Volume change in infrapatellar fat pad is associated not with obesity but with cartilage degeneration

Masaki, Tadashi; Takahashi, Kenji; Hashimoto, Sanshiro; Ikuta, Futoshi; Watanabe, Atsuya; Kiuchi, Shinji; Okuaki, Tomoyuki; Mochizuki, Yusuke; Takai, Shinro

doi:10.1002/jor.24201

Cited by 20 publications

(19 citation statements)

References 26 publications

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“…Higher BMI negatively correlated with the IPFP areas (r = − 0.161, P value = 0.018). Similarly, Masaki et al reported statistically significant negative correlation between IPFP volume and BMI (r = − 0.29; P < 0.001) [15]. While other results reported by Han et al found no significant association between IPFP area and BMI [14].…”

Section: Discussionmentioning

confidence: 85%

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Infrapatellar fat pad area on knee MRI: does it correlate with the extent of knee osteoarthritis?

Ragab

Serag

2021

Egypt J Radiol Nucl Med

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Background Osteoarthritis (OA) of the knee joint is a common cause of chronic disability in older adults. During the past 10 years, the infrapatellar fat pad (IPFP) has emerged as a new player in the pathogenesis of knee OA. Its exact role in the pathogenesis of knee OA remains uncertain. While many studies focused on the detrimental effect of the chemical mediators released by IPFP and their role in the accentuation of the development of OA, only few studies elucidated the beneficial effect of IPFP maximal area as a local shock absorber protecting the adjacent articular structures from progressive damage. The aim of this study was to evaluate the relation between the IPFP maximal area and the prevalence of OA manifestations. We also studied the relation between the subcutaneous (SC) fat thicknesses on the medial aspect of the knee as a surrogate marker of body obesity and the IPFP area. Results A total of 216 knee scans for 188 adult patients (64 males and 124 females) who met the inclusion criteria were examined. They were between 45 and 66 years (mean 52.5 years). The mean IPFP area for all patients was 6.9 cm2 (± 1.6 SD) (ranged from 4.5 to 11 cm2). After adjustment for potential confounders, there was a significant negative association between IPFP area and radiographic manifestations of OA (osteophites, joint space narrowing, and grade of OA) (P value < 0.001 for each), as well as MRI manifestations of OA (cartilage defects and subchondral bone marrow lesions) (P value < 0.001 and < 0.003, respectively). There was a negative but non-significant association between IPFP area and SC fat thickness. Conclusion In our study, we found supportive evidence that IPFP maximal area is associated with fewer osteoarthritic knee changes and less cartilage damage, suggesting that it plays a protective role against the development and progression of OA. Further large-scale clinical studies are awaited to confirm the obtained results. Based on our findings, it would be recommended to avoid IPFP resection during surgery in order to maintain its protective effect.

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Section: Discussionmentioning

confidence: 85%

“…They stated that the lack of significant association between measures of body adiposity (SC fat, trunk fat) and the size of the IPFP might suggest that the IPFP size is not simply a marker of systemic obesity. Similarly, Masaki et al [15] stated that IPFP is maintained even in starved conditions where SC fat diminishes.…”

Section: Discussionmentioning

confidence: 91%

Infrapatellar fat pad area on knee MRI: does it correlate with the extent of knee osteoarthritis?

Ragab

Serag

2021

Egypt J Radiol Nucl Med

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“…It is particularly important to estimate dimensions of Hoffa's fat pad because variations in its volume and thickness can result in degenerative changes of the knee joint, as seen for example in Osteoarthritis, reducing physical performance and consequently abilities to perform well in activities of daily living, becoming a cause of chronic disability [33].…”

Section: Discussionmentioning

confidence: 99%

Hoffa’s fat pad thickness: a measurement method with sagittal MRI sequences

et al. 2021

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Background Hoffa’s fat pad is a structure located within the fibrous joint capsule of the knee joint, but outside the synovial cavity. It plays an important biomechanical and metabolic role in knee joint, reducing the impact of forces generated by loading and producing cytokines. Changes in its size can induce modifications in the knee homeostasis. However, a great variability exists regarding its measurements. This work aims to evaluate the reliability of a measurement method of Hoffa’s fat pad dimensions through MRI. Methods 3T sagittal IW 2D TSE fat-suppressed MRI sequences, taken from the OAI (Osteoarthritis initiative) database, of 191 male and female patients, aged between 40 and 80 years, were analysed; a manual measurement of the thickness of Hoffa’s fat pad of each subject was then performed by two different readers. The interobserver reliability and intraobserver reliability of the measurements were described by coefficient of variation (CV), Pearson correlation and Bland–Altman plots. Results All statistical analyses have shown that not significant intra- or interobservers differences were evident (intraobserver CV % for the first observer was 2.17% for the right knee and 2.24% for the left knee, while for the second observer 2.31% for the right knee and 2.24% for the left knee; linear correlation was for the first observer r = 0.96 for the right knee and r = 0.96 for the left knee, while for the second observer r = 0.97 for the right knee and r = 0.96 for the left knee; in addition, the interobserver CV % was 1.25% for the right knee and 1.21% for the left knee and a high interobserver linear correlation was found: r = 0.97 for the right knee and r = 0.96 for the left knee). All results suggest that this manual measurement method of Hoffa’s fat pad thickness can be performed with satisfactory intra- and interobserver reliability. Conclusions Hoffa’s fat pad thickness can be measured, using sagittal MRI images, with this manual method that represents, for his high reliability, an effective means for the study of this anatomical structure.

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“…This study is the first step aiming toward this goal. Hence, as IPFP is now considered an early marker of OA incidence or progression [5][6][7][8][9] , being able to predict this tissue volume with serum biomarkers could enable a next step in which this information will be used to predict/discriminate OA progressors from non-progressors.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies suggest that alteration in the infrapatellar fat pad (IPFP), an adipose tissue and the largest soft tissue structure in the knee joint 4 , is a potential early marker of OA disease incidence or progression [5][6][7][8][9] . Some inflammatory factors and adipokines produced by the IPFP have been identified as having a role in OA progression 10,11 .…”

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confidence: 99%

Serum adipokines/related inflammatory factors and ratios as predictors of infrapatellar fat pad volume in osteoarthritis: Applying comprehensive machine learning approaches

Bonakdari

Tardif

Abram

et al. 2020

Sci Rep

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Objective. The infrapatellar fat pad (IPFP) has been associated with knee osteoarthritis onset and progression. This study uses machine learning (ML) approaches to predict serum levels of some adipokines/related inflammatory factors and their ratios on knee IPFP volume of osteoarthritis patients. Methods. Serum and MRI were from the OAI at baseline. Variables comprised the 3 main osteoarthritis risk factors (age, gender, BMI), 6 adipokines, 3 inflammatory factors, and their 36 ratios. IPFP volume was assessed on MRI with a ML methodology. The best variables and models were identified in Totalcohort (n = 678), High-BMI (n = 341) and Low-BMI (n = 337), using a selection approach based on ML methods. Results. The best model for each group included three risk factors and adipsin/C-reactive protein combined for Total-cohort, adipsin/chemerin; High-BMI, chemerin/adiponectin HMW; and Low-BMI, interleukin-8. Gender separation improved the prediction (13-16%) compared to the BMI-based models. Reproducibility with osteoarthritis patients from a clinical trial was excellent (R: female 0.83, male 0.95). Pseudocodes based on gender were generated.Conclusion. This study demonstrates for the first time that the combination of the serum levels of adipokines/inflammatory factors and the three main risk factors of osteoarthritis could predict IPFP volume with high reproducibility, with the superior performance of the model accounting for gender separation.

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Volume change in infrapatellar fat pad is associated not with obesity but with cartilage degeneration

Cited by 20 publications

References 26 publications

Infrapatellar fat pad area on knee MRI: does it correlate with the extent of knee osteoarthritis?

Infrapatellar fat pad area on knee MRI: does it correlate with the extent of knee osteoarthritis?

Hoffa’s fat pad thickness: a measurement method with sagittal MRI sequences

Serum adipokines/related inflammatory factors and ratios as predictors of infrapatellar fat pad volume in osteoarthritis: Applying comprehensive machine learning approaches

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