Fabellar Snapping as a Cause of Knee Pain After Total Knee Replacement: Assessment Using Dynamic Sonography

Segal, Ayal; Miller, Theodore T.; Krauss, Eugene S.

doi:10.2214/ajr.183.2.1830352

Cited by 40 publications

(30 citation statements)

References 7 publications

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“…There have been previous reports of soft tissue impingement in the intercondylar notch [3] and impingement or tethering in the patellofemoral joint [4, 5] causing pain following TKR. Fabellar impingement is also a rare cause of such pain [6–9]. This case demonstrates a specific location and cause of pain due to soft tissue impingement following TKR which, to our knowledge, has not been previously reported.…”

Section: Discussionmentioning

confidence: 73%

An Unusual Cause of Lateral Knee Pain following Total Knee Replacement

Barr

Khanduja

Owen

2011

Case Reports in Orthopedics

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A 70-year-old male underwent elective total knee replacement for osteoarthritis. At initial review six weeks after surgery the prosthesis was functioning well and he was asymptomatic. He reattended clinic four months postoperatively having developed worsening pain on the lateral aspect of the knee but without any loss of function or stiffness of the joint. He subsequently underwent arthroscopy where synovial folds in the lateral gutter were debrided and entirely alleviated his symptoms. This is an unusual cause of pain following total knee replacement which has not been previously reported.

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Section: Discussionmentioning

confidence: 73%

An Unusual Cause of Lateral Knee Pain following Total Knee Replacement

Barr

Khanduja

Owen

2011

Case Reports in Orthopedics

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“…Other described features include posterolateral knee swelling, pain on direct pressure of the fabella, pain on extension of the knee, clicking sensations, and common peroneal nerve dysfunction. Fabella syndrome has been described secondary to total knee arthroplasty [16, 21-25], however, we describe the only known documented case of fabella syndrome occurring secondary to femoral de-rotation surgery.…”

Section: Discussionmentioning

confidence: 90%

Fabella Syndrome Following De-Rotation Surgery to Correct a Femoral Malunion

Rankin¹,

Rehman²,

Ashcroft³

2018

TOORTHJ

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Background:The fabella is a sesamoid bone situated within the lateral head of the gastrocnemius tendon, close to the lateral femoral condyle, and adjoined to the fabellofibular ligament. It is a normal variant, found in up to 87% of patients. Fabella Syndrome describes traditionally posterolateral knee pain, occurring due to biomechanical pressure of the fabella against the lateral femoral condyle. Given its rarity, its diagnosis is often overlooked. We present a case of Fabella Syndrome with a modified surgical excision technique and review of the literature.Methods and Results:A thirty-four-year-old man presented with posterolateral knee pain following de-rotation surgery to correct a femoral malunion, from a previous femoral shaft fracture. Due to the patient’s complex orthopaedic history, Fabella Syndrome was not initially diagnosed. Fabellectomy eliminated all symptoms of knee pain, with no limitations in knee function.Conclusion:Review of the literature identified ten publications (evidence level IV) describing Fabella Syndrome. This is the first reported case of Fabella Syndrome secondary to femoral de-rotation surgery. The authors recommend fabellectomy as a definitive treatment for Fabella Syndrome, in keeping with published literature.

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“…Among those conditions, the most reported are traumatic and stress fractures of the fabella, total knee arthroplasty-related fabellar impingement or snapping [2, 6], chondromalacia fabellae [7, 10], tendinitis of the lateral head of the gastrocnemius muscle, primary osteoarthritis, compression of the thickened gastrocnemius tendon against the femoral condyle, and peroneal nerve irritation/compression [1, 8]. …”

Section: Discussionmentioning

confidence: 99%

“…The fabella is a fibrocartilaginous or ossified sesamoid bone of the knee, classically located within the tendon of the lateral head of the gastrocnemius muscle, but may rarely be found within the medial head of that muscle [1, 2]. …”

Section: Introductionmentioning

confidence: 99%

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Fracture of the Fabella: A Rare Injury in Knee Trauma

Barreto

Chagas-Neto

Crema

et al. 2012

Case Reports in Radiology

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We present a case of a 21-year-old woman sustaining a traumatic [fabellar] fracture following a motor vehicle accident. The fabellar fracture was confirmed on plain films, which prompted further evaluation of the knee with ultrasound and magnetic resonance imaging to evaluate other possible associated injuries. Fracture of the fabella is a rare condition. Clinically, patients present with posterolateral knee pain, edema, and limited knee extension. Occasionally these symptoms may be very subtle, delaying the correct diagnosis and patient management.

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Fabellar Snapping as a Cause of Knee Pain After Total Knee Replacement: Assessment Using Dynamic Sonography

Cited by 40 publications

References 7 publications

An Unusual Cause of Lateral Knee Pain following Total Knee Replacement

An Unusual Cause of Lateral Knee Pain following Total Knee Replacement

Fabella Syndrome Following De-Rotation Surgery to Correct a Femoral Malunion

Fracture of the Fabella: A Rare Injury in Knee Trauma

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