The presence of the fabella is usually asymptomatic; however, it can be a source of posterolateral knee pain. The pain is usually periodic and is accentuated with the knee in extension, because of the compression of the fabella against the lateral femoral condyle in this position. Irritation of the common peroneal nerve resulting in neurologic symptoms, such as numbness or pain, may be present in some patients.
Conservative treatment can be an effective way to reduce painful symptoms and increase activities involving extension, flexion, and rotation of the knee. However, in patients who do not respond to nonoperative treatment, surgical treatment may be performed. A fabella excision can be successfully performed either as an open or arthroscopic procedure.