Cyamella (a popliteal sesamoid bone) prevalence: A systematic review, meta‐analysis, and proposed classification system

Journal article


Berthaume, M. and Bull, A. (2021). Cyamella (a popliteal sesamoid bone) prevalence: A systematic review, meta‐analysis, and proposed classification system. Clinical anatomy. pp. 1-11. https://doi.org/10.1002/ca.23743
AuthorsBerthaume, M. and Bull, A.
AbstractThe 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 (a) determine cyamella prevalence in a Korean population, (b) examine coincident development of the cyamella and fabella, and (c) perform a systematic review and meta-analysis on the cyamella in humans. Medical computed tomography scans of 106 individuals were reviewed. A systematic review and meta-analysis were performed following PRISMA guidelines. 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. 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. [Abstract copyright: © 2021 American Association of Clinical Anatomists.]
KeywordsAnatomy; Sesamoid bones; General Medicine; Cyamella; Fabella; Prevalence rate; Systematic review; Meta-analysis
Year2021
JournalClinical anatomy
Journal citationpp. 1-11
PublisherWiley
ISSN0897-3806
1098-2353
Digital Object Identifier (DOI)https://doi.org/10.1002/ca.23743
Web address (URL)https://onlinelibrary.wiley.com/doi/abs/10.1002/ca.23743
Funder/ClientOregon Department of Agriculture
National Institute for Health Research
Publication dates
Online04 May 2021
Publication process dates
Accepted01 Mar 2021
Deposited27 May 2021
Accepted author manuscript
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File Access Level
Open
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This is the peer reviewed version of the following article: Berthaume, M. A., & Bull, A. M. J. (2021). Cyamella (a popliteal sesamoid bone) prevalence: A systematic review, meta-analysis, and proposed classification system. Clinical Anatomy, 1– 11, which has been published in final form at https://doi.org/10.1002/ca.23743. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

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