Zenteno CB, Morales CIF, De la Torre GIG

Language: Spanish
References: 9
Page: 264-266
PDF size: 435.66 Kb.

ABSTRACT

Objective: to present a case of fabella syndrome in a 27-year-old high performance runner who responded favorably to the surgical resection of this sesamoid bone, after multiple failed conservative treatments. To discuss the difficulty to diagnose this syndrome due to its anatomical location, and mention the frequent performance of unnecessary arthroscopic studies and procedures in this type of patients. We present the case of a high performance runner who underwent multiple tests and treatments for left posterolateral knee pain, which was resolved surgically; the specimen was sent to pathology for the confirmation of the diagnosis. The presence of a symptomatic fabella was reported in a high performance athlete whose pain was relieved only after surgery. The athlete resumed training and high international level competitions 3 months after surgery. At the 2-year and 10-month follow-up she was completely asymptomatic and competing in high performance athletic races. Conclusions: posterolateral knee pain located in the anatomical area of the fabella, in cases in which the latter is present and after ruling out concomitant lesions like that of the lateral meniscus, should initially be managed conservatively. But if symptoms persist, the resection of the fabella, with the appropriate reconstruction of the posterolateral corner of the knee, is a definitive treatment effective for allowing the athlete to resume training and competitions.

REFERENCES

1. LaPrade R, Morgan P, et al: The anatomy of the posterior aspect of the knee. J Bone Joint Surg Am 2007; 89: 758-64,

2. Dannawi Z, Khanduja V, Vemulapalli KK, et al: Arthroscopic excision of the fabella. J Knee Surg 2007; 20(4): 299-301.

3. Kawashima T, Takeishi H, Yoshitomi S, et al: Anatomical study of the fabella complex and its clinical implications. Surg Radiol Anat 2007; 29(8): 611-6.

4. MInowa T, Murakami G, Kura H, et al: Does the fabella contribute to the reinforcement of the posterolateral corner of the knee by inducing the development of associated ligaments? J Orthop Sci 2004; 9(1): 59-65.

5. Franceschi F, Longo UG, Razzini L, et al: Dislocation of an enlarged fabella as uncommon cause of knee pain: a case report. Knee 2007; 14(4): 330-2.

6. Pecina M, Bojanic I: Overuse injuries of the musculoskeletal system, (2nd Ed.), CRC Press, Boca Raton Fl, 2003: 237-8.

7. Robertson A, Jones SC, Paes R, et al: The fabella: a forgotten source of knee pain? Knee 2004; 11(3): 243-5.

8. Weiner DS, Macnab I: The “fabella syndrome”: an update. J Pediatr Northup 1982; 2(4): 405-8.

9. Zipple JT, Hammer RL, Loubert PV: Treatment of fabella syndrome with manual therapy: a case report. J Orthop Sports Phys Ther 2003; 33(1): 33-9.