Arthroscopic excision of the fabella

The fabella (little bean) is a sesamoid bone found in the lateral head of the gastrocnemius muscle. Its incidence varies from 10% to 30%, and when present, usually occurs bilaterally. The fabella can lead to posterolateral knee pain either due to cartilage softening (chondromalacia fabellae) or other osteoarthritic changes on its articular surface. We present two patients with symptoms in the posterolateral aspect of the knee who underwent an arthroscopic excision of the fabella. We report on the technique used and the clinical outcome.