Cyamella (a popliteal sesamoid bone) prevalence: a systematic review, meta-analysis, and proposed classification system
File(s)
Accepted version
Accepted version
Author(s)
Berthaume, Michael A
Bull, Anthony MJ
Type
Journal Article
Abstract
INTRODUCTION: The cyamella is a rare, generally asymptomatic, knee sesamoid bone located in the proximal tendon of the popliteal muscle. Only two studies have investigated cyamella presence/absence in humans, putting ossified prevalence rates at 0.57-1.8%. We aim to 1) determine cyamella prevalence in a Korean population, 2) examine coincident development of the cyamella and fabella, and 3) perform a systematic review and meta-analysis on the cyamella in humans. MATERIALS AND METHODS: Medical computed tomography scans of 106 individuals were reviewed. A systematic review and meta-analysis were performed following PRISMA guidelines. RESULTS: Cyamellae were found in 3/212 knees (1.4%), and presence/absence was uncorrelated to height, age, and sex. The cyamella was not found coincidentally with the fabella, although the statistical power was low. Our systematic review/meta-analysis revealed cyamellae were generally asymptomatic and ossification could occur at 14 years. Cyamellae were equally likely to be found in both sexes, knees, one or both knees, and there appeared to be no global variation in prevalence rates. Cyamellae were found in three distinct locations. CONCLUSIONS: There is little support for the role of intrinsic genetic and/or environmental factors in cyamella development in humans. However, the apparent phylogenetic signal in Primates suggests genetics plays a role in cyamella development. We propose a cyamella classification system based on cyamella location (Class I, popliteal sulcus; Class II, tibial condyle; Class III, fibular head) and hypothesize locations may correspond to distinct developmental pathways, and cyamella function may vary with location. This article is protected by copyright. All rights reserved.
Date Issued
2021-07-01
Date Acceptance
2021-03-01
Citation
Clinical Anatomy, 2021, 34 (5), pp.810-820
ISSN
0897-3806
Publisher
Wiley
Start Page
810
End Page
820
Journal / Book Title
Clinical Anatomy
Volume
34
Issue
5
Copyright Statement
© 2021 American Association of Clinical Anatomists. This is the accepted version of the following article: Berthaume, M.A. and Bull, A.M.J., Clinical Anatomy. 2021;1–11, which has been published in final form at https://doi.org/10.1002/ca.23743
Sponsor
National Institute for Health Research
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/33905585
Grant Number
GHR Project: 16/137/45
Subjects
cyamella; fabella; prevalence; classification; systematic review; meta-analysis
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2021-04-27