A one-piece fastener or staple includes a base that contacts tissue and a prong that extends through the tissue. A suture lead is anchored to the base and a needle is attached to the suture lead. A tool positions the fastener adjacent to the tissue, and is operated to drive the prong and the suture needle through the tissue. The tool includes a needle grabber that is operated to grab the needle and pull the needle out of the patient. Since the suture lead is attached to the fastener, a prosthesis can be placed on the suture lead and pushed down to the tissue. A cassette is releasably mounted on the tool and contains the fastener, the suture lead and the suture needle. Alternative forms of the anchor have sutures attached to a base at locations that are spaced apart from each other, and sutures associated with each of two adjacent anchors can be tied together or sutures associated with a single anchor can be tied together. A suture threadably connected to an anchor can be used as a running suture. A prosthetic device can have a running suture associated therewith that is threadably attached to each of a plurality of anchors. Another form of the system includes a running suture with loops that can have additional anchors attached thereto as needed if the surgeon decides to add further anchors to the system to customize the system to the particular patient.