Suture anchor driver

Abstract

To provide a suture anchor driver with a tensioning mechanism.SOLUTION: A suture anchor driver has a handle with a proximal end and a distal end. The handle has a recess with a shaft extending centrally therefrom. The suture anchor driver has a detent ring and a spool. The detent ring has a central aperture and one or more projections. The spool has a central aperture and is rotatable between first and second configurations. The spool has a plurality of protrusions extending from its side face. The shaft extends through the central apertures in the detent ring and in the spool such that the projections of the detent ring are adjacent to the protrusions extending from the spool. In the first configuration, one of the projections extends between two of the protrusions. In the second configuration, one of the projections is aligned with one of the protrusions.SELECTED DRAWING: Figure 10

Description

[Technical Field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims priority to U.S. Provisional Patent Application No. 62 / 646,954, entitled "Quickset Anchor System," filed March 23, 2018; U.S. Provisional Patent Application No. 62 / 647,255, entitled "Auto Release Spool," filed March 23, 2018; and U.S. Provisional Patent Application No. 62 / 648,034, entitled "Auto Release Spool," filed March 26, 2018.

[0002] FIELD OF THE INVENTION The present disclosure relates generally to suture anchor devices for soft tissue bone repair procedures, and more particularly to a suture anchor driver having a tensioning mechanism. [Background technology]

[0003] 2. Description of Related Art Suture anchors are commonly used in surgical procedures to repair soft tissue to bone. Typically, a suture anchor is first inserted into a pre-formed hole with a driver. The suture is then removed from the driver by pulling from the retention cleat. In many suture anchor drivers, removing the suture and needle after inserting the anchor is an additional step that requires extra time during the procedure. In the case of deployable anchors, such as full suture anchors, traction forces must be applied to the suture rim to form the anchor into its final shape and secure the anchor in the bone hole. Currently, the steps of removing the driver, releasing the suture, and traction on the anchor are performed separately, which reduces the surgeon's efficiency and increases fatigue.

[0004] Therefore, a need exists for an easy-to-use suture anchor driver that has a tensioning mechanism that biases the deployable anchor into its final shape and automatically releases the suture from the handle. Summary of the Invention

[0005] An embodiment of the present invention relates to a suture anchor driver. According to one aspect, the suture anchor driver has a handle having a proximal end and a distal end. The handle has a recess with a shaft extending centrally therefrom. The suture anchor driver has a detent ring and a spool. The detent ring has a central opening and one or more protrusions. The spool has a central opening and is rotatable between a first configuration and a second configuration. The spool has a first side and a second side. The second side has a plurality of protrusions extending therefrom. The shaft within the recess extends through the central opening of the detent ring and the central opening of the spool such that the protrusions of the detent ring are adjacent to the plurality of protrusions extending from the spool. In the first configuration, one of the one or more protrusions extends between two of the plurality of protrusions. In the second configuration, one of the one or more protrusions is aligned with one of the plurality of protrusions.

[0006] According to another aspect, a suture anchor driver has a handle having a proximal end, a distal end, and a locking arm having a pawl extending therefrom. The handle has a recess having a barrier member extending therethrough. The recess is configured to hold a spool having a first surface and a second surface. The spool has a first channel and a second channel at least partially separated between the first and second surfaces. A plurality of teeth extend radially from the second surface of the spool. The second channel of the spool has a recess configured to receive a needle connected to a length of suture. The first In one configuration, the pawl of the locking arm extends between two of the plurality of teeth. In a second configuration, the locking arm moves so that the pawl is above the plurality of teeth. The spool is not rotatable in the first configuration and is rotatable in the second configuration.

[0007] According to some embodiments described herein, the suture can be released / unwound from a spool (e.g., spinnable against a static detent ring) on ​​the handle of a suture anchor driver or anchor deployment device; however, before the spool can be rotated (by way of example), it must overcome a force imparted by a tensioning mechanism—teeth on the spool—that impacts and deflects finger-like or other projections on the static detent ring, which in turn imparts tension to the suture (wound around the spool and extending through a slot on the handle) and the attached anchor (when the anchor is at least partially secured in the bone hole). If the anchor is a soft anchor, this force can be adjusted, pre-set, and / or configured / utilized to set and / or test the setting / placement of a soft anchor after the anchor is set / deployed in the bone hole. Additionally, the force can be used to test the setting / placement of a hard anchor. The force used to overcome the force imparted by the tensioning mechanism and rotate the spool to set and / or test the setting / placement is applied by the user by pulling the handle away from the bone hole / deployment site. The force imparted by the tensioning mechanism can be increased / decreased in many ways, including, for example, by altering the thickness, density and / or length of the finger-like projections (or teeth), as should be understood by one of ordinary skill in the art in conjunction with a review of this disclosure.

[0008] It should be understood that all combinations of the foregoing concepts and additional concepts discussed in more detail below (provided such concepts are not mutually inconsistent) are contemplated as part of the inventive subject matter disclosed herein. In particular, all combinations of subject matter recited in the claims appearing at the end of this disclosure are contemplated as part of the inventive subject matter disclosed herein. Additionally, terms explicitly used herein, which may also appear in any disclosure incorporated by reference, should be understood to correspond to a meaning that most closely matches the specific concepts disclosed herein.

[0009] These and other aspects of the invention will be apparent from and elucidated with reference to the embodiment(s) described hereinafter. [Brief explanation of the drawings]

[0010] One or more aspects of the invention are particularly pointed out and particularly claimed as examples in the claims at the conclusion of this specification. The foregoing and other objects, features, and advantages of the invention will become apparent from the following description taken in conjunction with the accompanying drawings.

[0011] [Figure 1] FIG. 1 is a schematic, partially exploded perspective view of a suture anchor driver, according to one embodiment. [Figure 2] FIG. 2 is a schematic, partial cutaway, bottom view of a suture anchor driver, according to one embodiment. [Figure 3] FIG. 3 is a schematic perspective view of a detent ring of a tensioning mechanism of a suture anchor driver, according to one embodiment. [Figure 4] FIG. 4 is a schematic cutaway side view of a spool and detent ring in a first configuration, according to one embodiment. [Figure 5] FIG. 5 is a schematic cutaway side view of a spool and detent ring in a second configuration, according to one embodiment. [Figure 6] FIG. 6 is a schematic perspective view of a suture anchor driver according to an alternative embodiment. [Figure 7] FIG. 7 is a schematic, partially exploded, perspective view of a suture anchor driver according to an alternative embodiment. [Figure 8] FIG. 8 is a schematic side view of a detent ring and spool of an anchor driver in a first configuration according to an alternative embodiment. [Figure 9] FIG. 9 is a schematic side view of a detent ring and spool of an anchor driver in a second configuration according to an alternative embodiment. [Figure 10] FIG. 10 is a partially exploded perspective view of a suture anchor driver according to another alternative embodiment. [Figure 11]FIG. 11 is a schematic side view of a suture anchor driver in a first configuration according to yet another alternative embodiment. [Figure 12] FIG. 12 is a schematic side view of a driver of a suture anchor driver inserted into a guide according to yet another alternative embodiment. [Figure 13] FIG. 13 is a schematic side view of a suture anchor driver in a second configuration according to yet another alternative embodiment. [Figure 14] FIG. 14 is a schematic perspective view of a spool and suture component of a suture anchor driver in accordance with yet another alternative embodiment. [Figure 15] FIG. 15 is a schematic top view of a spool of a suture anchor driver according to yet another alternative embodiment. [Figure 16] FIG. 16 is a schematic top view of a spool with a suture component loaded thereon, according to yet another alternative embodiment. [Figure 17] FIG. 17 is a schematic top view of a spool loaded into a suture anchor driver according to yet another alternative embodiment. DETAILED DESCRIPTION OF THE INVENTION

[0012] Aspects of the present invention and specific features, advantages, and details thereof are more fully described below with reference to non-limiting examples illustrated in the accompanying drawings. Descriptions of well-known structures are omitted so as not to unnecessarily obscure the details of the invention. It should be understood, however, that the detailed description and specific non-limiting examples, while illustrating aspects of the present invention, are given by way of illustration only, and not limitation. Various substitutions, modifications, additions, and / or arrangements within the spirit and / or scope of the concepts underlying the invention will be apparent to those skilled in the art from this disclosure.

[0013] Referring now to the drawings, wherein like reference numerals refer to like parts throughout, FIG. 1 shows a schematic perspective view of a suture anchor driver 100, according to one embodiment. The suture anchor driver 100 comprises a handle 102. The handle 102 extends along a central longitudinal yy axis from a proximal end 104 to a distal end 106. The handle 102 can be any shape, such as, for example, cylindrical or rectangular. As shown in the illustrated embodiment, the handle 102 is ergonomically designed such that the handle 102 is configured to fit within a user's hand. The handle 102 can be made of plastic or any other suitable material (as should be understood by one of ordinary skill in the art in conjunction with a review of this disclosure).

[0014] Referring now to FIG. 2, a schematic, partial cutaway bottom view of a suture anchor driver 100 is shown, according to one embodiment. The anchor driver 100 shown in FIG. 1 also includes a driver 108 extending within the distal end 106 of the handle 102. The driver 108 may be made of a metal, such as stainless steel, or any other suitable material (as should be understood by those skilled in the art in conjunction with a review of this disclosure). In the illustrated embodiment, the driver 108 extends distally from the distal end 106 along a central longitudinal yy axis.

[0015] As shown in FIGS. 1 and 2, the anchor driver 100 further includes a tensioning mechanism 200. The tensioning mechanism 200 includes a detent ring 202, a spool 204, and a shaft 206, as shown in FIG. 1. In the embodiment shown in FIG. 1, the handle 102 includes a recess 110 sized and configured to axially retain the detent ring 202 and spool 204 therein. The shaft 206 is centrally located within the recess 110 and extends from the recess 110 to a first side 112 of the handle 102. In the illustrated embodiment, the shaft 206 does not extend beyond the first side 112 of the handle 102 (although it could). Additionally, as shown in FIGS. 1 and 2, the shaft 206 has a pronged end 208 such that the detent ring 202 and spool 204 can be removably mounted within the recess 110 and around the shaft 206. The prong end 208 maintains the detent ring 202 and spool 204 within the recess 110 , but the detent ring 202 and spool 204 can be removed from the recess 110 when the prongs of the prong end 208 move toward each other.

[0016] 2 , detent ring 202 is positioned within recess 110 around shaft 206. Spool 204 is then positioned within recess 110 around shaft 206 and over detent ring 202 such that spool 204 extends to first side 112 of handle 102. Prior to inserting spool 204 into recess 110, suture 300 (connected to a suture anchor (not shown)) is wound around spool 204. The suture anchor (not shown) may be any anchor, such as the all-suture or “soft” anchor shown and described in U.S. Pat. No. 9,826,971, which is incorporated herein by reference in its entirety.

[0017] As a brief background, suture anchor, as used herein, can include soft suture anchors and hard suture anchors. Soft suture anchors are formed from filaments of suture material that are retained within a pre-formed bone hole by deforming the filament so that its diameter exceeds the size of the hole, thereby residing within the cancellous bone and subcortically. One such suture anchor is disclosed in U.S. Pat. No. 9,826,971. Because soft anchors are typically made entirely of suture material, they are sometimes referred to as "all-suture" anchors and generally include an anchor body portion of a fibrous construct (or a fibrous, braided, or woven-type structure, such as a flexible web, as described in U.S. Pat. No. 9,173,652), and a suture or filament portion, the entirety of which is incorporated herein by reference. Methods and devices for inserting / deploying such all-suture anchors are known, examples of which are disclosed in U.S. Pat. No. 9,173,652.

[0018] As described in U.S. Patent No. 8,409,252, for example, a "non-soft," "hard," or "rigid" suture anchor generally includes a "hard" anchor body portion (which may or may not include an inner member and an outer member) and a suture / filament portion. The anchor body of such a suture anchor may be formed of a biocompatible and / or bioabsorbable material. These materials may be of such compositions that are resorbed by the body, for example, during the bone healing process. Exemplary materials suitable for use in the inner and outer members include, but are not limited to, polyetheretherketone ("PEEK"), polylactic acid / β-tricalcium phosphate ("PLA / beta-TCP") composite, ultra-high molecular weight polyethylene ("UHMWPE"), and other metallic, non-metallic, and polymeric materials.

[0019] 2, the first end 302 of the suture 300 may be pulled through an opening 210 in the spool 204 to prevent the suture 300 from unraveling as it is wound around the spool 204. In another embodiment, the spool 204 may have a conventional slot, hook, or connector to secure the first end 302 of the suture 300. The suture 300 may be wound such that the second end 304 of the suture 300 is near the driver 108, as shown in FIG. Extending from the spool 204 so as to extend distally from the driver 102. In the embodiment shown in FIG. 10 , the handle 102 includes a slot 114 or other opening extending from the recess 110 to a location on the handle 102 adjacent the driver 102.

[0020] 3, a schematic perspective view of detent ring 202 of tensioning mechanism 200 of suture anchor driver 100 is shown, according to one embodiment. In the illustrated embodiment, detent ring 202 includes a central opening 212 that accommodates shaft 206 of tensioning mechanism 200 when detent ring 202 is positioned within recess 110 of handle 102. Detent ring 202 also includes one or more finger-like projections 214 extending from a surface 216 of detent ring 202. Finger-like projections 214 engage spool 204 as described below.

[0021] 1-2, the spool 204 similarly includes a central opening 213 for receiving the shaft 206 within the recess 110 of the handle 102. The spool 204 also includes a plurality of ridges, teeth, or other protrusions 218 extending therefrom. The teeth 218 extend from the spool 204 toward a surface 216 of the detent ring 202. When the detent ring 202 and spool 204 are installed within the recess 110, the finger-like protrusions 214 on the detent ring 202 abut the teeth 218 on the spool 204.

[0022] 4 and 5, schematic cutaway side views of spool 204 and detent ring 202 are shown in a first and second configuration, respectively, according to one embodiment. In the first configuration, as shown in FIG. 4, protrusion 214 of detent ring 202 is within gap 220 between two teeth 218 on spool 204. To move tensioning mechanism 200 to the second configuration, spool 204 is rotated. Spool 204 rotates when traction is applied to suture 300. The traction on suture 300 exerts a torque on spool 204, causing it to rotate.

[0023] The spool 204 resists rotation due to the protrusions 214 of the detent ring 202 extending into the gaps 220 between the teeth 218 of the spool 204, or capture on the teeth 218 of the spool 204. The resistance to rotation applies a force to an anchor (not shown) attached to the suture 300. The force causes the deployable suture anchor (not shown) to expand or form toward its final shape. The force is applied to the suture until the protrusions 214 of the detent ring 202 overcome the resistance or traction force and move out of the gaps 220 between the teeth 218 and align with one of the teeth 218, as shown in FIG. 5 . Additional tension on the suture 300 causes the protrusions 214 of the detent ring 202 to move into the adjacent gaps 220, where the spool 204 resists rotation. As described above, the resistance applies a force to the suture anchor (not shown), causing the suture anchor to deploy or form toward its final shape. Thus, tension can be selectively applied to a suture anchor (not shown) through a selected number of rotations of the spool 204 .

[0024] 6 and 7, there are shown schematic, partially exploded perspective views of a suture anchor driver 100 according to an alternative embodiment. In the illustrated embodiment, detent ring 202 of tensioning mechanism 200 of anchor driver 100 includes one or more arms 214' instead of protrusions 214 shown in the embodiment of FIGS. 1-2. In FIG. 7, arms 214' extend radially, whereas in FIGS. 1-2, protrusions 214 extend from surface 216 of detent ring 202 toward first side 112 of handle 102. To accommodate radial arms 214', the embodiment of spool 204 of FIGS. 6-7 includes radial ridges, teeth, or other protrusions 218' that extend inward toward central opening 213 of spool 204.

[0025] 8 and 9, there are shown schematic side views of detent ring 202 and spool 204 of anchor driver 100 in first and second configurations, respectively, according to an alternative embodiment (which may be applied to and substantially exemplify portions of the alternative embodiment shown and described in connection with FIGS. 6-7 and 10). In the first configuration, as shown in FIG. 8, arms 214' of detent ring 202 are within gaps 220' between teeth 218' of spool 204. To move tensioning mechanism 200 to the second configuration, spool 204 is rotated by traction applied to suture 300. As described above, spool 204 resists rotation, applying a force to the suture anchor (not shown) to partially deploy the suture anchor. Spool 204 resists rotation until arms 214' of detent ring 202 eventually move out of gaps 220' between teeth 218' and align with teeth 218', as shown in FIG. 9. As described above, each successive rotation of spool 204 applies additional force to suture 300 and the suture anchor (not shown), deploying the suture anchor (not shown).

[0026] Referring now to FIG. 10 , a schematic, partially exploded perspective view of a suture anchor driver 100 according to another alternative embodiment is shown. Similar to the embodiment shown in FIGS. 6-9 , the anchor driver 100 of FIG. 10 includes a detent ring 202 having arms 214′ extending radially therefrom. The radial arms 214′ engage radial ridges, teeth, or other protrusions 218′ on the spool 204, as shown in FIG. 10 . However, in the embodiment shown in FIG. 10 , the shaft 206′ of the tensioning mechanism 200 does not have the pronged end 208 (shown in FIG. 1 ). In the illustrated embodiment, the shaft 206′ is a rigid tube and is cylindrical in shape. To maintain the detent ring 202 and spool 204 within the recess 110 of the handle 102, the tensioning mechanism 200 additionally includes a fastener 222. In the illustrated embodiment, the fastener 222 is a cap 224 having a stem 226 extending centrally therefrom. In use, the stem 226 of the fastener 222 is positioned through the opening 213 in the spool 204 and the opening 212 in the detent ring 202, and through the internal channel 228 in the tubular shaft 206'.

[0027] 11-13, schematic side views of a suture anchor driver 400 between a first configuration and a second configuration are shown according to yet another alternative embodiment. In the embodiment shown in FIGS. 11-13, the anchor driver 400 includes a handle 402 extending from a proximal end 404 to a distal end 406 along a central longitudinal yy-axis. The handle 402 can be made of plastic or any other suitable material and can have any shape ergonomically designed to fit within a user's hand (as described in conjunction with the embodiment shown in FIGS. 1-10). The anchor driver 400 shown in FIG. 11 also includes a driver 408 extending within the distal end 406 of the handle 402. The driver 408 may be made of metal (or any other suitable material) and extends distally from the distal end 406 along the central longitudinal yy-axis. As shown in FIG. 11, the handle 402 includes a recess 410 that receives a spool 504 of the tensioning mechanism 500. In the illustrated embodiment, the spool 504 slides into the recess 410 and is held within the recess 410 by a barrier member 502 of the tensioning mechanism 500 , such as an arm or rod of the handle 402 .

[0028] 14-17, various views of a spool 504 and suture component 600 are shown in accordance with yet another alternative embodiment. FIG. 14 shows a perspective view of the spool 504 and suture component 600 of the suture anchor driver 400. The suture component 600 includes a foam block 602 having a needle 604 embedded or hooked therein and a length of suture 606 attached to the needle 604. The suture component 600 also includes a suture anchor 306 on the length of suture 300. In the illustrated embodiment, the needle 604 is curved or hooked.

[0029] Figure 15 illustrates one embodiment of a spool 504 having a first surface 506 and a second surface 508 with at least partially separated first and second channels 510 and 512 therebetween. As shown in both Figures 15 and 16 (and Figure 11), the second surface 508 of the spool 504 includes a plurality of radially extending teeth 514. The second channel 512 of the spool 504 includes a recess 516 configured to receive or otherwise accommodate a foam block 602, as shown in Figure 16.

[0030] Because the needle 604 is curved or hooked, the needle 604 extends along the second channel 512 when the foam block 602 is inserted into the recess 516 of the spool 504. As shown in FIG. 17 , the length of suture 606 attached to the needle 604 is wound around the first channel 510. After the length of suture 606 attached to the needle 604 is loaded onto the spool 504, the spool 504 is placed into the recess 410 of the handle 402. As shown in FIG. 11 , the spool 504 is placed into the recess 410 so that the second surface 508 and the teeth 514 are adjacent the barrier member 502 of the handle 402. The suture anchor 306 (and attached suture 300) is also loaded onto the driver 408.

[0031] 11 , handle 402 additionally includes a locking arm 416 having a pawl 412 or other similar protrusion that extends into a gap 518 between two of the teeth 514 of spool 504 when anchor driver 400 is in the first configuration. In the first configuration, pawl 412 prevents spool 504 from rotating within recess 410 of handle 402 so that suture anchor 306 may be inserted with suture 300 having a fixed tension. Specifically, suture anchor 306 is inserted into a pre-formed hole (or bone hole) connected to spool 504 of handle 402 by tension on suture 300. Because spool 504 cannot rotate, slack (or a reduction in tension) is not introduced into suture 300. Once a fixing tension is applied to the suture anchor 306, the driver 408 inserts the suture anchor 306 through the guide 700 and into the bone hole, as shown in FIG.

[0032] 13 , a side view of the suture anchor driver 400 in a second configuration is shown, according to yet another alternative embodiment. In the illustrated embodiment, the driver 408 has advanced as far as possible into the guide 700. The guide 700 includes a feature 702 that fits into a slot 414 in the handle 402 adjacent to a locking arm 416 having a pawl 412. As the driver 408 extends as far as possible into the guide 700, the feature 702 of the guide 700 fits into the slot 414, deflecting the locking arm 416 away from the spool 504. As the locking arm 416 deflects away from the spool 504, the pawl 412 disengages the gap 518 between the teeth 514 of the spool 504. The spool 504 is then free to spin or rotate within the recess 410 of the handle 402. The spool 504 can be spun within the recess 410 so that the needle 604 and attached length of suture 606, and the suture 300 (connected to the suture anchor 306) can be unwound (i.e., removed) from the handle 402, completing the placement of the suture anchor 306.

[0033] All definitions defined and used herein should be understood to control for dictionary definitions, definitions in documents incorporated by reference, and / or ordinary meanings of the defined terms.

[0034] While various embodiments have been described and illustrated herein, those skilled in the art will readily envision various other means and / or structures for performing the functions and / or obtaining the results and / or one or more advantages described herein, and such modifications and variations will be apparent to those skilled in the art. Each of the variations and / or modifications is considered within the scope of the embodiments described herein. More generally, those skilled in the art will readily appreciate that all parameters, dimensions, materials, and configurations described herein are exemplary, and that the actual parameters, dimensions, materials, and / or configurations will depend on the specific application or applications for which the teachings are used. Those skilled in the art will recognize, or be able to ascertain using no more than routine experimentation, many equivalents to the specific embodiments described herein. Accordingly, the foregoing embodiments are presented by way of example only, and it will be understood that, within the scope of the appended claims and their equivalents, the embodiments may be practiced otherwise than as specifically described and claimed. Embodiments of the present disclosure are directed to each individual feature, system, article, material, kit, and / or method described herein. Furthermore, any combination of two or more such features, systems, articles, materials, kits, and / or methods, where such features, systems, articles, materials, kits, and / or methods are not mutually inconsistent, is within the scope of the present disclosure.

[0035] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the singular forms "a," "an," and "the" are intended to include the plural forms as well, unless the context clearly dictates otherwise. It will be further understood that the terms "comprise" (and any form of comprise, such as "comprises" or "comprising"), "have" (and any form of have, such as "has" or "having"), "include" (and any form of include, such as "includes" or "including"), and "contain" (and any form of contain, such as "contains" or "containing") are open-ended linking verbs. Consequently, a method or device "comprises," "have," "include," or "contain" one or more steps or elements. Similarly, a method step or device element that "comprises," "has," "includes," or "contains" one or more features has those one or more features, but is not limited to possessing only those features or features. Furthermore, a device or structure that is configured in a particular way is configured in at least that way, but may also be configured in ways not listed.

[0036] Corresponding structure, materials, acts, and equivalents of all means or step-plus-function elements in the following claims are intended to include the structure, materials, or acts for performing the function, if any, in combination with the elements of other claims that are specifically claimed. The description of the present invention has been presented for purposes of illustration and description, but is not intended to be exhaustive or limited to the invention in the form disclosed. Many modifications and variations will be apparent to those skilled in the art without departing from the scope and spirit of the invention. The embodiments were chosen and described to best explain the principles and practical application of one or more aspects of the invention and to enable others skilled in the art to appreciate one or more aspects of the invention in various embodiments with various modifications suitable for the particular use contemplated.

Claims

1. 1. A suture anchor driver comprising: a handle having a proximal end and a distal end; a recess in said handle having a shaft extending centrally therefrom; a detent ring having a central opening, said detent ring having one or more protrusions; a spool having a central opening, the spool being rotatable between a first configuration and a second configuration, the spool having a first side and a second side, the second side having a plurality of protrusions extending therefrom; the shaft extends through the central opening of the detent ring and the central opening of the spool such that the projections of the detent ring are adjacent to the plurality of protrusions extending from the spool; In the first configuration, one of the one or more protrusions extends between two of the plurality of protrusions, and in the second configuration, one of the one or more protrusions is aligned with one of the plurality of protrusions.

2. The suture anchor driver of claim 1 , further comprising a driver extending from the distal end of the handle.

3. The suture anchor driver of claim 1 , wherein the one or more protrusions extend from the detent ring toward the second side of the spool within the recess.

4. The suture anchor driver of claim 3 , wherein the plurality of protrusions extend from the second side of the spool toward the detent ring within the recess.

5. The suture anchor driver of claim 1 , wherein the one or more protrusions are arms extending radially from the detent ring.

6. The suture anchor driver of claim 5 , wherein the plurality of protrusions extend radially toward the central opening of the spool.

7. The suture anchor driver of claim 1 , wherein the shaft further includes a pronged end.

8. The suture anchor driver of claim 1 , wherein the recess extends to a first side of the handle.

9. The suture anchor driver of claim 1 , further comprising a slot on an exterior of the handle, the slot extending into the recess.

10. The suture anchor driver of claim 9 , wherein the slot is adjacent to a driver extending from the distal end of the handle.

11. The suture anchor driver of claim 9, further comprising a suture wound around the spool and extending through the slot on the handle.

12. The suture anchor driver of claim 10 , wherein the spool includes an opening on the first side configured to receive an end of the suture therethrough.

13. The suture anchor driver of claim 1 , further comprising a fastener having a cap with a stem extending centrally therefrom, the stem configured to extend into the interior channel of the shaft.

14. 2. The suture anchor driver of claim 1, wherein at least one of the one or more protrusions is configured to move from between two of the plurality of protrusions to an adjacent two of the plurality of protrusions upon application of a predetermined force.

15. The suture anchor driver of claim 14, wherein the predetermined force is applied to a suture wound around the spool and extending through the slot on the handle.

16. The suture anchor driver of claim 14 , wherein the predetermined force is applied to an anchor attached to the suture.

17. 1. A suture anchor driver comprising: a handle having a proximal end, a distal end, and a locking arm having a pawl extending therefrom; a recess in the handle having a barrier member extending across the recess, the recess configured to hold a spool having first and second surfaces and at least partially separated first and second channels extending therebetween; a plurality of teeth extending radially from the second surface of the spool; a recess in the second channel of the spool configured to receive a needle connected to a length of suture; the locking arm moves such that in a first configuration, the pawl of the locking arm extends between two of the plurality of teeth, and in a second configuration, the pawl is above the plurality of teeth; A suture anchor driver, wherein the spool is non-rotatable in the first configuration and rotatable in the second configuration.

18. The suture anchor driver of claim 17, further comprising a slot at a distal end of the handle configured to receive a guide feature.

19. The suture anchor driver of claim 18, wherein the feature of the guide displaces the locking arm of the handle when the feature is in the slot.

20. The suture anchor driver of claim 17, further comprising a driver extending from the distal end of the handle.

21. The suture anchor driver of claim 17, wherein rotation of the spool in the second configuration releases tension on the length of suture.

22. The suture anchor driver of claim 17, wherein the needle is at least partially within a foam block, the foam block being housed within the recess in the second channel of the spool.

23. The suture anchor driver of claim 17, wherein a length of suture connected to a suture anchor is wound around the spool, the length of suture extending from the distal end of the handle.

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