Complete tibial insertion of the biceps femoris tendon: an MRI-based study to assess the prevalence of this variant

  • Geethal N. MalalagamaEmail author
  • Lucian B. Solomon
  • William K. Loftus
Original Article



To quantify the prevalence of complete tibial insertion of the biceps femoris tendon in patients presenting for knee MRI scans.


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.


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.


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.


Biceps Femoris Insertion Anatomical Variant 



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.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Flinders Medical CentreAdelaideAustralia
  2. 2.University of AdelaideAdelaideAustralia
  3. 3.Sound RadiologyAdelaideAustralia

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