The fat pad and its relationship to anterior knee pain

Duri, Zaid A.A.; Aichroth, Paul; Dowd, G.S.E.; Ware, Howard

doi:10.1016/s0968-0160(97)00017-3

Cited by 18 publications

(23 citation statements)

References 11 publications

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“…Patients with Hoffa's disease commonly describe burning or aching anterior knee pain near the patellar tendon and the inferior pole of the patella. 9,15,16 Patients may also present with swelling, clicking, locking, and catching sensations, and they may stand with hyperextended knees to prevent fat pad impingement. A positive Hoffa's test result, in which the patient has increased pain when the knee is brought from 30° to 60° flexion to full extension while firm pressure is applied inferior to the patella outside the margins of the patellar tendon, is suggestive of Hoffa's disease.…”

Section: Clinical Evaluationmentioning

confidence: 99%

See 1 more Smart Citation

Nonligamentous Soft Tissue Pathology About the Knee: A Review

Erickson¹,

Campbell²,

Cvetanovich³

et al. 2016

Orthopedics

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Knee pain is one of the most frequent complaints evaluated by orthopedic surgeons. It encompasses a broad range of pathology and can present in a variety of ways. Most of this pain can be attributed to essential structures of the knee, including the menisci, cruciate or collateral ligaments, and articular cartilage. However, there are underrecognized structures in and around the knee that can frequently be a cause of knee pathology and pain. Knee pain stemming from these structures may be missed or incorrectly diagnosed, and these patients often present for second and third opinions because of failure to diagnose and treat the underlying pathology. The synovial plica, suprapatellar pouch, lateral retinaculum, infrapatellar fat pad, and infrapatellar branch of the saphenous nerve are less common but still significant causes of knee pain. Although initial treatment involves various nonoperative modalities, operative treatment is often warranted. Operative and nonoperative management of these soft tissue structures may occur in isolation or with concomitant procedures, including knee ligament reconstruction, total knee arthroplasty, tibial tuberosity osteotomy, or lysis of adhesions. With proper recognition of the role of these structures in knee pain, the orthopedic surgeon can offer a valuable primary or adjunctive treatment option for patients with knee pain, especially those without localizing signs of meniscal, ligamentous, or cartilage damage.

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Section: Clinical Evaluationmentioning

confidence: 99%

“…Injections of lidocaine with methylprednisolone or hydrocortisone can also lead to improvement in pain. 16,22 If conservative measures are unsuccessful, several operative interventions can be used. Arthroscopic partial resection of the infrapatellar fat pad has shown good results (Figure 1).…”

Section: Treatmentmentioning

confidence: 99%

Nonligamentous Soft Tissue Pathology About the Knee: A Review

Erickson¹,

Campbell²,

Cvetanovich³

et al. 2016

Orthopedics

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“… 7 IFP restrictions can be assessed on physical examination by moving the IFP medially and laterally, determining restriction of motion compared with the contralateral and uninjured lower extremity ( Figure 5 , a and b).The IFP may be tender and/or firm. 9 , 14 , 18 Pain elicited by direct pressure (Hoffa test) may indicate fat pad restrictions. 17 , 21 Additionally, the superior glide and superior tipping of the patella is compared for motion restrictions ( Figure 6 ) 14 , 19 , 21 as the involved knee is flexed to approximately 60°.…”

Section: Clinical Assessment and Treatment Of Surgical And Nonsurgicamentioning

confidence: 99%

Evaluation, Treatment, and Rehabilitation Implications of the Infrapatellar Fat Pad

Hannon¹,

Bardenett

Singleton

et al. 2015

Sports Health

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Context:The infrapatellar fat pad (IFP) is in the anterior knee compartment and may be a major pain generator.Evidence Acquisition:A PubMed database search using the terms Hoffas fat pad, anterior interval, and infrapatellar fat pad was performed from the years 1970 to 2015.Study Design:Clinical review.Level of Evidence:Level 5.Results:Limited research exists examining the role of the IFP in relation to potential treatment and rehabilitation implications.Conclusions:Alterations in IFP mobility, whether the result of postsurgical scarring or faulty movement patterns, result in pain and disability in a variety of patient populations. The majority of treatment approaches are driven by the surgical technique.

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“…[7][8][9] The study of the IFP structural configuration and mechanical properties is also important with reference to the pathologies of the knee, first of all osteoarthritis (OA), which is the most common joint disease and a major cause of pain and disability, especially in the elderly population. [10][11][12][13] Abnormal biomechanical loading is an etiological factor that can be caused by partial or total meniscectomy, malalignment, joint instability, muscle weakness, peripheral neuropathy. 10 Moreover, OA IFP is more fibrous compared with those of control patients and shows smaller adipose lobules.…”

Section: Introductionmentioning

confidence: 99%

A numerical investigation of the infrapatellar fat pad

Fontanella

Macchi

Porzionato

et al. 2020

Proc Inst Mech Eng H

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The infrapatellar fat pad is an adipose tissue in the knee that facilitates the distribution of synovial fluid and absorbs impulsive actions generated through the joint. The correlation between morphological configuration and mechanical properties is analyzed by a computational approach. The microscopic anatomy of the infrapatellar fat pad is studied aiming to measure the dimension of adipose lobules and the thickness of connective septa. Results from histomorphometric investigations show that the infrapatellar fat pad is an inhomogeneous tissue, constituted by large lobules in the superficial part and smaller lobules in the deepest one. Finite element models of the infrapatellar fat pad are developed. The first model considers the inhomogeneous conformation of the infrapatellar fat pad, composed of micro- and macro-chambers, while the second model considers a homogeneous distribution of adipose lobules with similar dimensions. Computational analyses are performed considering the static standing configuration and the passive flexion–extension movement. The computational results allow us to identify the different stress and strain fields within the tissue and to appreciate the variation of the mechanical performance of the overall system considering the distribution of adipose lobules. Results show that the distribution of adipose lobules in macro- and micro-chambers allows major deformation of the infrapatellar fat pad, decreasing the stress inside the tissues.

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The fat pad and its relationship to anterior knee pain

Cited by 18 publications

References 11 publications

Nonligamentous Soft Tissue Pathology About the Knee: A Review

Nonligamentous Soft Tissue Pathology About the Knee: A Review

Evaluation, Treatment, and Rehabilitation Implications of the Infrapatellar Fat Pad

A numerical investigation of the infrapatellar fat pad

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