Complete tibial insertion of the biceps femoris tendon: an MRI-based study to assess the prevalence of this variant
- 15 Downloads
Abstract
Purpose
To quantify the prevalence of complete tibial insertion of the biceps femoris tendon in patients presenting for knee MRI scans.
Methods
Knee MRI scans over a 4-year period (2014–2018) were accessed at a tertiary referral centre and community-based private practice. A total of 433 scans were reviewed. 30 scans were excluded from the study due to repeat imaging or incomplete coverage of the biceps femoris tendon insertion. Appearances of the distal biceps tendon bony insertion were scrutinized on the remaining 403 scans. Each biceps femoris tendon insertion was classified into one of the four categories—complete fibular insertion, predominant fibular insertion, predominant tibial insertion and complete tibial insertion.
Results
Out of the final 403 scans included in the study, five cases of complete tibial insertion of the biceps femoris tendon were identified (just over 1% of the total population). 42 cases were identified as having predominant tibial insertion (10% of the total population). 113 cases had predominantly fibular insertion and 243 cases had complete fibular insertion.
Conclusion
Complete anomalous insertion of the biceps femoris tendon on the anterolateral tibia is an uncommon entity. Such an attachment is found in approximately 1% of patients presenting for MRI evaluation of the knee.
Keywords
Biceps Femoris Insertion Anatomical VariantNotes
Acknowledgements
The authors acknowledge with thanks their patient Mr Jake Larwood for his cooperation with and interest in the study.
Author contributions
GM: project development, data collection, data analysis, manuscript writing. LBS: project development, manuscript editing. WKL: project development, data collection, data analysis, manuscript editing.
Compliance with ethical standards
Conflicts of interest
The authors declare that they have no conflict of interest.
References
- 1.Bagchi K, Grelsamer RP (2003) Partial fibular head resection for bilateral snapping biceps femoris tendon. Orthopedics 26:1147–1149PubMedGoogle Scholar
- 2.Branch EA, Anz AW (2015) Distal insertions of the biceps femoris: a quantitative analysis. Orthop J Sports Med. https://doi.org/10.1177/2325967115602255 CrossRefPubMedPubMedCentralGoogle Scholar
- 3.Hernandez JA, Rius M, Noonan KJ (1996) Snapping knee from anomalous biceps femoris tendon insertion: a case report. Iowa Orthop J 16:161–163PubMedPubMedCentralGoogle Scholar
- 4.Kristensen G, Nielsen K, Blyme PJ (1989) Snapping knee from biceps femoris tendon: a case report. Acta Orthop Scand 60:621CrossRefGoogle Scholar
- 5.Marshall JL, Girgis FG, Zelko RR (1972) The biceps femoris tendon and its functional significance. J Bone Jt Surg Am 54:1444–1450CrossRefGoogle Scholar
- 6.Schnurr C, Csécsei G, Nessler J, Eysel P, König DP (2011) How much tibial resection is required in total knee arthroplasty? Int Orthop 35:989–994. https://doi.org/10.1007/S00264-010-1025-5 CrossRefPubMedGoogle Scholar
- 7.Sneath RS (1955) The insertion of the biceps femoris. J Anat 89:550–553PubMedPubMedCentralGoogle Scholar
- 8.Solomon LB, Stevenson AW (2008) Tibial insertion of the biceps femoris tendon: anatomical and radiological description of an anatomical variant. Clin Anat 21:802–804. https://doi.org/10.1002/CA.20722 CrossRefPubMedGoogle Scholar
- 9.Terry GC, Laprade RF (1996) The biceps femoris muscle complex at the knee Its anatomy and injury patterns associated with acute anterolateral-anteromedial rotatory instability. Am J Sports Med 24:2–8. https://doi.org/10.1177/036354659602400102 CrossRefPubMedGoogle Scholar
- 10.Testut L, Jacob O (1931) Traite D’Anatomie Topographique. 5th edn, Paris, pp 1000–1002Google Scholar
- 11.Tubbs RS, Caycedo FJ, Oakes WJ, Salter EG (2006) Descriptive anatomy of the insertion of the biceps femoris muscle. Clin Anat 19:517–521. https://doi.org/10.1002/CA.20168 CrossRefPubMedGoogle Scholar