Deformation analysis of Hoffa's fat pad from CT images of knee flexion and extension

Abstract

Recent advances in medicine conjecture that certain body fat may have mechanical function in addition to its classical role of energy storage. In particular we aim to analyze if the intra-articular fat pad of Hoffa is merely a space holder or if it changes shape to provide cushioning for the knee bones. Towards this goal, 3D CT images of real knees, as well as a skeletal knee model with fat simulating Hoffa's pad, were acquired in both extension and flexion. Image segmentation was performed to automatically extract the real and simulated fat regions from the extension and flexion images. Utilizing the segmentation results as binary masks, we performed automatic multi-resolution image registration of the fat pad between flexed and extended knee positions. The resulting displacement fields from flexion-extension registration are examined and used to calculate local fat volume changes thus providing insight into shape changes that may have a mechanical component.

The Effect of Infrapatellar Fat Pad Excision on Complications After Minimally Invasive TKA: A Randomized Controlled Trial

“…Our study found that the patients in the complete infrapatellar fat pad excision group had more anterior knee pain after 6 weeks to 1 year compared with the no infrapatellar fat pad excision group, which had no anterior knee pain up to final followup. The pain could be caused by the lack of a fat pad, which acts as a cushion between the patellar tendon and anterior surface of the tibial components [5]. This study supported findings from a previous retrospective study [16], which indicated that nearly twice the patients with complete infrapatellar fat pad excision experienced postoperative knee pain when compared with patients with no infrapatellar fat pad excision (mean followup of 5.1 years).…”

“…Scarring of the fat pad may cause patellar infera and limit ROM after TKA [6]. The fat pad acts as a cushion between the patellar tendon and anterior tibial plateau [5]. Excision of the fat pad can cause anterior impingement, anterior knee pain, and worse results after the operation [4,16].…”

Virtual Collaborative Environment for radiological 3D consultations

“…However, the PACS systems allow only transmission and archiving of the data. It fails to provide the functionality of online network consultations [3], [4].…”

The Impact of an Intact Infrapatellar Fat Pad on Outcomes after Total Knee Arthroplasty

“…An important function of the IPFP is to cushion the interface between patellar tendon and the tibial plateau, especially during kneeling [34]. Of the small number of studies that have investigated the impact of TKA on the ability to kneel, only one has explicitly stated the rate of IPFP resection.…”