Incidence and radiological characteristics of fabellae in an Asian population

<p><b>INTRODUCTION</b>The fabella, a sesamoid bone sometimes found in the lateral head of the gastrocnemius muscle, often articulates directly with the lateral femoral condyle. This study aimed to determine the incidence of fabellae in an Asian population and to characterise the radiological features of the fabella.</p><p><b>METHODS</b>Electronic radiographs and magnetic resonance imaging films of 80 consecutive patients who underwent knee arthroscopy between May 2005 and October 2009 were reviewed to determine the presence and characteristics of the fabella.</p><p><b>RESULTS</b>The incidence of fabellae was 31.25% in our study cohort. The median length, thickness, width and distance of the fabella from the lateral femoral condyle were 7.06 mm, 4.89 mm, 6.12 mm and 33.19 mm, respectively. The fabella was consistently bony and located in the lateral head of the gastrocnemius, with 52% of the fabellae having an articulating facet. Fabellae in men were found to be larger than in women, although the difference was not statistically significant. The presence of an articulating groove was associated with increased size of the fabella, but not with the distance between the fabella and its insertion onto the lateral head of the gastrocnemius.</p><p><b>CONCLUSION</b>The incidence of fabellae in our population was lower than that in regional studies. They were consistently bony and not all had articulating grooves on the lateral femoral condyle. We found that the larger the fabella, the higher the chances of it having an articulating groove. By defining the radiological characteristics of the fabella, we provide objective parameters to help differentiate the fabella from other loose bodies or calcifications in the knee.</p>

Arthroscopic Bankart repair augmented by plication of the inferior glenohumeral ligament via horizontal mattress suturing for traumatic shoulder instability

<p><b>INTRODUCTION</b>This study aimed to evaluate the two-year clinical outcomes of arthroscopic Bankart repair augmented by plication of the inferior glenohumeral ligament (IGHL) via horizontal mattress suturing.</p><p><b>METHODS</b>This study was a retrospective analysis of 76 arthroscopic Bankart repairs by a single surgeon from 2004 to 2008. Bioabsorbable suture anchors were used, with anchors placed at the 5:30, 4 and 3 o'clock positions of the right shoulder (correspondingly at the 6:30, 8 and 9 o'clock positions for the left shoulder). The lower most anchor was tied via horizontal mattress suture with plication of the IGHL, while the remaining two anchors were tied using simple sutures. The patients were postoperatively assessed, clinically and using the University of California Los Angeles (UCLA) shoulder rating scale.</p><p><b>RESULTS</b>The mean age of the patients at the time of presentation was 24.09 ± 7.98 years, and the mean duration of follow-up was 28.7 months. The postoperative recurrence rate of dislocation was 7.89% (six shoulders), of which five shoulders required revision surgeries. Excluding the revision cases, clinical assessment of the strength of the supraspinatus and the range of motion of the operated shoulders at two years post operation were either maintained or full in all patients. Analysis of the UCLA results showed pre- and postoperative mean scores of 25.94 ± 3.43 and 33.77 ± 3.07, respectively (p < 0.05).</p><p><b>CONCLUSION</b>Arthroscopic Bankart repair augmented by plication of the IGHL and anchored via horizontal mattress suturing is a safe and reliable treatment for shoulder instability, with good clinical outcomes and low recurrence rates.</p>