Volume and mobility of the infrapatellar fat pad during quasi-static knee extension after manual therapy in patients with knee osteoarthritis: a randomized control trial study

Abstract

This study aimed to determine whether the volume and mobility of the infrapatellar fat pad (IPFP) change as a result of manual release or stretching during quasi-static knee extension in patients with knee osteoarthritis (KOA). [Participants and Methods] Fourteen patients with KOA were allocated to one of two groups: the manual release (R) and stretching (S, control) groups. They all underwent 12 treatment sessions in in a space of four weeks. We created 3D models of the IPFP, tibia, patella, and patellar tendon using sagittal MRI scans with the knee at 30° or 0°. We compared the differences in (1) the distance of anterior movement of the anterior surface of the IPFP (IPFP movement) and (2) the volume of the IPFP, between the R and S groups, using the 3D models. [Results] Neither group showed any anterior movement of the IPFP during quasi-static knee extension at pre-intervention; however, both groups showed significant anterior movement of the IPFP at post-intervention. IPFP movement decreased in the S group, meanwhile it increased in the R group at post-intervention. [Conclusion] Anterior movement of the IPFP was more increased by manual release than by stretching since the latter may have shortened the distance between the patella and tibial tuberosity at 0° and 30° flexion.

Anterior knee pain post-multiple surgeries for tibia fracture effectively managed with infrapatellar fat pad injection: a case report

“…With knee extension, the IFP is becomes captured between the femoral condyles and the tibial plateau [ 7 ], leading to injury, hypertrophy, and inflammation [ 8 ]. With the overload or trauma to the IFP or secondary to other knee disorders (e.g., meniscus injury [ 9 ], osteoarthritis [ 10 ], knee surgery [ 9 ], etc.) can cause inflammation, fatty tissue proliferation, and fibrosis, resulting in loss of flexibility, mobility impairment, and pain (i.e., Hoffa’s disease) [ 2 , 9 , 11 ].…”