{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T20:18:10Z","timestamp":1793305090231,"version":"4.5.0"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T00:00:00Z","timestamp":1568073600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T00:00:00Z","timestamp":1568073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100011710","name":"Shaanxi Provincial Science and Technology Department","doi-asserted-by":"publisher","award":["2018SF-200"],"award-info":[{"award-number":["2018SF-200"]}],"id":[{"id":"10.13039\/501100011710","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81201373"],"award-info":[{"award-number":["81201373"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009996","name":"Shaanxi Province Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2016BSHEDZZ93"],"award-info":[{"award-number":["2016BSHEDZZ93"]}],"id":[{"id":"10.13039\/501100009996","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The fabella is a sesamoid bone of the knee that can degenerate in some patients with osteoarthritis. The purpose of this study was to examine the prevalence and degeneration grades of fabellae in the Chinese population and to analyse their relationships with subject ages and knee osteoarthritis grades. The anteroposterior and lateral knee roentgenograms of 1150 subjects were recruited from the institutional database. The Kellgren-Lawrence scoring system was used to evaluate knee osteoarthritis. The degeneration grades of fabellae were scored in lateral roentgenograms by screening their shapes, sizes, subchondral sclerosis and osteophyte formation. The prevalence and degeneration of fabellae among ages, genders and knee sides were analysed by the Pearson Chi-Square test, and their relationships with knee osteoarthritis were analysed by the Spearman nonparametric correlation test. The overall prevalence of fabellae was 48.6% in 1359 knees. There was no significant difference in fabellar prevalence between the two sides (<jats:italic>\u03c7<\/jats:italic>\u00b2\u2009=\u20090.025, <jats:italic>P<\/jats:italic>\u2009=\u20090.87437) and genders (<jats:italic>\u03c7<\/jats:italic>\u00b2\u2009=\u20093.647, <jats:italic>P<\/jats:italic>\u2009=\u20090.05617), while the prevalence increased with the increasing ages of the subjects (<jats:italic>\u03c7<\/jats:italic>\u00b2\u2009=\u2009213.868, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009<jats:italic>0.001<\/jats:italic>). The fabellar degeneration grades were correlated with age (<jats:italic>r<\/jats:italic>\u2009=\u20090.5288, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and knee osteoarthritis scores (<jats:italic>r<\/jats:italic>\u2009=\u2009<jats:italic>0.6892, P<\/jats:italic>\u2009&lt;\u2009<jats:italic>0.001<\/jats:italic>). These results suggested that the fabellar prevalence and degeneration grades were correlated with age and knee osteoarthritis scores.<\/jats:p>","DOI":"10.1038\/s41598-019-49174-1","type":"journal-article","created":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T10:03:36Z","timestamp":1568109816000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Fabellar prevalence, degeneration and association with knee osteoarthritis in the Chinese population"],"prefix":"10.1038","volume":"9","author":[{"given":"Weikun","family":"Hou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingbo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanzhen","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,9,10]]},"reference":[{"key":"49174_CR1","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1002\/ca.980010110","volume":"1","author":"S Mottershead","year":"1988","unstructured":"Mottershead, S. Sesamoid bones and cartilages: An enquiry into their function. Clinical anatomy 1, 59\u201362 (1988).","journal-title":"Clinical anatomy"},{"key":"49174_CR2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2015\/343728","volume":"2015","author":"NH Hauser","year":"2015","unstructured":"Hauser, N. H., Hoechel, S., Toranelli, M., Klaws, J. & M\u00fcllergerbl, M. Functional and Structural Details about the Fabella: What the Important Stabilizer Looks Like in the Central European Population. Biomed Research International 2015, 1\u20138 (2015).","journal-title":"Biomed Research International"},{"key":"49174_CR3","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1007\/s00276-007-0259-4","volume":"29","author":"T Kawashima","year":"2007","unstructured":"Kawashima, T., Takeishi, H., Yoshitomi, S., Ito, M. & Sasaki, H. Anatomical study of the fabella, fabellar complex and its clinical implications. Surgical & Radiologic Anatomy 29, 611\u2013616 (2007).","journal-title":"Surgical & Radiologic Anatomy"},{"key":"49174_CR4","doi-asserted-by":"publisher","first-page":"105","DOI":"10.4067\/S0717-95022010000100015","volume":"28","author":"Silva","year":"2010","unstructured":"Silva et al. Morphological Analyisis of the Fabella in Brazilians. International Journal of Morphology 28, 105\u2013110 (2010).","journal-title":"International Journal of Morphology"},{"key":"49174_CR5","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1007\/s00276-011-0828-4","volume":"34","author":"SX Zeng","year":"2012","unstructured":"Zeng, S. X. et al. Anatomic study of fabella and its surrounding structures in a Chinese population. Surgical and radiologic anatomy: SRA 34, 65\u201371, https:\/\/doi.org\/10.1007\/s00276-011-0828-4 (2012).","journal-title":"Surgical and radiologic anatomy: SRA"},{"key":"49174_CR6","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1007\/s00776-003-0739-2","volume":"9","author":"T Minowa","year":"2004","unstructured":"Minowa, T. et al. Does the fabella contribute to the reinforcement of the posterolateral corner of the knee by inducing the development of associated ligaments? Journal of Orthopaedic Science 9, 59 (2004).","journal-title":"Journal of Orthopaedic Science"},{"key":"49174_CR7","doi-asserted-by":"publisher","first-page":"1379","DOI":"10.2106\/00004623-198466090-00009","volume":"66","author":"JW Pritchett","year":"1984","unstructured":"Pritchett, J. W. The incidence of fabellae in osteoarthrosis of the knee. Journal of Bone & Joint Surgery-american Volume 66, 1379\u20131380 (1984).","journal-title":"Journal of Bone & Joint Surgery-american Volume"},{"key":"49174_CR8","doi-asserted-by":"publisher","first-page":"688","DOI":"10.2106\/00004623-195234030-00025","volume":"34","author":"RR Goldenberg","year":"1952","unstructured":"Goldenberg, R. R. & Wild, E. L. Chondromalacia fabellae. Jbjs 34, 688\u2013690 (1952).","journal-title":"Jbjs"},{"key":"49174_CR9","first-page":"135","volume":"31","author":"M Oshida","year":"2012","unstructured":"Oshida, M. Two Cases of Fabello-femoral Osteoarthritis That Required Surgical Treatment and the Results of an Anatomical Study of Fabello-femoral Osteoarthritis in Aged Cadavers. Japanese. Journal of Rheumatism & Joint Surgery 31, 135\u2013139 (2012).","journal-title":"Journal of Rheumatism & Joint Surgery"},{"key":"49174_CR10","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1016\/j.knee.2007.03.007","volume":"14","author":"F Franceschi","year":"2007","unstructured":"Franceschi, F. et al. Dislocation of an enlarged fabella as uncommon cause of knee pain: a case report. Knee 14, 330\u2013332 (2007).","journal-title":"Knee"},{"key":"49174_CR11","first-page":"396710","volume":"2015","author":"T Cherrad","year":"2015","unstructured":"Cherrad, T., Louaste, J., Bousba\u00e4, H., Amhajji, L. & Khaled, R. Fracture of the Fabella: An Uncommon Injury in Knee. Case Reports in Orthopedics,2015, (2015-9-13) 2015, 396710 (2015).","journal-title":"Case Reports in Orthopedics,2015, (2015-9-13)"},{"key":"49174_CR12","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-15-100","volume":"15","author":"A Driessen","year":"2014","unstructured":"Driessen, A. et al. The fabella syndrome - a rare cause of posterolateral knee pain: a review of the literature and two case reports. BMC Musculoskeletal Disorders 15, 100 (2014).","journal-title":"BMC Musculoskeletal Disorders"},{"key":"49174_CR13","unstructured":"Ando, Y. et al. A case report on a very rare variant of popliteal artery entrapment syndrome due to an enlarged fabella associated with severe knee osteoarthritis. Journal of Orthopaedic Science (2015)."},{"key":"49174_CR14","doi-asserted-by":"publisher","first-page":"613","DOI":"10.2106\/00004623-198870040-00020","volume":"70","author":"FF Jaffe","year":"1988","unstructured":"Jaffe, F. F., Kuschner, S. & Klein, M. Fabellar impingement: a cause of pain after total knee replacement. A case report. Journal of Bone & Joint Surgery American Volume 70, 613\u2013616 (1988).","journal-title":"Journal of Bone & Joint Surgery American Volume"},{"key":"49174_CR15","first-page":"1","volume":"2016","author":"TC Kwee","year":"2016","unstructured":"Kwee, T. C., Heggelman, B., Gaasbeek, R. & Nix, M. Fabella Fractures after Total Knee Arthroplasty with Correction of Valgus Malalignment. Case Reports in Orthopedics,2016,(2016-6-1) 2016, 1\u20135 (2016).","journal-title":"Case Reports in Orthopedics,2016,(2016-6-1)"},{"key":"49174_CR16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2016\/4328462","volume":"2016","author":"E Okano","year":"2016","unstructured":"Okano, E. et al. Fabella Syndrome as an Uncommon Cause of Posterolateral Knee Pain after Total Knee Arthroplasty: A Case Report and Review of the Literature. Case Reports in Orthopedics 2016, 1\u20135 (2016).","journal-title":"Case Reports in Orthopedics"},{"key":"49174_CR17","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1136\/ard.16.4.494","volume":"16","author":"JH Kellgren","year":"1957","unstructured":"Kellgren, J. H. & Lawrence, J. S. Radiological Assessment of Osteo-Arthrosis. Annals of the Rheumatic Diseases 16, 494 (1957).","journal-title":"Annals of the Rheumatic Diseases"},{"key":"49174_CR18","unstructured":"Jin, Z. W. et al. A new insight into the fabella at knee: the fetal development and evolution. Folia morphologica (2016)."},{"key":"49174_CR19","first-page":"269","volume":"248","author":"JA M\u00e9rida\u2010Velasco","year":"1997","unstructured":"M\u00e9rida\u2010Velasco, J. A. & Jim\u00e9nez\u2010Collado, J. Development of the human knee joint. Anatomical Record-advances in Integrative Anatomy & Evolutionary Biology 248, 269\u2013278 (1997).","journal-title":"Anatomical Record-advances in Integrative Anatomy & Evolutionary Biology"},{"key":"49174_CR20","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1002\/(SICI)1097-0185(19991015)257:5<174::AID-AR6>3.0.CO;2-O","volume":"257","author":"VK Sarin","year":"1999","unstructured":"Sarin, V. K., Erickson, G. M., Giori, N. J., Bergman, A. G. & Carter, D. R. Coincident development of sesamoid bones and clues to their evolution. Anatomical Record 257, 174 (1999).","journal-title":"Anatomical Record"},{"key":"49174_CR21","doi-asserted-by":"publisher","first-page":"169","DOI":"10.2106\/00004623-196143020-00002","volume":"43","author":"EB Kaplan","year":"1961","unstructured":"Kaplan, E. B. The fabellofibular and short lateral ligaments of the knee joint. Journal of Bone & Joint Surgery-american Volume 43, 169\u2013179 (1961).","journal-title":"Journal of Bone & Joint Surgery-american Volume"},{"key":"49174_CR22","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1007\/s00167-007-0301-4","volume":"15","author":"O Raheem","year":"2007","unstructured":"Raheem, O., Philpott, J., Ryan, W. & O\u2019Brien, M. Anatomical variations in the anatomy of the posterolateral corner of the knee. Knee Surgery Sports Traumatology Arthroscopy 15, 895\u2013900 (2007).","journal-title":"Knee Surgery Sports Traumatology Arthroscopy"},{"key":"49174_CR23","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1148\/radiology.198.1.8539378","volume":"198","author":"JS Yu","year":"1996","unstructured":"Yu, J. S. et al. Posterolateral aspect of the knee: improved MR imaging with a coronal oblique technique. Radiology 198, 199\u2013204 (1996).","journal-title":"Radiology"},{"key":"49174_CR24","first-page":"732","volume":"24","author":"GC Terry","year":"1996","unstructured":"Terry, G. C. & Laprade, R. F. The posterolateral aspect of the knee. Anatomy and surgical approach. American Journal of Sports Medicine 24, 732 (1996).","journal-title":"Anatomy and surgical approach. American Journal of Sports Medicine"},{"key":"49174_CR25","unstructured":"Piyawinijwong, S., Sirisathira, N. & Sricharoenvej, S. The fabella, fabellofibular and short lateral ligaments: an anatomical study in Thais cadavers. Siriraj Medical Journal (2016)."},{"key":"49174_CR26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11604-013-0253-1","volume":"32","author":"S Ehara","year":"2014","unstructured":"Ehara, S. Potentially symptomatic fabella: MR imaging review. Japanese Journal of Radiology 32, 1 (2014).","journal-title":"Japanese Journal of Radiology"},{"key":"49174_CR27","doi-asserted-by":"publisher","first-page":"198","DOI":"10.11622\/smedj.2014185","volume":"55","author":"CP Chew","year":"2014","unstructured":"Chew, C. P., Lee, K. H., Koh, J. S. & Howe, T. S. Incidence and radiological characteristics of fabellae in an Asian population. Singapore Med J 55, 198\u2013201 (2014).","journal-title":"Singapore Med J"},{"key":"49174_CR28","first-page":"299","volume":"27","author":"H Iida","year":"1976","unstructured":"Iida, H., Arisawa, H. & Yufu, J. A case report of peroneal nerve palsy compressed by the fabella. Orthop Surg 27, 299\u2013302 (1976).","journal-title":"Orthop Surg"},{"key":"49174_CR29","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1002\/ca.21049","volume":"24","author":"P Phukubye","year":"2011","unstructured":"Phukubye, P. & Oyedele, O. The incidence and structure of the fabella in a South African cadaver sample. Clinical anatomy 24, 84\u201390, https:\/\/doi.org\/10.1002\/ca.21049 (2011).","journal-title":"Clinical anatomy"},{"key":"49174_CR30","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1002\/ca.22153","volume":"26","author":"Y Tabira","year":"2013","unstructured":"Tabira, Y. et al. Influence of a fabella in the gastrocnemius muscle on the common fibular nerve in Japanese subjects. Clinical anatomy 26, 893\u2013902, https:\/\/doi.org\/10.1002\/ca.22153 (2013).","journal-title":"Clinical anatomy"},{"key":"49174_CR31","doi-asserted-by":"publisher","first-page":"478","DOI":"10.5603\/FM.a2016.0080","volume":"76","author":"OF Egerci","year":"2017","unstructured":"Egerci, O. F. et al. Prevalence and distribution of the fabella: a radiographic study in Turkish subjects. Folia morphologica 76, 478\u2013483, https:\/\/doi.org\/10.5603\/FM.a2016.0080 (2017).","journal-title":"Folia morphologica"},{"key":"49174_CR32","first-page":"58","volume":"36","author":"AM Clarke","year":"1991","unstructured":"Clarke, A. M. & Matthews, J. G. Osteoarthritis of the fabella: a fourth knee compartment? Journal of the Royal College of Surgeons of Edinburgh 36, 58 (1991).","journal-title":"Journal of the Royal College of Surgeons of Edinburgh"},{"key":"49174_CR33","doi-asserted-by":"crossref","unstructured":"Mccalden, R. W. et al. Clinical Results and Survivorship of the GENESIS II Total Knee Arthroplasty at a Minimum of 15 Years. Journal of Arthroplasty (2017).","DOI":"10.1016\/j.arth.2017.02.006"},{"key":"49174_CR34","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3109\/17453674.2014.916487","volume":"85","author":"A Ali","year":"2014","unstructured":"Ali, A. et al. Dissatisfied patients after total knee arthroplasty. Acta Orthopaedica 85, 229 (2014).","journal-title":"Acta Orthopaedica"},{"key":"49174_CR35","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1016\/j.arth.2016.09.035","volume":"32","author":"RB Seah","year":"2016","unstructured":"Seah, R. B. et al. Unexplained pain post total knee arthroplasty with an Oxford knee score \u226520 at 6 months predicts good 2 year outcome. Journal of Arthroplasty 32, 807\u2013810 (2016).","journal-title":"Journal of Arthroplasty"},{"key":"49174_CR36","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/S0883-5403(06)80114-2","volume":"8","author":"JE Larson","year":"1993","unstructured":"Larson, J. E. & Becker, D. A. Fabellar impingement in total knee arthroplasty. A case report. Journal of Arthroplasty 8, 95\u201397 (1993).","journal-title":"Journal of Arthroplasty"},{"key":"49174_CR37","first-page":"185","volume":"18","author":"JW Wang","year":"1995","unstructured":"Wang, J. W. Fabellar impingement after total knee replacement\u2013a case report. Changgeng Yi Xue Za Zhi 18, 185\u2013189 (1995).","journal-title":"Changgeng Yi Xue Za Zhi"},{"key":"49174_CR38","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.2214\/AJR.04.1230","volume":"185","author":"SJ Theodorou","year":"2005","unstructured":"Theodorou, S. J., Theodorou, D. J. & Resnick, D. Painful stress fractures of the fabella in patients with total knee arthroplasty. Ajr American Journal of Roentgenology 185, 1141\u20131144 (2005).","journal-title":"Ajr American Journal of Roentgenology"},{"key":"49174_CR39","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.1302\/0301-620X.73B6.1955425","volume":"73","author":"L Laird","year":"1991","unstructured":"Laird, L. Fabellar joint causing pain after total knee replacement. Journal of Bone & Joint Surgery British Volume 73, 1007\u20131008 (1991).","journal-title":"Journal of Bone & Joint Surgery British Volume"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-49174-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-49174-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-49174-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,17]],"date-time":"2022-12-17T13:22:57Z","timestamp":1671283377000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-49174-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,10]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,12]]}},"alternative-id":["49174"],"URL":"https:\/\/doi.org\/10.1038\/s41598-019-49174-1","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,10]]},"assertion":[{"value":"8 January 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 August 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 September 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}],"article-number":"13046"}}