[Fabella syndrome in a high performance runner. Case presentation and literature review]

To present a case of fabella syndrome in a 27-year-old high performance runner who responded favorably to the surgical resection of this sesamoid bone, after multiple failed conservative treatments. To discuss the difficulty to diagnose this syndrome due to its anatomical location, and mention the frequent performance of unnecessary arthroscopic studies and procedures in this type of patients. We present the case of a high performance runner who underwent multiple tests and treatments for left posterolateral knee pain, which was resolved surgically; the specimen was sent to pathology for the confirmation of the diagnosis. The presence of a symptomatic fabella was reported in a high performance athlete whose pain was relieved only after surgery. The athlete resumed training and high international level competitions 3 months after surgery. At the 2-year and 10-month follow-up she was completely asymptomatic and competing in high performance athletic races.

posterolateral knee pain located in the anatomical area of the fabella, in cases in which the latter is present and after ruling out concomitant lesions like that of the lateral meniscus, should initially be managed conservatively. But if symptoms persist, the resection of the fabella, with the appropriate reconstruction of the posterolateral corner of the knee, is a definitive treatment effective for allowing the athlete to resume training and competitions.