tissue to be secured includes moving a portion of the retainer member formed of bone into the tissue to be secured and transmitting force between an outer side surface area on the retainer member formed of bone and the tissue to be secured.

334. A method as set forth in claim 330 further including the step of interrupting movement of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body when the leading end portion of the retainer member formed of bone has moved a predetermined distance into the portion of the bone disposed in the patient'"'"'s body.

335. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with the tissue to be secured, said step of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes deflecting material of the portion of the bone disposed in the patient'"'"'s body under the influence of force transmitted through the retainer member formed of bone without rotating the retainer member formed of bone relative to the portion of the bone in the patient'"'"'s body and interrupting movement of the retainer member formed of bone relative to the portion of the bone in the patient'"'"'s body with the retainer member formed of bone disposed in engagement with the portion of the bone in the patient'"'"'s body, said step of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body at least partially includes enclosing the retainer member formed of bone with a tubular member, applying force against a trailing end portion of the retainer member formed of bone, and moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body under the influence of force applied against the trailing end portion of the retainer member formed of bone while the retainer member formed of bone is at least partially enclosed by the tubular member.

336. A method as set forth in claim 335 wherein said step of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes moving the retainer member formed of bone to initiate formation of an opening in a compact outer layer of the portion of the bone in the patient'"'"'s body.

337. A method as set forth in claim 335 further including the step of interrupting movement of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body when a leading end portion of the retainer member formed of bone has moved a predetermined distance into the portion of the bone in the patient'"'"'s body.

338. A method as set forth in claim 335 further including the step of tensioning the tissue to be secured prior to moving the retainer member formed of bone into the portion of the bone in the patient'"'"'s body.

339. A method as set forth in claim 335 further including the step of removing a hard surface area from a location on the portion of the bone in the patient'"'"'s body, said step of moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes transmitting force from the leading end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body at the location where the hard surface area was removed.

340. A method as set forth in claim 335 wherein said step of moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes pushing material of the portion of the bone in the patient'"'"'s body aside under the influence of the force applied against the trailing end portion of the retainer member formed of bone.

341. A method as set forth in claim 335 wherein said step of moving the leading a leading end portion of the retainer member into the portion of the bone in the patient'"'"'s body includes moving at least a portion of the retainer member through a compact outer layer of the portion of the bone in the patient'"'"'s body into cancellous bone enclosed by the compact outer layer.

342. A method as set forth in claim 335 wherein said step of connecting the retainer member formed of bone with tissue to be secured includes moving a portion of the retainer member formed of bone into the tissue to be secured and transmitting force between an outer side surface area on the retainer member formed of bone and the tissue to be secured.

343. A method as set forth in claim 335 wherein said steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through the portion of the bone in the patient'"'"'s body into the tissue to be secured.

344. A method as set forth in claim 335 wherein said steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through a first portion of the bone in the patient'"'"'s body into a second portion of the bone in the patient'"'"'s body.

345. A method as set forth in claim 335 wherein the bone in the patient'"'"'s body is divided into a first portion and a second portion by a fracture and the tissue to be secured is the second portion of the bone, said steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through the first portion of the bone into the second portion of the bone.

346. A method as set forth in claim 335 wherein the portion of a bone in the patient'"'"'s body is a first bone and the tissue to be secured is a second bone in the patient'"'"'s body, said steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured includes moving a portion of the retainer member through the first bone into the second bone to prevent relative movement between the first and second bones.

347. A method as set forth in claim 346 further including the step of breaking the retainer member formed of bone to enable relative movement to occur between the first and second bones.

348. A method as set forth in claim 335 wherein said step of moving the retainer member formed of bone into the patient'"'"'s body includes moving the retainer member formed of bone through a compact outer layer of bone into cancellous bone, said step of connecting the retainer member formed of bone with the tissue to be secured includes transmitting force between the tissue to be secured and the retainer member through a suture.

349. A method as set forth in claim 348 wherein said step of moving the retainer member formed of bone into the patient'"'"'s body includes changing the orientation of the retainer member formed of bone relative to the compact outer layer of bone after performing said step of moving the retainer member formed of bone through the compact outer layer cancellous bone.

350. A method as set forth in claim 348 wherein said step of transmitting force between the tissue to be secured and the retainer member through a suture includes maintaining the retainer member in a spaced apart relationship with the compact outer layer of the bone in the patient'"'"'s body under the influence of force applied against the retainer member formed of bone by the cancellous bone.

351. A method as set forth in claim 335 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes engaging a portion of the tissue to be secured, tensioning at least a portion of the tissue to be secured by moving the engaged portion of the tissue to be secured from a first location relative to the portion of the bone in the patient'"'"'s body to a second location relative to the portion of the bone in the patient'"'"'s body, said step of moving the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes moving the retainer member into the portion of the bone in the patient'"'"'s body at the second location.

352. A method as set forth in claim 351 wherein said step of engaging a portion of the tissue to be secured includes engaging the portion of the tissue to be secured with the retainer member formed of bone prior to performing said step of moving the leading end portion of the retainer member into the portion of the bone in the patient'"'"'s body at the second location.

353. A method as set forth in claim 351 wherein said step of moving the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body at the second location is performed prior to performance of said step of moving the engaged portion of the tissue to be secure from the first location to the second location.

354. A method as set forth in claim 335 wherein said step of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes moving a member into the portion of the bone in the patient'"'"'s body to form an opening of a first size, said step of moving the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes increasing the size of the opening formed in the bone in the patient'"'"'s body from the first size to a second size which is larger than the first size.

355. A method as set forth in claim 335 wherein said step of moving the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes moving a thin elongated member into the portion of the bone in the patient'"'"'s body, said step of moving the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes guiding movement of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body with the thin elongated member.

356. A method as set forth in claim 335 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes moving the retainer member formed of bone into the tissue to be secured and applying force to the retainer member to tension the tissue to be secured, said step of moving the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body is performed while maintaining the tension in the tissue to be secured.

357. A method as set forth in claim 335 wherein said step of connecting the retainer member formed of bone with the tissue to be secured includes moving the tubular member into the tissue to be secured, applying force to the tubular member to tension the tissue to be secured, and positioning the retainer member formed of bone in the tubular member.

358. A method as set forth in claim 357 further including the step of disengaging the tubular member from the tissue to be secured and the retainer member formed of bone after performing said step of moving the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body.

359. A method of securing tissue against movement relative to a portion of a bone in a patient'"'"'s body, said method comprising the steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body, tensioning the tissue to be secured prior to moving the retainer member formed of bone into the portion of the bone in the patient'"'"'s body, and connecting the retainer member formed of bone with the tissue to be secured, said step of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes deflecting material of the portion of the bone disposed in the patient'"'"'s body under the influence of force transmitted through the retainer member formed of bone without rotating the retainer member formed of bone relative to the portion of the bone in the patient'"'"'s body and interrupting movement of the retainer member formed of bone relative to the portion of the bone in the patient'"'"'s body with the retainer member formed of bone disposed in engagement with the portion of the bone in the patient'"'"'s body.

360. A method as set forth in claim 359 wherein said step of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes utilizing the retainer member formed of bone to initiate formation of an opening in a compact outer layer of the portion of the bone in the patient'"'"'s body.

361. A method as set forth in claim 359 wherein said step of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body at least partially includes enclosing the retainer member formed of bone with a tubular member.

362. A method as set forth in claim 359 further including the step of interrupting movement of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body when a leading end portion of the retainer member formed of bone has moved a predetermined distance into the portion of the bone in the patient'"'"'s body.

363. A method as set forth in claim 359 further including the step of removing a hard surface area from a location on the portion of the bone in the patient'"'"'s body, said step of moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes transmitting force from the leading end portion of the retainer member formed of bone to the portion of the bone in the patient'"'"'s body at the location where the hard surface area was removed.

364. A method as set forth in claim 359 wherein said step of moving a leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes pushing material of the portion of the bone in the patient'"'"'s body aside under the influence of the force applied against the trailing end portion of retainer member formed of bone.

365. A method as set forth in claim 359 wherein said step of moving a leading end portion of the retainer member into the portion of the bone in the patient'"'"'s body includes moving at least a portion of the retainer member through a compact outer layer of the portion of the bone in the patient'"'"'s body into cancellous bone enclosed by the compact outer layer.

366. A method as set forth in claim 359 wherein said step of tensioning the tissue to be secured includes moving a portion of the retainer member formed of bone into the tissue to be secured and transmitting force between an outer side surface area on the retainer member formed of bone and the tissue to be secured.

367. A method as set forth in claim 359 wherein said steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through a first portion of the bone in the patient'"'"'s body into a second portion of the bone in the patient'"'"'s body.

368. A method as set forth in claim 359 wherein the bone in the patient'"'"'s body is divided into a first portion and a second portion by a fracture and the tissue to be secured is the second portion of the bone, said steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured include moving a portion of the retainer member through the first portion of the bone into the second portion of the bone.

369. A method as set forth in claim 359 wherein the portion of a bone in the patient'"'"'s body is a first bone and the tissue to be secured is a second bone in the patient'"'"'s body, said steps of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body and connecting the retainer member formed of bone with the tissue to be secured includes moving a portion of the retainer member through the first bone into the second bone to prevent relative movement between the first and second bones.

370. A method as set forth in claim 359 further including the step of breaking the retainer member formed of bone to enable relative movement to occur between the first and second bones.

371. A method as set forth in claim 359 wherein said step of moving the retainer member formed of bone into the patient'"'"'s body includes moving the retainer member formed of bone through a compact outer layer of bone into cancellous bone, said step of connecting the retainer member formed of bone with the tissue to be secured includes transmitting force between the tissue to be secured and the retainer member through a suture.

372. A method as set forth in claim 371 wherein said step of moving the retainer member formed of bone into the patient'"'"'s body includes changing the orientation of the retainer member formed of bone relative to the compact outer layer of bone after performing said step of moving the retainer member formed of bone through the compact outer layer into cancellous bone.

373. A method as set forth in claim 371 wherein said step of transmitting force between the tissue to be secured and the retainer member through a suture includes maintaining the retainer member in a spaced apart relationship with the compact outer layer of the bone in the patient'"'"'s body under the influence of force applied against the retainer member formed of bone by the cancellous bone.

374. A method as set forth in claim 359 wherein said step of tensioning the tissue to be secured includes moving a portion of the tissue to be secured from a first location relative to the portion of the bone in the patient'"'"'s body to a second location relative to the portion of the bone in the patient'"'"'s body, said step of moving the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes moving the retainer member into the portion of the bone in the patient'"'"'s body at the seed location.

375. A method as set forth in claim 359 wherein said step of moving a retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes moving a member into the portion of the bone in the patient'"'"'s body to form an opening of a first size, said step of moving the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes increasing the size of the opening formed in the bone in the patient'"'"'s body from the first size to a second size which is larger than the first size.

376. A method as set forth in claim 359 wherein said step of moving the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes moving a thin elongated member into the portion of the bone in the patient'"'"'s body, said step of moving the leading end portion of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body includes guiding movement of the retainer member formed of bone into the portion of the bone in the patient'"'"'s body with the thin elongated member.