Unique myological changes associated with ossified fabellae: a femorofabellar ligament and systematic review of the double-headed popliteus

X-ray Imaging Versus Anatomical Dissection for Identification of the Fabella

INTRODUCTION

Reported prevalence rates of the fabella sesamoid bone vary widely, particularly between studies based on either X-ray imaging or anatomical dissection approaches. The purpose of this study was to directly compare these two methodologies in their detection of fabellae and investigate whether variability in the density of fabellae could explain any discrepancies.

METHODS

Fifty cadaveric knee segments were examined for the presence of a fabella by both X-ray imaging and anatomical dissection. The relative density of each excised fabella specimen was then quantified using a separate set of radiographs.  Results: Fabellae were detected in 40% of the sample knees via a manual dissection approach but in just 12% of those same specimens using X-ray imaging. Relative density measurements confirmed that fabellae identifiable only via dissection were significantly less dense than fabellae visible in whole knee radiographs but denser than the surrounding tissue.

CONCLUSION

Radiology cannot reliably detect cartilaginous or incompletely ossified fabellae, which were found in 28% of the study population. Clinicians should consider the potential occurrence of a fabella when diagnosing posterolateral knee pain, even if it may not be visible via X-ray.

Biomechanics in anthropology

Biomechanics is the set of tools that explain organismal movement and mechanical behavior and links the organism to the physicality of the world. As such, biomechanics can relate behaviors and culture to the physicality of the organism. Scale is critical to biomechanical analyses, as the constitutive equations that matter differ depending on the scale of the question. Within anthropology, biomechanics has had a wide range of applications, from understanding how we and other primates evolved to understanding the effects of technologies, such as the atlatl, and the relationship between identity, society, culture, and medical interventions, such as prosthetics. Like any other model, there is great utility in biomechanical models, but models should be used primarily for hypothesis testing and not data generation except in the rare case where models can be robustly validated. The application of biomechanics within anthropology has been extensive, and holds great potential for the future.

Sensitivity of musculoskeletal models to variation in muscle architecture parameters

Musculoskeletal models, like all theoretical models of physical processes, depend on the assumptions needed to construct the model. For musculoskeletal models, these assumptions include, among other things, the kinematic data, the kinetic data and the muscle parameters. The former (dynamic) data can be acquired relatively easily from living subjects, but the latter are usually based on limited information, frequently determined from cadaver studies performed on elderly individuals. Previously, we determined the sensitivity of forces to dynamic differences among 10 humans walking on a straight path. Here, we assess the sensitivity of the muscle and joint reaction forces developed in human walking to variable muscle parameters obtained from 10 living adults, whose data were recently reported, and compared the results with the values from a standard model that depends on cadaveric data. We found that, while the force patterns across the stance cycle were similar among muscle parameter models, differences of as much as 15% in the force magnitude were produced. Whether or not the variation between the standard model and other muscle parameters is important depends on why the forces are required.