Os fabella Syndrome in a professional swimmer
ESSKA Academy. Lopez-Vidriero Tejedor R. Nov 8, 2019; 284456; epESMA-59 Topic: Open Surgery
Dra Rosa Lopez-Vidriero Tejedor
Dra Rosa Lopez-Vidriero Tejedor
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Os fabella Syndrome in a professional swimmer

ePoster - epESMA-59

Topic: General Sports Medicine

López-Vidriero Tejedor R.1, López-Vidriero Tejedor E.2
1ISMEC, Madrid, Spain, 2ISMEC, Seville, Spain

Introduction: The fabella is a sesamoid bone in the posterolateral capsule of the knee joint. The presence of the fabella varies widely from 20% to 87%.
Posterolateral knee pain can be associated with the presence of a fabella.
The fabella syndrome is characterized by periodic pain in the posterolateral aspect of the knee.
Pain increases with extension of the knee causing tension by pressing the fabella onto the lateral femoral condyle.
Objectives: present a case report of Os fabella Syndrome in a professional swimmer and the results after surgery.
Aims: remind this rare pathology and show our results.
Method: One male professional swimmer (200m butterfly) with a long history (> 12 month) of posterolateral knee pain of unknown origin who referred pain with knee hyperextension and impulse while swimming, resolving hours after resting. No symptoms in activities of daily living were reported.
Standard clinical examination was performed (Lachman Test, anterior & posterior drawer Test, medial and lateral collateral ligament test, mensicus test, palpation of posterolateral aspect of the knee) and radiographic diagnostics such as ultrasound, plain radiographs (a.p. and lateral view) and MRI were ordered.
Standard examination and radiographic imaging such as X-Ray and MRI could exclude other intra- and extra articular pathologies possibly causing pain.
The athlete underwent surgical excision of the fabella through a dorsolateral incision between the biceps muscle and the iIiotibial band after having had unsatisfying reduction of pain under physiotherapy. The fabella was located by US and resected.
Pain and knee function were analysed using the IKDC score and the Visual Analogue score (VAS). All scores were delivered preoperatively and at 6 weeks and 12 months postoperatively.
Results: Immediate pain relief after surgery (VAS 6 weeks post op: 0, and 12 months: 0). Swimming readaptation was begun 20 days post op. Return to swimming training at 6 weeks post op. IKDC pre op:47,1, IKDC 6 weeks: 94,3 IKDC 12 months:100
Conclusions: Os fabella Syndrome should be considered in case of posterolateral corner pain with knee extension. As a rare pathology, is commonly misdiagnosed.
US assessment is useful for the diagnose and the surgery (to locate the nerve)
Surgical treatment is effective and with little comorbidity.
Further studies are needed in elite athletes.
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