Accessory Biceps Femoris Tenotomy and Tenodesis to Biceps Femoris Tendon for Symptomatic Lateral Knee Snapping in Athletes

Snapping biceps femoris tendon represents a rare but clinically significant cause of lateral knee pain in young athletes. Anomalous tendon insertions can create pathologic subluxation across the fibular head during knee motion, resulting in mechanical symptoms resistant to conservative treatment. We describe a surgical technique for managing this condition. A 20-year-old male athlete presented with lateral knee snapping caused by accessory biceps femoris insertion on the anterosuperior fibular head. The surgical technique involves release of the accessory tendon band from its aberrant insertion and tenodesis to the native biceps femoris insertion on the posterior fibular head using figure-of-8 suture configuration. This approach preserves tendon function while eliminating pathologic snapping through anatomic restoration of the tendon vector. Biceps femoris accessory tendon tenodesis offers an effective treatment option that maintains biomechanical function while addressing the underlying pathology.