Provencher Matthew T, Sanchez George, Ferrari Márcio B, Moatshe Gilbert, Chahla Jorge, Akamefula Ramesses, LaPrade Robert F
Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
Oslo University Hospital and University of Oslo, Oslo, Norway.
Arthrosc Tech. 2017 Mar 27;6(2):e369-e374. doi: 10.1016/j.eats.2016.10.011. eCollection 2017 Apr.
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.
籽骨是一种并非在所有人身上都能见到的解剖变异，由于软骨软化、骨关节炎、骨折或对股骨外侧髁的生物力学压力，它可能成为慢性膝关节疼痛的一个来源。它位于关节内，靠近股骨外侧髁、外侧腓肠肌肌腱和腓肠豆腓侧韧带。鉴于其罕见性，在评估持续存在膝关节后外侧疼痛的患者时，有症状籽骨的诊断常常被忽视。然而，尤其是在高性能跑步者、骑自行车的人和铁人三项运动员中，这种诊断应始终被考虑。虽然非手术治疗可能会缓解与此病症相关的症状，但通过关节镜辅助手术切除籽骨是治疗那些无法从非手术治疗中获益的患者的一种可靠且安全的替代方法。我们展示了详细阐述用于治疗膝关节后外侧疼痛的籽骨切除术的技术，其中包括对籽骨进行关节镜评估，以评估股骨髁的损伤情况，并尽量减少过度切除以及对周围结构的潜在损伤。
