Preservation vs. resection of the infrapatellar fat pad during total knee arthroplasty part II: A systematic review of published evidence

Nisar, Sohail; Lamb, Jonathan; Somashekar, N.; Pandit, Hemant; Duren, Bernard H van

doi:10.1016/j.knee.2019.01.007

Cited by 21 publications

(11 citation statements)

References 21 publications

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“…More recently, a systematic review reported that IFP preservation leads to a reduction in long-term knee pain [41]. However, there is a need of level one randomized controlled trials, which would shed light on this issue [41, 42].…”

Section: The Role Of the Ifp-synovial Membrane As A Functional Unimentioning

confidence: 99%

Contribution of Infrapatellar Fat Pad and Synovial Membrane to Knee Osteoarthritis Pain

Belluzzi

Stocco

Pozzuoli

et al. 2019

BioMed Research International

132

124

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Osteoarthritis (OA) is the most common form of joint disease and a major cause of pain and disability in the adult population. Interestingly, there are patients with symptomatic OA displaying pain, while patients with asymptomatic OA that do not experience pain but show radiographic signs of joint damage. Pain is a complex experience integrating sensory, affective, and cognitive processes related to several peripheral and central nociceptive factors besides inflammation. During the last years, the role of infrapatellar fat pad (IFP), other than the synovial membrane, has been investigated as a potential source of pain in OA. Interestingly, new findings suggest that IFP and synovial membrane might act as a functional unit in OA pathogenesis and pain. The present review discuss the role of IFP and synovial membrane in the development of OA, with a particular focus on pain onset and the possible involved mediators that may play a role in OA pathology and pain mechanisms. Inflammation of IFP and synovial membrane may drive peripheral and central sensitization in KOA. Since sensitization is associated with pain severity in knee OA and may potentially contribute to the transition from acute to chronic, persistent pain in knee OA, preventing sensitization would be a potentially effective and novel means of preventing worsening of pain in knee OA.

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Section: The Role Of the Ifp-synovial Membrane As A Functional Unimentioning

confidence: 99%

Contribution of Infrapatellar Fat Pad and Synovial Membrane to Knee Osteoarthritis Pain

Belluzzi

Stocco

Pozzuoli

et al. 2019

BioMed Research International

132

124

View full text Add to dashboard Cite

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“…• The retro-patellar bursa and Infra Patellar Fat Pad (I.P.F.P.) are preserved, since they act as a hydraulic shock absorber, filling the anterior compartment [12,19,20]. The I.P.F.P.…”

Section: Discussionmentioning

confidence: 99%

The Eeklo Modified Subvastus Approach for Total Knee Arthroplasty: Detailed Surgical Tips and Tricks

Ghijselings¹,

den²,

Demurie³

et al. 2021

J Orthop Surg Tech

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“…Nine studies described the blinding of outcome assessment, and three studies described the blinding of participants and personnel. All studies retained complete outcome data, avoided selective reporting, and had an unclear risk of other bias analysis [21] comparing IPFP resection and IPFP preservation in primary TKA. However, the inclusion criteria of the previous meta-analyses included only 2 RCTs and five retrospective cohort studies design, which are potentially subject to selection bias.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, this is the first meta-analysis of only RCTs comparing IPFP resection and IPFP preservation in primary TKA. We only found one meta-analysis [ 21 ] comparing IPFP resection and IPFP preservation in primary TKA. However, the inclusion criteria of the previous meta-analyses included only 2 RCTs and five retrospective cohort studies design, which are potentially subject to selection bias.…”

Section: Discussionmentioning

confidence: 99%

“…Meanwhile, the remaining damaged nerve fibers were also the source of ongoing pain in the IPFP Resection group. The meta-analysis by Nisar et al [ 21 ] demonstrated a trend toward increased pain in the early 1- to 2-month post-operative period in the IPFP-P group. At 3 to 6 months, this trend is reversed with a higher incidence of knee pain in the IPFP-R group.…”

Section: Discussionmentioning

confidence: 99%

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Infrapatellar fat pad resection or preservation during total knee arthroplasty: a meta-analysis of randomized controlled trials

Sun

Zhang

Lee³

et al. 2020

J Orthop Surg Res

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Background: The infrapatellar fat pad (IPFP) or Hoffa's fat pad is often resected during total knee arthroplasty in order to improve visibility. However, the management of the IPFP during total knee arthroplasty (TKA) is the subject of an ongoing debate that has no clear consensus. The purpose of this review was to appraise if resection of the IPFP affects clinical outcomes. Methods: We conducted a meta-analysis to identify relevant randomized controlled trials involving infrapatellar fat pad resection and infrapatellar fat pad preservation during total knee arthroplasty in electronic databases, including Web of Science, Embase, PubMed, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CBM, CNKI, VIP, and Wanfang database, up to March 2020. Results: Nine randomized controlled trials, involving 783 TKAs (722 patients), were included in the systematic review. Outcome measures included patellar tendon length (PTL), Insall-Salvati ratio (ISR), rate of anterior knee pain, Knee Society Scores (KSS), and knee range of motion. The meta-analysis identified a trend toward the shortening of the patellar tendon with IPFP resection at 6 months (P = 0.0001) and 1 year (P = 0.001). We found no statistical difference in ISR (P = 0.87), rate of anterior knee pain within 6 months (p = 0.45) and 1 year (p = 0.38), KSS at 1 year (p = 0.77), and knee range of motion within 6 months (p = 0.61) and 1 year (0.46). Conclusion: Based on the available level I evidence, we were unable to conclude that one surgical technique of IPFP can definitively be considered superior over the other. More adequately powered and better-designed randomized controlled trial (RCT) studies with long-term follow-up are required to produce evidence-based guidelines regarding IPFP resection.

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Preservation vs. resection of the infrapatellar fat pad during total knee arthroplasty part II: A systematic review of published evidence

Abstract: This is a repository copy of Preservation vs. resection of the infrapatellar fat pad during total knee arthroplasty part II: A systematic review of published evidence.

Cited by 21 publications

References 21 publications

Contribution of Infrapatellar Fat Pad and Synovial Membrane to Knee Osteoarthritis Pain

Contribution of Infrapatellar Fat Pad and Synovial Membrane to Knee Osteoarthritis Pain

The Eeklo Modified Subvastus Approach for Total Knee Arthroplasty: Detailed Surgical Tips and Tricks

Infrapatellar fat pad resection or preservation during total knee arthroplasty: a meta-analysis of randomized controlled trials

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