Biomechanical and clinical studies have demonstrated the importance of the biceps muscle in upper extremity function, and most surgeons would recommend anatomic repair of the ruptured distal biceps tendon to the radial tuberosity to prevent the loss of strength in forearm supination and elbow flexion.1–4 In rupture, the tendon usually avulses from the radial tuberosity. Two main approaches have been described for reattachment: the single-incision anterior approach and the two-incision technique.5,6 The two-incision technique typically involves bone tunnels to secure the tendon to the radial tuberosity. However, this technique can be associated with radioulnar synostosis.1,5,7 A single-incision anterior approach with the use of suture anchors or interference screw fixation has become popular in recent years.8–12 However, with this technique, there are technical challenges associated with knot-tying and tendon tensioning in the muscular forearm.