Influence of a fabella in the gastrocnemius muscle on the common fibular nerve in Japanese subjects

Tabira, Yoko; Saga, Tsuneo; Takahashi, Nagahiro; Watanabe, Koichi; Nakamura, Moriyoshi; Yamaki, Koh-Ichi

doi:10.1002/ca.22153

Cited by 47 publications

(65 citation statements)

References 29 publications

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“…As reported by Tabira et al. [12], cyamella occur more frequently in Asians. The cyamella was usually found in patients with symptomatic knee OA, especially in patients with the symptom of morning stiffness.…”

Section: Discussionsupporting

confidence: 54%

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The efficacy of shock wave therapy in patients with knee osteoarthritis and popliteal cyamella

Chen

Lin

et al. 2014

The Kaohsiung J of Med Scie

103

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This randomized, controlled study was performed to compare the effects of extracorporeal shockwave therapy (ESWT) and ultrasound on the rehabilitation of knee osteoarthritis with popliteal cyamella. One hundred and twenty patients with bilateral moderate knee osteoarthritis (Altman III) and popliteal cyamella were selected and randomly assigned to four groups (GI-GIV). Patients in Groups I-III received isokinetic muscular strengthening exercises three times weekly for 8 weeks. Group II received pulse ultrasound treatment for popliteal cyamella three times weekly for 8 weeks, Group III received weekly shock wave therapy for popliteal cyamella for the first 6 weeks, and Group IV acted as controls. The therapeutic effects were evaluated by changes in the arthritic knees range of motion (ROM), visual analogue scale, Lequesne's index, and muscle peak torques after treatment and at follow-up 6 months later. Each treated group exhibited increased muscle peak torques and significantly reduced pain and disability after treatment and at follow-ups. However, only patients in Groups II and III showed significant improvements in ROM after treatment, and only participants in Group III showed immediate improvement in ROM after each treatment. Patients in Group III also showed the greatest increase in muscular strength and the greatest decrease in disability after treatment and at the follow-ups. ESWT is better than pulse ultrasound in rehabilitation of patients with knee osteoarthritis and popliteal cyamella results in more functional improvements.

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Section: Discussionsupporting

confidence: 54%

“…The cyamella is a sesamoid bone that is embedded in the tendon of the lateral or, rarely, the medial head of the gastrocnemius muscle. The sesamoid bone is reported to occur in 10–30% of the population and to occur bilaterally in ∼80% of these individuals [12]. In addition, cyamellae reportedly occur more frequently in Asians.…”

Section: Introductionmentioning

confidence: 99%

The efficacy of shock wave therapy in patients with knee osteoarthritis and popliteal cyamella

Chen

Lin

et al. 2014

The Kaohsiung J of Med Scie

103

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“…Its presence is a normal variant, with a prevalence reported as ranging from 20 to 87% [1-7]. It is situated within the lateral head of gastrocnemius tendon, with the fabellofibular ligament (or ligament of Vallois) connecting it to its distal insertion at the fibular head [8].…”

Section: Introductionmentioning

confidence: 99%

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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“…The presence of the fabella in humans varies widely and is reported in the literature to range from 20% to 87% [1-7]. …”

Section: Introductionmentioning

confidence: 99%

“…The CF nerve has been shown to be significantly reduced in diameter in relation to the fabella compared to proximally [1]. …”

Section: Introductionmentioning

confidence: 99%

The fabella syndrome - a rare cause of posterolateral knee pain: a review of the literature and two case reports

Driessen

Balke

Offerhaus³

et al. 2014

BMC Musculoskelet Disord

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BackgroundThe purpose of this article was to evaluate the risks and benefits of non-operative treatment versus surgical excision of a fabella causing posterolateral knee pain. We performed a systematic review of literature and also present two case reports.Twelve publications were found in a PubMed literature review searching the word “fabella syndrome”. Non-operative treatment and surgical excision of the fabella has been described.Case presentationTwo patients presented to our outpatient clinic with persisting posterolateral knee pain. In both cases the presence of a fabella was identified, located in close proximity to the posterolateral femoral condyle. All other common causes of intra- and extra articular pathologies possibly causing the posterolateral knee pain were excluded.Following failure to respond to physiotherapy both patients underwent arthroscopy which excluded other possible causes for posterolateral knee pain. The decision was made to undertake surgical excision of the fabella in both cases without complication.Both patients were examined 6 month and one year after surgery with the Tegner activity score, the Visual Analogue Scale (VAS), and International Knee Documentation Committee Score (IKDC).ConclusionConsistent posterolateral pain during exercise might indicate the presence of a fabella syndrome. Resecting the fabella can be indicated and is a minor surgical procedure with minimal risk. Despite good results in the literature posterolateral knee pain can persist and prevent return to a high level of sports. Level of evidence: IV, case reports and analysis of literature.

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Influence of a fabella in the gastrocnemius muscle on the common fibular nerve in Japanese subjects

Cited by 47 publications

References 29 publications

The efficacy of shock wave therapy in patients with knee osteoarthritis and popliteal cyamella

The efficacy of shock wave therapy in patients with knee osteoarthritis and popliteal cyamella

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

The fabella syndrome - a rare cause of posterolateral knee pain: a review of the literature and two case reports

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