Case: A snapping biceps femoris tendon, a rare etiology for symptomatic pain in the lateral aspect of the knee, has been reported infrequently. We report 2 cases of an acutely symptomatic unilateral snapping biceps femoris tendon with an intraoperatively intact anomalous insertion onto the tibia, which were treated with anatomic repositioning and "pie-crust" lengthening via a single suture anchor.
Conclusion: Anatomic repositioning and lengthening is a novel technique that successfully resolved the painful snapping and allowed full return to competitive sports by 6 months postoperatively, with maintenance of improvement at ≥14 months postoperatively.