Nurdan ÇAY, Sinem AKKAŞOĞLU, Selma ÇALIŞKAN

Os fabella; radiologic study on 500 cases

Aim: Aim of the present study is to indicate the incidence of os fabella in our population and to evaluate the side and gender relateddifferences.Material and Methods: 500 patients (224 females, 276 males) who underwent Magnetic Resonance Imaging (MRI) for variousindications were enrolled in the present study. Patients had no history of trauma or surgery. MR images of the patients were evaluatedretrospectively.Results: 140 patients with os fabella were reported (28%). 52 of the 140 patients were females (37%) 88 were males (63%). Malepredominance in this study was statistically significant. (p= 0.003). Bilaterality incidence of os fabella was 25.71%. There was nostatistically significant incidence difference between left and right sides. (p = 0.1005) Difference between genders according tolength and width of os fabella was evaluated in 96 patients who underwent bilateral knee MR imaging. Length of right sided osfabella was greater in males than in females (p = 0.003).Conclusion: Proper understanding of anatomy and variations of knee region is important for diagnosis and treatment of patientswith knee problems. Os fabella is one of the variations in the knee region which has clinical importance and may cause diagnosticpitfalls and surgical complications.

PDF

___

1. Theodorou SJ, Theodorou DJ, Resnick D. Painful stress fractures of the fabella in patients with total knee arthroplasty. AJR Am J Roentgenol 2005 ;185:1141-4.
2. Cherrad T, Louaste J, Bousbaa H, et al. Fracture of the fabella: an uncommon injury in knee. Case Rep Orthop. 2015;2015:396710. doi: 10.1155/2015/396710. Epub 2015 Sep 13.
3. Segal A, Miller TT, Krauss ES. Fabellar snapping as a cause of knee pain after total knee replacement: assessment using dynamic sonography. AJR Am J Roentgenol 2004;183:352-4.
4. Dalip D, Iwanaga J, Oskouian RJ, et al. A Comprehensive Review of the Fabella Bone. Cureus 2018;10:2736.
5. Heideman GM, Baynes KE, Mautz AP, et al. Fabella fracture with CT imaging: a case report. Emerg Radiol 2011;18:357-61.
6. Kim T, Chung H, Lee H, et al. A case report and literature review on fabella syndrome after high tibial osteotomy. Medicine (Baltimore) 2018;97:9585.
7. Kawashima T, Takeishi H, Yoshitomi S, et al. An atomical study of the fabella, fabellar complex and its clinical implications. Surg Radiol Anat 2007;29:611-6.
8. Barreto AR, Chagas-Neto FA, Crema MD, et al. Fracture of the fabella: a rare injury in knee trauma. Case Rep Radiol 2012;2012:390150.
9. Patel A, Singh R, Johnson B, et al. Compression neuropathy of the common peroneal nerve by the fabella BMJ Case Rep 2013;2013:2013202154.
10. Jaffe FF, Kuschner S, Klein M. Fabellar impingement: a cause of pain after total knee replacement. A case report, J Bone Joint Surg Am 1988;70:613-6.
11. Levowitz BS, Kletschka HD, Fracture of the fabella; report of a case. J. Bone Joint Surg Am 1955;37: 876-7.
12. Provencher MT, Sanchez G, Ferrari MB, et al. Arthroscopy-Assisted Fabella Excision: Surgical Technique. Arthrosc Tech 2017;6:369-74.
13. Corvalan C, Tang C, Robinson M. Fabella and cyamella of the human knee joint: discovery by dissection and ultrasound examination. Eur J Anat 2018;22:103-9.
14. Kuur E. Painful fabella. A case report with review of the literature. Acta Orthop Scand 1986;57:453-4.
15. Zhou F, Zhang F, Deng G, et al. Fabella fracture with radiological imaging: A case report. Trauma Case Rep 2017;12:19-23.
16. Hauser H, Hoechel S, Toranelli M, et al. Functional and Structural Details about the Fabella: What the Important Stabilizer Looks Like in the Central European Population. Biomed Res Int 2015;2015:343728.
17. Hou W, Xu L, Wang J, et al. Fabellar prevalence, degeneration and association with knee osteoarthritis in the Chinese population. Sci Rep 2019;9:13046.