Anterior cruciate ligament and popliteus tendon injuries associated with a cyamella: a rare case report

Authors

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20254239

Keywords:

Cyamella, Popliteus, Sesamoid, Posterolateral corner instability, ACL tear

Abstract

The cyamella is a rare sesamoid bone in the popliteus muscle. This small ossicle may alter the biomechanics of the popliteus, potentially affecting knee function leading to instability. We report a 19-year-old male with a right knee injury from an auto rollover accident. Imaging revealed an anterior cruciate ligament (ACL) rupture, an intra-articular loose body, a cyamella, and a popliteal tendon avulsion. ACL reconstruction was performed, and the cyamella and loose body were excised. The tendon avulsion was repaired with a suture anchor. At one-year follow-up, the patient had full knee movement without instability. This case highlights a rare injury combination and excellent surgical outcomes when promptly identified and treated.

 

References

Khanna V, Maldjian C. The cyamella, a lost sesamoid: Normal variant or posterolateral corner anomaly? Radiol Case Rep. 2015;9:e00031.

Benthien, JP, Brunner, A. A symptomatic sesamoid bone in the popliteus muscle (cyamella). Musculoskeletal Surg. 2010;94:141-4.

Berthaume MA, Bull AMJ. Cyamella (a popliteal sesamoid bone) prevalence: A systematic review, meta-analysis, and proposed classification system. Clin Anat. 2021;34:810-20.

Dykes MI, Vijay RK. Sesamoiditis of the cyamella: Imaging features of this rare presentation. Jpn J Radiol. 2014;32:105-8.

Jadhav SP, More SR, Riascos RF, Lemos DF, Swischuk LE. Comprehensive review of the anatomy, function, and imaging of the popliteus and associated pathologic conditions. Radiographics. 2014;34(2):496-513.

Akansel G, Inan N, Sarisoy HT, Anik Y, Akansel S. Popliteus muscle sesamoid bone (cyamella): appearance on radiographs, CT and MRI. Surg Radiol Anat. 2006;28:642-5.

Dheer S, Silverberg C, Zoga AC, Morrison WB. A 14-year-old with lateral knee pain and locking. Skeletal Radiol. 2011;41:1.

Reddy S, Vollala VR, Rao R. Cyamella in man – its morphology and review of literature. Int J Morphol. 2007;25:381-3.

Su S, Lu Y, Chen Y, Li Z. A symptomatic cyamella in the popliteus tendon causing snapping knee: a case report and literature review. BMC Musculoskelet Disord. 2019;20(1):8.

Başaran S, Coşkun Benlidayı İ. Coexistence of symptomatic cyamella and multiple fabellae: A case report. Arch Rheumatol. 2022;38(1):156-8.

Rehmatullah N, McNair R, Sanchez-Ballester J. A cyamella causing popliteal tendonitis. Ann Royal Coll Surg Engl. 2014;96(1):1-3.

Duarte ML, Silva AQP, Alvarenga SB, Prado JLMA, Scoppetta LCD. Giant cyamella: a rare sesamoid bone. Radiologia Brasileira. 2017;50(4):270-1.

Ryu JH, Lee SW, Lee DH. An all-arthroscopic surgery technique for snapping popliteal tendon syndrome: A case report and literature review. Medicine (Baltimore). 2022;101(44):e31347.

Khanna V, Maldjian C. The cyamella, a lost sesamoid: Normal variant or posterolateral corner anomaly? Radiol Case Rep. 2014;9(1):907.

Azzopardi C, Kiernan G, Botchu R. Imaging review of normal anatomy and pathological conditions involving the popliteus. J Clin Orthop Trauma. 2021;18:224-9.

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Published

2025-12-26

How to Cite

Chodavarapu, M. N. S., Kambhampati, S. B. S., Chinta, S. K., & Bhogadi, H. (2025). Anterior cruciate ligament and popliteus tendon injuries associated with a cyamella: a rare case report. International Journal of Research in Orthopaedics, 12(1), 253–256. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20254239