An Acute Osteochondral Defect Secondary to Fabella Impaction: A Case Report

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Knee Biomechanics

Background:

• Deep knee flexion maneuvers, such as those during skiing, can precipitate unique knee injuries.
• Osteochondral defects, particularly those involving the fabella and adjacent femoral condyle, are uncommon but significant pathologies.

Observation:

• A healthy 37-year-old male experienced acute knee pain and swelling after a deep flexion skiing injury.
• Persistent knee extension limitation and posterolateral pain led to the diagnosis of an acute osteochondral defect adjacent to the fabella.
• The defect involved the posterolateral femoral condyle and was directly related to the fabella.

Findings:

• Nonoperative interventions were initially trialed without full resolution of symptoms.
• The patient underwent arthroscopic-assisted open excision of the fabella.
• A chondroplasty was performed on the posterolateral femoral condyle defect.

Implications:

• Traumatic osteochondral defects secondary to lateral fabella impaction require careful evaluation in athletes with persistent knee symptoms after deep flexion.
• Arthroscopic chondroplasty combined with fabella excision offers a viable surgical solution for such injuries.
• This combined surgical approach can facilitate the return of patients to their desired activity levels.