Posterior Hoffa's fat pad impingement secondary to a thickened infrapatellar plica: a case report and review of the literature

Radu, Arnold; Discepola, Federico; Volesky, Monika; Munk, Peter L.; Le, Huy

doi:10.3941/jrcr.v9i3.2037

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…Although most studies reported restricted range of motion and pain at the end of extension, one study reported painful limitation at 20 degrees flexion. 21 Hoffa's test was positive in seven patients. 13,15,16,[18][19][20]22 Retrospective studies described pain and tenderness around the patella and painful terminal extension.…”

Section: Clinical Presentationmentioning

confidence: 91%

“…The duration was in weeks in 5 of 14 patients in case reports, [13][14][15][16] from weeks to months in 2 of 14 patients 16,17 and years in 7 of 14 patients. 16,[18][19][20][21][22] Six of the 14 patients had worsening of the pain with activity. [13][14][15][16]21,22 A total of six patients described a history of trauma that predated this condition: hyperflexion in two patients 15,19 as well as chronic repetition in four patients.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…16,[18][19][20][21][22] Six of the 14 patients had worsening of the pain with activity. [13][14][15][16]21,22 A total of six patients described a history of trauma that predated this condition: hyperflexion in two patients 15,19 as well as chronic repetition in four patients. 14,16,18 In retrospective studies, patients presented with both acute and chronic pain with a history of injury or doing regular sporting activities.…”

Section: Clinical Presentationmentioning

confidence: 99%

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Infrapatellar Fat Pad Impingement: A Systematic Review

et al. 2017

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Infrapatellar fat pad impingement represents a source of anterior knee pain that is often overlooked. Due to the scarcity of reports related to this disorder, we conducted a systematic review of the literature related to infrapatellar fat pad impingement in evaluating the following: (1) clinical presentation, (2) imaging, (3) management, and (4) clinical outcomes. A systematic review was conducted investigating all available primary literature related to the clinical presentation, imaging, management, and outcomes of infrapatellar fat pad impingement syndrome. A total of 15 studies (9 case reports, 1 case series, and 5 retrospective studies) comprising 167 patients met eligibility criteria for this review. Patients with infrapatellar fat pad impingement were found to most often present with anterior knee pain that worsened with activity, and was frequently associated with trauma. Anterior knee pain, tenderness to palpation over the patellar tendon, loss in terminal extension, and pain with direct pressure on the medial or lateral side of the patella with the knee extended was often found on examination. Although patients may have classic imaging findings on magnetic resonance imaging (localized edema of the infrapatellar fat pad, deep fluid-filled infrapatellar bursa, nonvisualization of clefts, fibrosis, and calcifications), not all patients had positive imaging findings, thus making infrapatellar fat pad impingement a clinical diagnosis. Treatment begins with nonoperative management, but in recalcitrant cases, patients can be surgically treated with arthroscopic fat pad resection. Most patients who undergo operative treatment report improvement or complete resolution of symptoms in terms of pain and range of motion, and are able to return to work. To the best of our knowledge, this is the first comprehensive review on infrapatellar fat pad impingement to better aid the orthopaedic surgeons in diagnosing, treating, and managing patient expectations for this often overlooked knee pathology.

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