Larson J E, Becker D A
Department of Orthopedics, Mayo Clinic, Rochester, Minnesota.
J Arthroplasty. 1993 Feb;8(1):95-7. doi: 10.1016/s0883-5403(06)80114-2.
Fabellar impingement can cause postoperative pain, swelling, and catching, and can significantly compromise the results of total knee arthroplasty. The appearance of a large fabella on preoperative radiographs should raise suspicion about possible impingement. Impingement against the femoral or tibial component of the prosthesis should be assessed by inspection and palpation during trial reduction. The fabella can be removed via the anterior approach prior to component fixation, although it tends to be firmly embedded in the lateral head of the gastrocnemius tendon and requires careful dissection. A separate posterolateral approach will most likely be needed to accomplish complete fabellar excision after the components are secured.
豆状骨撞击可导致术后疼痛、肿胀和卡顿，并会显著影响全膝关节置换术的效果。术前X线片上出现较大的豆状骨应引起对可能撞击的怀疑。在试行复位期间，应通过检查和触诊评估假体的股骨或胫骨部件的撞击情况。尽管豆状骨往往牢固地嵌入腓肠肌腱外侧头，需要仔细解剖，但在固定部件之前可通过前入路将其切除。在部件固定后，很可能需要单独的后外侧入路来完成豆状骨的完整切除。
