A case report on a very rare variant of popliteal artery entrapment syndrome due to an enlarged fabella associated with severe knee osteoarthritis

Ando, Yumiko; Miyamoto, Yasuo; Tokimura, Fumiaki; Nakazawa, Tatsu; Hamaji, Hiroshi; Kanetaka, Masakazu; Koshiishi, Akira; Hirabayashi, Kenichi; Anamizu, Yorito; Miyazaki, Tsuyoshi

doi:10.1016/j.jos.2015.06.025

Cited by 19 publications

(16 citation statements)

References 15 publications

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“…) and the elderly (Laird, ; Ando et al. ). Finally, unlike in other mammals, the fabella likely offers no significant mechanical advantage in humans, as when excised (common practice to address fabella syndrome), no ill mechanical effects are observed (Weiner & Macnab, ; Zenteno et al.…”

Section: Resultsmentioning

confidence: 99%

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Fabella prevalence rate increases over 150 years, and rates of other sesamoid bones remain constant: a systematic review

2019

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The fabella is a sesamoid bone located behind the lateral femoral condyle. It is common in non‐human mammals, but the prevalence rates in humans vary from 3 to 87%. Here, we calculate the prevalence of the fabella in a Korean population and investigate possible temporal shifts in prevalence rate. A total of 52.83% of our individuals and 44.34% of our knees had fabellae detectable by computed tomography scanning. Men and women were equally likely to have a fabella, and bilateral cases (67.86%) were more common than unilateral ones (32.14%). Fabella presence was not correlated with height or age, although our sample did not include skeletally immature individuals. Our systematic review yielded 58 studies on fabella prevalence rate from 1875–2018 which met our inclusion criteria, one of which was an outlier. Intriguingly, a Bayesian mixed effects generalized linear model revealed a temporal shift in prevalence rates, with the median prevalence rate in 2000 (31.00%) being ~ 3.5 times higher than that in 1900 (7.64%). In all four countries with studies before and after 1960, higher rates were always found after 1960. Using data from two other systematic reviews, we found no increase in prevalence rates of 10 other sesamoid bones in the human body, indicating that the increase in fabella prevalence rate is unique. Fabella presence/absence is due to a combination of genetic and environmental factors: as the prevalence rates of other sesamoid bones have not changed in the last 100 years, we postulate the increase in fabella prevalence rate is due to an environmental factor. Namely, the global increase in human height and weight (due to improved nutrition) may have increased human tibial length and muscle mass. Increases in tibial length could lead to a larger moment arm acting on the knee and on the tendons crossing it. Coupled with the increased force from a larger gastrocnemius, this could produce the mechanical stimuli necessary to initiate fabella formation and/or ossification.

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Section: Resultsmentioning

confidence: 99%

“…), popliteal artery entrapment syndrome (Ando et al. ), nerve palsy (Itoman et al. ; Takebe & Hirohata, ; Kubota et al.…”

Section: Introductionmentioning

confidence: 99%

Fabella prevalence rate increases over 150 years, and rates of other sesamoid bones remain constant: a systematic review

2019

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“…It may lead to peroneal nerve compression due to its close anatomical association at the posterolateral corner of the knee [18,36,38]. In addition, Ando Yukari et al [1] reported popliteal artery compression induced by the fabella. Although, presence or absence of the fabella is accepted as a normal variant, due to the above mentioned clinical conditions related with the fabella, clinicians should know a thorough knowledge about the anatomical characteristics and frequency of the fabella in population they practice.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and distribution of the fabella: a radiographic study in Turkish subjects

Eğerci¹,

Köse

Turan

et al. 2017

Folia Morphol

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“…Several reviews have investigated that fabella was more common in patients with primary KOA. In their study, fabella was present in 35% of 300 patients with primary KOA and only in 15% of knees in the age-matched control group [21][22][23] . Pritchett JW et al speculated that in some way, fabella can predict KOA to provide more useful information for clinical use [24] .…”

Section: Introductionmentioning

confidence: 88%

Relationship Between Classification of Fabellae and the Severity of Keen Osteoarthritis: A Relevant Study in Chinese Population

Zhang¹,

Wen²,

He³

et al. 2020

Preprint

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Background: The fabella is a sesamoid bone having anatomical variations and it is more common in patients with primary keen osteoarthritis (KOA). The purpose of this study was to classify the fabellae and discuss the relationship between the classification of fabellae and the severity of KOA in Chinese. Material and methods: 136 patients were measured and classified using CT three-dimensional reconstruction. According to the CT imaging characteristics, the fabellae were divided into 5 types: type Ⅰ, a fabella on the lateral femoral condyle; type Ⅱ, a fabella on the medial femoral condyle; type Ⅲ, a fabella on the lateral femoral condyle and a fabella on the medial femoral condyle; type Ⅳ, two fabellae on the medial femoral condyle and type Ⅴ, two fabellae on the lateral femoral condyle. The severity of KOA was assessed on the Recht grade by MRI. The data were analyzed with SPSS 24.0. Results: The classification of fabellae were correlated with KOA grades (c 2 =35.026, P<0.05). In terms of KOA grades, grade Ⅰ and grade Ⅱ were occupied most of fabellar type Ⅱ (32, 72.8%); type Ⅱ and other types were significant statistical difference (P<0.05). Grade Ⅰ and grade Ⅱ were also the most of fabellar type Ⅳ (4, 100%). Fabellar type Ⅴ’s biggest component were grade Ⅲ and grade Ⅳ (6, 75%). Type Ⅳ and type Ⅴ were significant statistical difference (P<0.05). Conclusion: The classification of fabellae were correlated with KOA grades. The type Ⅱ may mean the lower KOA grades while type Ⅴ may mean the higher KOA grades. Trial registration: the Ethics Inspection Committee at Southwest Medical University, V1.0/20180801. Registered 20 August 2018.

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A case report on a very rare variant of popliteal artery entrapment syndrome due to an enlarged fabella associated with severe knee osteoarthritis

Cited by 19 publications

References 15 publications

Fabella prevalence rate increases over 150 years, and rates of other sesamoid bones remain constant: a systematic review

Fabella prevalence rate increases over 150 years, and rates of other sesamoid bones remain constant: a systematic review

Prevalence and distribution of the fabella: a radiographic study in Turkish subjects

Relationship Between Classification of Fabellae and the Severity of Keen Osteoarthritis: A Relevant Study in Chinese Population

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