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Updated: Jun 16, 2026

Knotless Independent Double-Row Repair and Biceps Augmentation for Anterosuperior Rotator Cuff Tears
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Rerupture and Total Complication Rate After Single-Incision Power Optimizing Cost-Effective Distal Biceps Repair.

Charles Z Jiang1,2, Peter Howard2, Jacob Weinberg2

  • 1University of Pittsburgh School of Medicine, Pittsburgh, PA.

Journal of Hand Surgery Global Online
|June 15, 2026
PubMed
Summary
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The single-incision power optimizing cost-effective (SPOC) technique for distal biceps tendon repair shows a low rerupture rate and acceptable complications. This method is effective for both partial and complete ruptures, with a low rate of return to surgery.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Tendon Repair

Background:

  • The single-incision power optimizing cost-effective (SPOC) technique aims to optimize distal biceps tendon repair by reattaching the tendon to its native site.
  • Limited long-term data and ongoing debate surround the optimal fixation strategies for distal biceps tendon repair.

Purpose of the Study:

  • To evaluate the complication rates associated with the SPOC technique for distal biceps tendon repair.
  • To assess the efficacy of the SPOC technique in managing both complete and partial distal biceps tendon ruptures.

Main Methods:

  • Retrospective review of 84 patients undergoing SPOC distal biceps repair between 2016 and 2024.
  • Inclusion criteria: primary SPOC repair, >12 weeks follow-up. Exclusion criteria: revision, allograft, non-SPOC, <12 weeks follow-up.
Keywords:
ComplicationDistal bicepsRuptureSingle-incisionSurgical outcome

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  • Primary endpoint: rerupture. Secondary endpoints: complications, reoperation, operative time, tourniquet time.

    • Main Results:

    • No reruptures were documented in 84 arms (52 complete, 32 partial ruptures).
    • Overall complication rate was 26.2% (22/84), including nerve paresthesias and heterotopic ossification.
    • Low reoperation rate of 3.6% for specific complications.

    Conclusions:

    • The SPOC technique is a viable option for both partial and complete distal biceps tendon ruptures.
    • It demonstrates a low rerupture rate, comparable complication rates to other methods, and a low return to operating room rate.