Abstract: A system for coupling a tendon to a bone may include a tendon coupling device engageable with a tendon, a fastener to secure the tendon coupling device to the tendon, a bone coupling device, and a flexible element. The flexible element may include a first portion and a second portion. The first portion of the flexible element may be couplable with the fastener to securably attach the flexible element to the tendon. The bone coupling device may include a bone-facing surface engageable with a surface of the bone proximate a bone tunnel formed through the bone, and a hole formed through the bone coupling device. The second portion of the flexible element may be receivable through the bone tunnel and the hole formed through the bone coupling device to engage an opposing surface of the bone coupling device and securably couple the tendon to the bone.