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Michael A. Berthaume - One of the best experts on this subject based on the ideXlab platform.
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Unique myological changes associated with ossified Fabellae: a femoroFabellar ligament and systematic review of the double-headed popliteus
PeerJ, 2020Co-Authors: Michael A. Berthaume, Spencer C. Barnes, Kiron K. Athwal, Lukas WillingerAbstract:The Fabella is a sesamoid bone embedded in the tendon of the lateral head of the gastrocnemius. It is the only bone in the human body to increase in prevalence in the last 100 years. As the Fabella can serve as an origin/insertion for muscles, tendons, and/or ligaments (e.g., the oblique popliteal and fabellofibular ligaments), temporal changes in Fabella prevalence could lead to temporal changes in "standard" knee anatomy. The aim of this study was to investigate unique myological changes to the posterolateral corner knee associated with ossified Fabella presence and perform a systematic review to contextualize our results. Thirty-three fresh frozen cadaveric knees were considered. As the knees were all used for previous experimentation, the knees were in variable levels of preservation. Those with adequate preservation were used to determine ossified Fabella presence/absence. When ossified Fabellae were present, unique myologies associated with the Fabella were recorded. A systematic review was performed on the double-headed popliteus to investigate possible correlations between this anatomical variant and the Fabella. Of the 33 knees, 30 preserved enough soft tissue to determine Fabella presence/absence: 16/30 knees had Fabellae (five cartilaginous and 11 ossified). Eight of the eleven knees with ossified Fabellae retained enough soft tissue to investigate the posterolateral knee anatomy. Of these, 4/8 exhibited unique myological changes. One knee had a double-headed popliteus muscle where one head originated from the medial side of a large, bulbous Fabella. A systematic review revealed double-headed popliteus muscles are rare, but individuals are 3.7 times more likely to have a Fabella if they have a double-headed popliteus. Another knee had a large, thick ligament stretching from the lateral edge of the Fabella to the inferoposterior edge of the lateral femoral epicondyle, deep to the lateral collateral ligament (LCL) and near the popliteal sulcus. We found no mention of such a ligament in the literature and refer to it here as the "femoroFabellar ligament". In all four knees, the plantaris and lateral gastrocnemius appeared to share a common tendinous origin, and the Fabella was located at/near the junction of these muscles. In the case of the double-headed popliteus, the Fabella clearly served as an origin for the plantaris. Despite being found in an average of 36.80% of human knees, most standard anatomical models fail to account for the Fabella and/or the unique myological changes associated with Fabella presence. Although our sample is small, these data highlight aspects of human biological variability generally not considered when creating generalized anatomical models. Further work is needed to identify additional changes associated with ossified Fabellae and the functional consequences of omitting these changes from models. © 2020 Berthaume et al.
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Human biological variation in sesamoid bone prevalence: the curious case of the Fabella.
Journal of Anatomy, 2019Co-Authors: Michael A. Berthaume, Anthony M. J. BullAbstract:The Fabella is a sesamoid bone located in the gastrocnemius behind the lateral femoral condyle. In humans, Fabellae are 3.5 times more common today than they were 100 years ago, with prevalence rates varying between and within populations. In particular, Fabellae have been assumed to be more common in Asians than non‐Asians, equally common in men and women, potentially more common in older individuals, and bilateral cases (one per knee) appear to be more common than unilateral ones. The roles of genetic and environmental factors in this phenotypic variation have been hypothesized, but not rigorously investigated. Given its clinical and evolutionary significance (i.e. being associated with several knee ailments, causing medical issues on its own, interfering with medical devices, and being less common in humans than in other mammals), it is important comprehensively to understand prevalence rate variation, and the roles of genetics and environmental factors in that variation. To address these questions, we performed a meta‐analysis on data from studies published from 1875 to 2018 to investigate possible variation in sexual dimorphic (n = 22 studies, 7911 knees), ontogenetic (n = 10 studies, 4391 knees), and global (n = 65 studies, 21 626 knees) Fabella prevalence rates. In addition, we investigated what proportion of cases are bilateral (n = 37 studies, 900 individuals), and among unilateral cases (n = 20 studies, 204 individuals), if Fabellae are more common in the left or right knee. Our results show that, today, Fabellae are 2.47–2.60% more common in men than women, and prevalence rates increase ontogenetically in old age (i.e. 70 years old), implying that Fabellae can ossify early (i.e. 12 years old) or late in life. Approximately 72.94% of cases are bilateral, and among unilateral ones, Fabellae are equally common in right and left knees. There is marked regional variation in Fabella prevalence rates, with rates being highest in Asia, followed by Oceania, South America, Europe, Middle East, and North America, and lowest in Africa. Worldwide, an average of 36.80% of knees has ossified Fabellae detectable by dissection. These results imply that, while the ability to form a Fabella may be genetically controlled, the mechanisms that trigger Fabella ossification may be environmentally controlled. What these environmental factors are, can only be speculated.
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Fabella prevalence rate increases over 150 years, and rates of other sesamoid bones remain constant: a systematic review
Journal of Anatomy, 2019Co-Authors: Michael A. Berthaume, Erica Di Federico, Anthony M. J. BullAbstract:The Fabella is a sesamoid bone located behind the lateral femoral condyle. It is common in non-human mammals, but the prevalence rates in humans vary from 3 to 87%. Here, we calculate the prevalence of the Fabella in a Korean population and investigate possible temporal shifts in prevalence rate. A total of 52.83% of our individuals and 44.34% of our knees had Fabellae detectable by computed tomography scanning. Men and women were equally likely to have a Fabella, and bilateral cases (67.86%) were more common than unilateral ones (32.14%). Fabella presence was not correlated with height or age, although our sample did not include skeletally immature individuals. Our systematic review yielded 58 studies on Fabella prevalence rate from 1875–2018 which met our inclusion criteria, one of which was an outlier. Intriguingly, a Bayesian mixed effects generalized linear model revealed a temporal shift in prevalence rates, with the median prevalence rate in 2000 (31.00%) being ~ 3.5 times higher than that in 1900 (7.64%). In all four countries with studies before and after 1960, higher rates were always found after 1960. Using data from two other systematic reviews, we found no increase in prevalence rates of 10 other sesamoid bones in the human body, indicating that the increase in Fabella prevalence rate is unique. Fabella presence/absence is due to a combination of genetic and environmental factors: as the prevalence rates of other sesamoid bones have not changed in the last 100 years, we postulate the increase in Fabella prevalence rate is due to an environmental factor. Namely, the global increase in human height and weight (due to improved nutrition) may have increased human tibial length and muscle mass. Increases in tibial length could lead to a larger moment arm acting on the knee and on the tendons crossing it. Coupled with the increased force from a larger gastrocnemius, this could produce the mechanical stimuli necessary to initiate Fabella formation and/or ossification.Key words: Fabella; Korea; prevalence rate; sesamoid bone.
Anthony M. J. Bull - One of the best experts on this subject based on the ideXlab platform.
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Human biological variation in sesamoid bone prevalence: the curious case of the Fabella.
Journal of Anatomy, 2019Co-Authors: Michael A. Berthaume, Anthony M. J. BullAbstract:The Fabella is a sesamoid bone located in the gastrocnemius behind the lateral femoral condyle. In humans, Fabellae are 3.5 times more common today than they were 100 years ago, with prevalence rates varying between and within populations. In particular, Fabellae have been assumed to be more common in Asians than non‐Asians, equally common in men and women, potentially more common in older individuals, and bilateral cases (one per knee) appear to be more common than unilateral ones. The roles of genetic and environmental factors in this phenotypic variation have been hypothesized, but not rigorously investigated. Given its clinical and evolutionary significance (i.e. being associated with several knee ailments, causing medical issues on its own, interfering with medical devices, and being less common in humans than in other mammals), it is important comprehensively to understand prevalence rate variation, and the roles of genetics and environmental factors in that variation. To address these questions, we performed a meta‐analysis on data from studies published from 1875 to 2018 to investigate possible variation in sexual dimorphic (n = 22 studies, 7911 knees), ontogenetic (n = 10 studies, 4391 knees), and global (n = 65 studies, 21 626 knees) Fabella prevalence rates. In addition, we investigated what proportion of cases are bilateral (n = 37 studies, 900 individuals), and among unilateral cases (n = 20 studies, 204 individuals), if Fabellae are more common in the left or right knee. Our results show that, today, Fabellae are 2.47–2.60% more common in men than women, and prevalence rates increase ontogenetically in old age (i.e. 70 years old), implying that Fabellae can ossify early (i.e. 12 years old) or late in life. Approximately 72.94% of cases are bilateral, and among unilateral ones, Fabellae are equally common in right and left knees. There is marked regional variation in Fabella prevalence rates, with rates being highest in Asia, followed by Oceania, South America, Europe, Middle East, and North America, and lowest in Africa. Worldwide, an average of 36.80% of knees has ossified Fabellae detectable by dissection. These results imply that, while the ability to form a Fabella may be genetically controlled, the mechanisms that trigger Fabella ossification may be environmentally controlled. What these environmental factors are, can only be speculated.
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Fabella prevalence rate increases over 150 years, and rates of other sesamoid bones remain constant: a systematic review
Journal of Anatomy, 2019Co-Authors: Michael A. Berthaume, Erica Di Federico, Anthony M. J. BullAbstract:The Fabella is a sesamoid bone located behind the lateral femoral condyle. It is common in non-human mammals, but the prevalence rates in humans vary from 3 to 87%. Here, we calculate the prevalence of the Fabella in a Korean population and investigate possible temporal shifts in prevalence rate. A total of 52.83% of our individuals and 44.34% of our knees had Fabellae detectable by computed tomography scanning. Men and women were equally likely to have a Fabella, and bilateral cases (67.86%) were more common than unilateral ones (32.14%). Fabella presence was not correlated with height or age, although our sample did not include skeletally immature individuals. Our systematic review yielded 58 studies on Fabella prevalence rate from 1875–2018 which met our inclusion criteria, one of which was an outlier. Intriguingly, a Bayesian mixed effects generalized linear model revealed a temporal shift in prevalence rates, with the median prevalence rate in 2000 (31.00%) being ~ 3.5 times higher than that in 1900 (7.64%). In all four countries with studies before and after 1960, higher rates were always found after 1960. Using data from two other systematic reviews, we found no increase in prevalence rates of 10 other sesamoid bones in the human body, indicating that the increase in Fabella prevalence rate is unique. Fabella presence/absence is due to a combination of genetic and environmental factors: as the prevalence rates of other sesamoid bones have not changed in the last 100 years, we postulate the increase in Fabella prevalence rate is due to an environmental factor. Namely, the global increase in human height and weight (due to improved nutrition) may have increased human tibial length and muscle mass. Increases in tibial length could lead to a larger moment arm acting on the knee and on the tendons crossing it. Coupled with the increased force from a larger gastrocnemius, this could produce the mechanical stimuli necessary to initiate Fabella formation and/or ossification.Key words: Fabella; Korea; prevalence rate; sesamoid bone.
Willinger L. - One of the best experts on this subject based on the ideXlab platform.
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Unique myological changes associated with ossified Fabellae: a femoroFabellar ligament and systematic review of the double-headed popliteus
'PeerJ', 2020Co-Authors: Berthaume M. A., Barnes S., Athwal K.k., Willinger L.Abstract:The Fabella is a sesamoid bone embedded in the tendon of the lateral head of the gastrocnemius. It is the only bone in the human body to increase in prevalence in the last 100 years. As the Fabella can serve as an origin/insertion for muscles, tendons, and/or ligaments (e.g., the oblique popliteal and fabellofibular ligaments), temporal changes in Fabella prevalence could lead to temporal changes in “standard” knee anatomy. The aim of this study was to investigate unique myological changes to the posterolateral corner knee associated with ossified Fabella presence and perform a systematic review to contextualize our results. Methods Thirty-three fresh frozen cadaveric knees were considered. As the knees were all used for previous experimentation, the knees were in variable levels of preservation. Those with adequate preservation were used to determine ossified Fabella presence/absence. When ossified Fabellae were present, unique myologies associated with the Fabella were recorded. A systematic review was performed on the double-headed popliteus to investigate possible correlations between this anatomical variant and the Fabella. Results Of the 33 knees, 30 preserved enough soft tissue to determine Fabella presence/absence: 16/30 knees had Fabellae (five cartilaginous and 11 ossified). Eight of the eleven knees with ossified Fabellae retained enough soft tissue to investigate the posterolateral knee anatomy. Of these, 4/8 exhibited unique myological changes. One knee had a double-headed popliteus muscle where one head originated from the medial side of a large, bulbous Fabella. A systematic review revealed double-headed popliteus muscles are rare, but individuals are 3.7 times more likely to have a Fabella if they have a double-headed popliteus. Another knee had a large, thick ligament stretching from the lateral edge of the Fabella to the inferoposterior edge of the lateral femoral epicondyle, deep to the lateral collateral ligament (LCL) and near the popliteal sulcus. We found no mention of such a ligament in the literature and refer to it here as the “femoroFabellar ligament”. In all four knees, the plantaris and lateral gastrocnemius appeared to share a common tendinous origin, and the Fabella was located at/near the junction of these muscles. In the case of the double-headed popliteus, the Fabella clearly served as an origin for the plantaris. Conclusions Despite being found in an average of 36.80% of human knees, most standard anatomical models fail to account for the Fabella and/or the unique myological changes associated with Fabella presence. Although our sample is small, these data highlight aspects of human biological variability generally not considered when creating generalized anatomical models. Further work is needed to identify additional changes associated with ossified Fabellae and the functional consequences of omitting these changes from models
Marcello Henrique Nogueira-barbosa - One of the best experts on this subject based on the ideXlab platform.
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Fracture of the Fabella: A Rare Injury in Knee Trauma
2016Co-Authors: Andre Rodrigues, Francisco Abaeté Chagas-neto, Michel D. Crema, Mário Müller Lorenzato, Mariana Tiemi Teixeira Kobayashi, Carlos Ribeiro Monteiro, Marcello Henrique Nogueira-barbosaAbstract:Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. We present a case of a 21-year-old woman sustaining a traumatic [Fabellar] fracture following amotor vehicle accident. The Fabellar fracture was confirmed on plain films, which prompted further evaluation of the knee with ultrasound and magnetic resonance imaging to evaluate other possible associated injuries. Fracture of the Fabella is a rare condition. Clinically, patients present with posterolateral knee pain, edema, and limited knee extension. Occasionally these symptoms may be very subtle, delaying the correct diagnosis and patient management. 1
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Fracture of the Fabella: A Rare Injury in Knee Trauma
Case Reports in Radiology, 2012Co-Authors: André Rodrigues Façanha Barreto, Francisco Abaeté Chagas-neto, Michel D. Crema, Mário Müller Lorenzato, Mariana Tiemi Teixeira Kobayashi, Carlos Ribeiro Monteiro, Marcello Henrique Nogueira-barbosaAbstract:We present a case of a 21-year-old woman sustaining a traumatic [Fabellar] fracture following a motor vehicle accident. The Fabellar fracture was confirmed on plain films, which prompted further evaluation of the knee with ultrasound and magnetic resonance imaging to evaluate other possible associated injuries. Fracture of the Fabella is a rare condition. Clinically, patients present with posterolateral knee pain, edema, and limited knee extension. Occasionally these symptoms may be very subtle, delaying the correct diagnosis and patient management.
Kristoffer R. Esquejo - One of the best experts on this subject based on the ideXlab platform.
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Gabriel F. Fabella: Talambuhay at Pamana ng Tinaguriang “Ama ng Hunyo 12,” 1898-19821
Philippine Social Sciences Review, 2012Co-Authors: Kristoffer R. EsquejoAbstract:In 1962, President Diosdado Macapagal signed Proclamation No. 28 which enacted the changing of Philippine Independence Day from July 4 to June 12. This nationalist gesture of the said former president was interpreted by many as an assertion of Philippine sovereignty by going back to the original date of independence declared by General Emilio Aguinaldo, president of the oldest Asian republic, who was still alive at that time. In a broader scope, this was seen as a radical attempt of our nation to break free from being a neo-colony of the United States, our former colonial master. However, it is a saddening fact that the real person who had the original idea behind this legislation seemed not given sufficient credit and almost forgotten – Prof. Gabriel F. Fabella, dubbed as “Father of June 12.” Who is Fabella? More than a historian and an academician at the University of the Philippines, he was also a playwright, journalist, lawyer, politician, founder of several organizations and schools, writer and Rizalist. Though a product of American colonial education, he is an example of an ideal individual who succeeded in rising from poverty and gave immense contributions and honor to his Filipino countrymen, especially to the people of Romblon. This paper seeks to highlight the life and legacies of Fabella to the country. In commemorating the 50th anniversary of the said event, this papel will try to prove that a historian does not only study, teach and write history. He or she also possesses the power to make or produce history of national significance.
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gabriel f Fabella talambuhay at pamana ng tinaguriang ama ng hunyo 12 1898 19821
Philippine Social Sciences Review, 2012Co-Authors: Kristoffer R. EsquejoAbstract:In 1962, President Diosdado Macapagal signed Proclamation No. 28 which enacted the changing of Philippine Independence Day from July 4 to June 12. This nationalist gesture of the said former president was interpreted by many as an assertion of Philippine sovereignty by going back to the original date of independence declared by General Emilio Aguinaldo, president of the oldest Asian republic, who was still alive at that time. In a broader scope, this was seen as a radical attempt of our nation to break free from being a neo-colony of the United States, our former colonial master. However, it is a saddening fact that the real person who had the original idea behind this legislation seemed not given sufficient credit and almost forgotten – Prof. Gabriel F. Fabella, dubbed as “Father of June 12.” Who is Fabella? More than a historian and an academician at the University of the Philippines, he was also a playwright, journalist, lawyer, politician, founder of several organizations and schools, writer and Rizalist. Though a product of American colonial education, he is an example of an ideal individual who succeeded in rising from poverty and gave immense contributions and honor to his Filipino countrymen, especially to the people of Romblon. This paper seeks to highlight the life and legacies of Fabella to the country. In commemorating the 50th anniversary of the said event, this papel will try to prove that a historian does not only study, teach and write history. He or she also possesses the power to make or produce history of national significance.