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, filed Mar. 23, 2018, entitled “Quickset Anchor System”; U.S. Provisional Patent Application No. 62 / 647,255, filed Mar. 23, 2018, entitled “Auto Release Spool”; and U.S. Provisional Patent Application No. 62 / 648,034, filed Mar. 26, 2018, entitled “Auto Release Spool”.

[0002] Field of the invention The present disclosure generally relates to suture anchor devices for soft tissue bone repair techniques, and more specifically to a suture anchor driver having a tension mechanism.

Background Art

[0003] 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 preformed hole together with a driver. Next, the suture is removed from the driver by pulling from a holding 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 all-suture anchors, it is necessary to apply a pulling force 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 pulling the anchor are performed separately, which reduces the surgeon's efficiency and increases fatigue.

[0004] Therefore, there is a need for an easy-to-use suture anchor driver having a tension mechanism that biases a deployable anchor into its final shape and automatically releases the suture from the handle.

Summary of the Invention

[0005] Embodiments of the present invention relate 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 having 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, the suture anchor driver has a handle having a proximal end, a distal end, and a locking arm having a detent extending therefrom. The handle has a recess having a barrier member extending across it. 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 surface and the second surface. 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 the length of suture. In the first configuration, the detent of the locking arm extends between two of the plurality of teeth. In the second configuration, the locking arm moves such that the detent 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 of a suture anchor driver or a handle of an anchor placement device (e.g., spinable relative to a static detent ring), but the spool needs to overcome the force applied by teeth of the spool that affect and deflect finger-like or other protrusions on the static detent ring, which is a tension mechanism, before (as an example) being able to rotate. Next, tension is applied 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 somewhat fixed within the bone hole). When the anchor is a soft anchor, after the anchor is set / placed within the bone hole, this force can be adjusted, preset, and / or configured / utilized to set the soft anchor and / or test the setting / placement of the soft anchor. Further, the force can be used to test the setting / placement of a rigid anchor. The force used to overcome the force applied by the tension mechanism and rotate the spool for placement / setting and / or testing is applied by the user by pulling the handle in a direction away from the bone hole / placement site. The force applied by the tension mechanism can be increased / decreased in many ways, including, for example, by changing the thickness, density, and / or length of the finger-like protrusions (or teeth), as should be understood by one of ordinary skill in the art in conjunction with the review of the present disclosure.

[0008] Of course, all combinations of the foregoing concepts and additional concepts discussed in more detail below (assuming such concepts are not mutually inconsistent) are considered to be part of the subject matter of the invention disclosed herein. In particular, all combinations of the subject matter recited in the claims that appear at the end of the present disclosure are considered to be part of the subject matter of the invention disclosed herein. Also, terms explicitly used herein that may also appear in any disclosure incorporated by reference should be understood to have a meaning that most closely matches the meaning consistent with the particular concepts disclosed herein.

[0009] These and other aspects of the invention will become apparent and will be elucidated with reference to the embodiments described hereinafter.

Brief Description of the Drawings

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

[0011]

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

[0013] Referring now to the drawings, like reference numerals refer to like parts throughout, and FIG. 1 shows a schematic perspective view of a suture anchor driver 100 according to one embodiment. The suture anchor driver 100 includes a handle 102. The handle 102 extends from a proximal end 104 to a distal end 106 along a central longitudinal y-y axis. The handle 102 can be of any shape, such as, for example, cylindrical or rectangular. As shown in the illustrated embodiment, the handle 102 is ergonomically designed so 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 those skilled in the art in conjunction with the review of the present disclosure).

[0014] Referring now to FIG. 2, a schematic partial cutaway bottom view of a suture anchor driver 100 according to one embodiment is shown. The anchor driver 100 shown in FIG. 1 also includes a driver 108 that extends into the distal end 106 of the handle 102. The driver 108 can 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 the review of the present disclosure). In the illustrated embodiment, the driver 108 extends distally from the distal end 106 along the central longitudinal y-y axis.

[0015] As shown in FIGS. 1 and 2, the anchor driver 100 further includes a tension mechanism 200 is provided. As shown in FIG. 1, the tension mechanism 200 includes a detent ring 202, a spool 204, and a shaft 206. In the embodiment shown in FIG. 1, the handle 102 is sized and configured to axially hold the detent ring 202 and the spool 204 therein and includes a recess 110. The shaft 206 is positioned centrally within the recess 110 and extends from the recess 100 to the first side surface 112 of the handle 102. In the illustrated embodiment, the shaft 206 does not extend beyond the first side surface 112 of the handle 102 (although it is possible to extend). Further, as shown in FIGS. 1 and 2, the shaft 206 has a prong end 208 such that the detent ring 202 and the spool 204 can be removably attached around the shaft 206 within the recess 110. The prong end 208 maintains the detent ring 202 and the spool 204 within the recess 110, but when the prongs of the prong end 208 are moved towards each other, the detent ring 202 and the spool 204 can be removed from the recess 110.

[0016] Referring further to FIG. 2, the detent ring 202 is positioned around the shaft 206 within the recess 110. The spool 204 is then positioned on the detent ring 202 around the shaft 206 within the recess 110 such that the spool 204 extends to the first side surface 112 of the handle 102. Before inserting the spool 204 into the recess 110, a suture 300 (connected to a suture anchor (not shown)) is wound around the spool 204. The suture anchor (not shown) may be any anchor such as a full suture or a “soft” anchor as shown and described in U.S. Patent No. 9,826,971, the entire disclosure of which is incorporated herein by reference.

[0017] As a simple background, suture anchors, as used herein, can include soft suture anchors and rigid suture anchors. Soft suture anchors are formed from filaments of suture material that are retained within a preformed bone hole by being deformed such that their diameter is larger than the size of the bone hole, and thereby exist within cancellous bone and subcortically. One such suture anchor is disclosed in U.S. Patent No. 9,826,971. Soft anchors are often made entirely of suture material and 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 fabric type structure such as a flexible web as described in U.S. Patent No. 9,173,652) and a suture or filament portion, the entire disclosure of U.S. Patent No. 9,173,652 being incorporated herein by reference. Methods and apparatus for inserting / placing such all-suture anchors are known, examples of which are disclosed in U.S. Patent No. 9,173,652.

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

[0019] As shown in FIG. 2, the first end 302 of the suture 300 can be pulled through the opening 210 in the spool 204 to prevent the suture 300 from unraveling when 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 extends from the spool 204 such that the second end 304 of the suture 300 extends distally from the handle 102 near the driver 108. In the embodiment shown in FIG. 10, the handle 102 includes a slot 114 or other opening that extends from the recess 110 to a position adjacent the driver 102 on the handle 102. As shown in FIG. 10, the handle 102 includes a slot 114 or other opening that extends from the recess 110 to a position adjacent the driver 102 on the handle 102.

[0020] Referring now to FIG. 3, a schematic perspective view of the detent ring 202 of the tension mechanism 200 of the suture anchor driver 100 according to one embodiment is shown. In the illustrated embodiment, the detent ring 202 includes a central opening 212 that houses the shaft 206 of the tension mechanism 200 when the detent ring 202 is disposed within the recess 110 of the handle 102. The detent ring 202 also includes one or more finger-like protrusions 214 that extend from the surface 216 of the detent ring 202. The finger-like protrusions 214 engage the spool 204 as described below.

[0021] Returning to FIGS. 1-2, the spool 204 similarly includes a central opening 213 for housing 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 that extend therefrom. The teeth 218 extend from the spool 204 toward the surface 216 of the detent ring 202. When the detent ring 202 and the spool 204 are installed within the recess 110, the finger-like protrusions 214 of the detent ring 202 are adjacent to the teeth 218 of the spool 204.

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

[0023] The spool 204 is resisted from rotating for capture on the protrusion 214 of the detent ring 202 extending within the gap 220 between the teeth 218 of the spool 204, or 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 expands a deployable suture anchor (not shown) or forms it towards its final shape. The force is applied to the suture until, as shown in FIG. 5, the protrusion 214 of the detent ring 202 overcomes the resistance or traction force and moves out of the gap 220 between the teeth 218 and aligns with one of the plurality of teeth 218. The additional tension on the suture 300 causes the protrusion 214 of the detent ring 202 to move into the adjacent gap 220 where the spool 204 is resisted from rotating. As described above, the resistance applies a force to the suture anchor (not shown) and positions or forms the suture anchor towards its final shape. Thus, tension can be selectively applied to the suture anchor (not shown) through a selected number of rotations of the spool 204.

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

[0025] Referring now to FIGS. 8 and 9, schematic side views of the detent ring 202 and spool 204 of the anchor driver 100 in a first configuration and a second configuration according to an alternative embodiment (which can be applied to and is substantially illustrative of a portion of the alternative embodiment shown and described in connection with FIGS. 6-7 and 10) are shown respectively. In the first configuration, as shown in FIG. 8, the arms 214' of the detent ring 202 are within the gap 220' between the teeth 218' of the spool 204. To move the tension mechanism 200 to the second configuration, the spool 204 is rotated by the traction force applied to the suture 300. As described above, the spool 204 resists rotation and applies a force to a suture anchor (not shown) to partially position the suture anchor. The spool 204 resists rotation until the arms 214' of the detent ring 202 finally move out of the gap 220' between the teeth 218' and align with the teeth 218', as shown in FIG. 9. As described above, the continued rotation of the spool 204 applies additional force to the suture 300 and a suture anchor (not shown) respectively, to position the suture anchor (not shown).

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

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

[0028] Referring briefly to FIGS. 14-17, various views of a spool 504 and suture components 600 according to yet another alternative embodiment are shown. FIG. 14 shows a perspective view of the spool 504 and suture components 600 of the suture anchor driver 400. The suture components 600 include 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 components 600 also include suture anchors 306 along the length of the suture 300. In the illustrated embodiment, the needle 604 is curved or hook-shaped.

[0029] FIG. 15 shows an embodiment of a spool 504 having a first surface 506 and a second surface 508, with a first channel 510 and a second channel 512 that are at least partially separated therebetween. As shown in both FIGS. 15 and 16 (and FIG. 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 house a foam block 602, as shown in FIG. 16.

[0030] Because the needle 604 is curved or hook-shaped, 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 the suture 606 attached to the needle 604 is wound around the first channel 510. After the length of the suture 606 attached to the needle 604 is loaded onto the spool 504, the spool 504 is placed within the recess 410 of the handle 402. As shown in FIG. 11, the spool 504 is placed within the recess 410 such that the second surface 508 and the teeth 514 are adjacent to the barrier member 502 of the handle 402. The suture anchor 306 (and attached suture 300) is also loaded onto the driver 408.

[0031] Referring further to FIG. 11, the handle 402 additionally includes a locking arm 416 having another similar protrusion that extends into the gap 518 between two of the plurality of teeth 514 of the ratchet 412 or the spool 504 when the anchor driver 400 is in the first configuration. In the first configuration, the ratchet 412 prevents the spool 504 from rotating within the recess 410 of the handle 402 so that the suture anchor 306 can be inserted with the suture 300 having a fixed tension. Specifically, the suture anchor 306 is inserted into a pre-formed hole (or bone hole) connected to the spool 504 of the handle 402 by the tension applied to the suture 300. Since the spool 504 cannot rotate, no slack (or reduction in tension) is introduced into the suture 300. When a fixed tension is applied on the suture anchor 306, as shown in FIG. 12, the suture anchor 306 is inserted into the bone hole through the guide 700 by the driver 408.

[0032] Referring now to FIG. 13, a side view of the suture anchor driver 400 in a second configuration according to yet another alternative embodiment is shown. In the illustrated embodiment, the driver 408 extends as far as possible into the guide 700. The guide 700 includes a feature 702 that enters a slot 414 in the handle 402 adjacent to the locking arm 416 having the ratchet 412. As the driver 408 extends as far as possible into the guide 700, the feature 702 of the guide 700 enters the slot 414 and deflects the locking arm 416 away from the spool 504. Since the locking arm 416 deflects away from the spool 504, the ratchet 412 disengages the gap 518 between the teeth 514 of the spool 504. The spool 504 then spins freely, or rotates, within the recess 410 of the handle 402. Since the spool 504 can spin within the recess 410, the length of the needle 604 and the attached suture 606, and the suture 300 (connected to the suture anchor 306) can be released (i.e., removed) from the handle 402, and the placement of the suture anchor 306 can be completed.

[0033] All definitions defined and used in this specification should be understood to control the dictionary definitions, definitions within the documents incorporated by reference, and / or the ordinary meaning of the defined terms.

[0034] Although various embodiments have been described and illustrated in this specification, those skilled in the art will readily conceive of various other means and / or structures for performing the functions described herein and / or obtaining the results and / or one or more of the advantages, and each such variation and / or modification is to be considered within the scope of the embodiments described herein. More generally, those skilled in the art will readily understand that all parameters, dimensions, materials, and configurations described herein are exemplary, and that the actual parameters, dimensions, materials, and / or configurations depend on one or more of the specific applications for which the teachings are used. Those skilled in the art can readily recognize, or confirm using no more than routine experimentation, numerous equivalents to the specific embodiments described herein. Accordingly, the foregoing embodiments are presented by way of example only, and within the scope of the appended claims and their equivalents, it will be understood that the embodiments can be practiced in other ways than specifically described and claimed. Embodiments of the present disclosure are directed to the individual features, systems, articles, materials, kits, and / or methods described herein. Further, any combination of two or more of such features, systems, articles, materials, kits, and / or methods is included within the scope of the present disclosure if such features, systems, articles, materials, kits, and / or methods do not mutually conflict.

[0035] The terms used in this specification are for the purpose of describing particular embodiments only and are not intended to limit the invention. As used in this specification, the singular forms "a", "an", and "the" are intended to include the plural forms as well, unless the context clearly indicates otherwise. 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 further understood to be open-ended linking verbs. As a result, a method or device "comprises", "has", "includes", or "contains" one or more steps or elements. Similarly, a step of a method, or an element of a device, that "comprises", "has", "includes", or "contains" one or more features has those one or more features, but is not limited to only holding those one or more features. Further, a device or structure configured in a particular way is at least so configured, but can also be configured in ways not listed.

[0036] All means or steps plus functional elements in the following claims, corresponding structures, materials, acts, and equivalents, if any, are intended to include structures, materials, or acts for performing the functions in combination with other claim elements specifically claimed, if any. The description of the invention has been presented for purposes of illustration and description, but is not intended to be exhaustive or limiting in the form disclosed. Many modifications and variations will be apparent to those of ordinary skill in the art without departing from the scope and spirit of the invention. Embodiments were chosen and described in order to best explain the principles and practical application of one or more aspects of the invention, and to enable others of ordinary skill in the art to understand the invention for one or more aspects with various modifications that are suited to the particular use contemplated.

Claims

**Claim 1** A suture anchor driver, comprising a handle having a proximal end and a distal end, a recess within the handle having a shaft extending centrally therefrom, a detent ring having a central opening, the 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 spool being positioned within the recess, a slot on an exterior of the handle, the slot extending into the recess, a driver extending from the distal end of the handle, a suture wound around the spool and extending through the slot on the handle, and the shaft extending through the central opening of the detent ring and the central opening of the spool such that the protrusion of the detent ring is 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, the slot being adjacent to the driver extending from the distal end of the handle, a suture anchor driver. **Claim 2** The suture anchor driver according to claim 1, wherein the one or more protrusions extend from the detent ring towards the second side of the spool within the recess. **Claim 3** The suture anchor driver according to claim 2, wherein the plurality of protrusions extend from the second side of the spool towards the detent ring within the recess. **Claim 4** The suture anchor driver according to claim 1, wherein the shaft further includes a prong end. **Claim 5** The suture anchor driver according to claim 1, wherein the recess extends onto a first side of the handle. **Claim 6** The suture anchor driver according to claim 1, wherein the spool includes an opening on the first side configured to receive an end of the suture therethrough. **Claim 7** The suture anchor driver according to claim 1, further comprising a fastener having a cap with a stem extending therefrom to the center, the stem being configured to extend into the inner channel of the shaft.

8. The suture anchor driver according to claim 1, wherein at least one of the one or more protrusions is configured to move between two of the plurality of protrusions to two adjacent ones of the plurality of protrusions each time a predetermined force is applied.

9. The suture anchor driver according to claim 8, wherein the predetermined force is applied to a suture wound around the spool and extending through the slot on the handle.

10. The suture anchor driver according to claim 8, wherein the predetermined force is applied to an anchor attached to the suture.

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