Introduction: The primary studies demonstrated that fabellar prevalence (FP) varied with ethnic and geographical distribution. Osteoarthritis (OA) and age-related degeneration have a significant association with FP. The prevalence of OA worldwide was doubled with life expectancy. Increased life expectancy has increased exposure to OA and age-related degeneration which could be a possible reason for the rise of FP. The analysis was conducted to provide insight about FP in respect to geographical, ethnic, sex, and laterality distribution. Methodology: Eighty-six studies were included which have data from 34,733 knee joints. Fifty radiological studies were consisting of 27,293 knees and 36 cadaveric studies had the data of 7,440 knees of dissected specimens, respectively. The prevalence, Odds, and rate ratios were calculated for aging, osteoarthritis, and ethnic variation.Results: The worldwide FP was 25% (95% CI, 0.22, 0.28). The prevalence of fabella was found to be higher in cadaveric studies (32%) than radiological studies (19%) with significant heterogeneity. The FP was 16-18% till 1950 which was doubled by 2020 (35%). The FP in OA knee was 51% which was thrice of baseline.
The persistence of embryonic vitelline duct occurs in about 2% of the population. Patent vitellointestinal duct (VID) is a rare condition in adults. This anomaly may remain asymptomatic throughout life or may present with umbilical sinus, abscess, fistula, intussusception, and various other intraabdominal complications. We present here an interesting case of 32-year-old man with patent VID presenting as paraumbilical abscess along with intestinal obstruction caused by marked inflammatory changes and adhesion. This patient was managed successfully with excision of the entire duct along with the wedge of ileal attachment. Such rare presentation in an adult has not been reported earlier to the best of our knowledge. Simple incision and drainage of abscess without excision of patient VID would not result in complete treatment of this condition. Therefore, surgeons and radiologists should have high index of suspicion of this uncommon presentation as it is likely to be missed.
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