A knot may be formed in suture material using a device having an elongated body with a longitudinal axis and a holder. A rail portion of the suture material is secured with a first grasper on the elongated body and a non-rail portion of the suture material is secured with a second grasper on the holder. A plurality of helical windings may be created with the non-rail portion. Detaching the holder from the elongated body in a motion away from the longitudinal axis of the elongated body completes the knot. The holder may be wrapped around the elongated body in a knot-forming pattern.