Treatment of Fabella Syndrome with Manual Therapy: A Case Report

Zipple, J Timothy; Hammer, Roger L.; Loubert, Peter V.

doi:10.2519/jospt.2003.33.1.33

Cited by 28 publications

(30 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A literature review revealed ten publications describing fabella syndrome [8, 9, 13, 14, 16-20]. All publications were evidence level IV, with six case reports and four case series, the largest of which described 16 patients [9].…”

Section: Discussionmentioning

confidence: 99%

“…Conservative treatment with physiotherapy was found to be successful in a minority of cases. Zipple et al describe in detail the technique of manual mobilisation of the fabella to achieve pain relief [13]. The largest case series described five out of sixteen patients (31%) responding to conservative treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Fabella syndrome has been treated conservatively with manual therapy involving extension, flexion and rotation of the knee [13]. Where conservative management has failed, operative treatment may be performed.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Rankin¹,

Rehman²,

Ashcroft³

2018

TOORTHJ

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Rankin¹,

Rehman²,

Ashcroft³

2018

TOORTHJ

View full text Add to dashboard Cite

show abstract

“…6,8 Because the fabella is an intra-articular structure with a cartilage lining, this can also degenerate and lead to chronic pain and localized arthritis. Physical examination may reveal the presence of swelling/tenderness in the posterolateral aspect of the knee.…”

Section: Discussionmentioning

confidence: 99%

“…6,9 Patel et al 9 presented the case of a 67-yearold man with symptoms of pain along the left lower limb as well as common peroneal nerve neuropathy of 18 months' duration. After open excision of the fabella, this patient had a significant improvement at 3 months with full recovery at 1 year.…”

mentioning

confidence: 99%

Arthroscopy-Assisted Fabella Excision: Surgical Technique

Provencher

Sánchez

Ferrari

et al. 2017

Arthroscopy Techniques

View full text Add to dashboard Cite

Abstract:The fabella is an anatomic variant not seen in all individuals and can potentially be a source of chronic knee pain due to chondromalacia, osteoarthritis, fractures, or biomechanical pressure against the lateral femoral condyle. It is situated intra-articular, close to the lateral femoral condyle, the lateral gastrocnemius head tendon, and the fabellofibular ligament. Given its rarity, the diagnosis of a symptomatic fabella is often overlooked when evaluating patients with persistent posterolateral knee pain. However, this diagnosis should always be considered, especially in high-performance runners, bikers, and triathletes. Although nonoperative management can potentially resolve symptoms associated with this condition, fabella excision via arthroscopically assisted surgery is a reliable and safe alternative to treat patients who do not benefit from nonsurgical treatment. We present our technique detailing fabella excision for treatment of posterolateral knee pain, which includes an arthroscopic evaluation of the fabella to assess damage to the femoral condyle and minimize over-resection and potential damage to surrounding structures.T he fabella is a sesamoid bone located in the posterolateral aspect of the knee, embedded in the muscular and tendon fibers of the lateral head of the gastrocnemius muscle. It articulates anteriorly with the posterior surface of the lateral condyle, and is bordered posteriorly by the oblique popliteal ligament. 1The presence of the fabella in humans is a variant and is reported to range from 20% to 87%.2 When the fabella is present, an additional ligament called the fabellofibular ligament (ligament of Vallois), which runs from the fabella to the fibular head, can be found.

show abstract

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

et al. 2012

View full text Add to dashboard Cite

The fabella is a sesamoid bone located in the proximal tendon of the gastrocnemius muscle. In rare cases, its presence may lead to a variety of clinical problems, including fabella syndrome and common fibular (CF) nerve palsy. The purpose of this study was to analyze the morphology of the fabella and CF nerve and discuss the influence of any existing fabellae on the size of the CF nerve. The morphology of the fabella and CF nerve in the popliteal region of the lateral head of the gastrocnemius muscle was investigated in 102 knees of 51 Japanese cadavers. The maximum circumference of the thigh, knee, and calf and the frequency, position, and size of the fabella were measured. In addition, the CF nerve width and thickness were measured proximal to the fabellar region and again as the CF nerve passed posterior, lateral, or medial to the region. A fabella was observed in 70 knees (68.6%). The CF nerve adjacent to the fabella was significantly wider and thinner than in the region proximal to the fabella (P < 0.001). In cases in which a bony fabella was present, there was a significant relationship between the thickness of the CF nerve and the circumference of the thigh and knee. The following factors were observed to contribute to the presence of a fabella causing alterations in the size of the CF nerve: a bony fabella, a CF nerve path posterior or lateral to the fabella, and subjects with a thin physique and bony fabella.

show abstract

Treatment of Fabella Syndrome with Manual Therapy: A Case Report

Cited by 28 publications

References 11 publications

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

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

Arthroscopy-Assisted Fabella Excision: Surgical Technique

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

Contact Info

Product

Resources

About