What is the infrapatellar fatpad?
The infrapatellar (Hoffa's) fatpad is an important structure within the knee, whose function and role are both poorly understood.
Why does the infrapatellar fat pad increase the risk of knee osteoarthritis?
One of the reasons is because the large amount of adipose tissue secretes some fa … Role of infrapatellar fat pad in pathological process of knee osteoarthritis: Future applications in treatment World J Clin Cases.
What is a fat pad for knee pain?
Hoffa’s Fat Pad is your knee bones cushioning shock absorber. It reduces the friction between your patella (knee cap), patella tendon, and the boney structure of your knee. It also prevents pinching of the connective tissues that encapsulate your knee joint.
Where is the patellar fat pad?
It is one of three fat pads in the front of your knee. It is located below the knee cap and above the patellar tendon, enclosed by the thigh bone and shin bone, and resting between the knee joint capsule and connective tissues of your knee.
What causes infrapatellar fat pad impingement?
Infrapatellar fat pad impingement can occur for many reasons, including: Overload of the extensor (quadriceps) mechanism such as when running and when kicking a ball during football. Hyperextension of the knee (over straightening of the knee), e.g. in gymnastics/dance.
What are the three fat pads of the knee?
There are three fat pads in anterior knee compartment: yellow = infrapatellar fat pad (of Hoffa) blue = posterior suprapatellar (prefemoral or supratrochlear) fat pad. red = anterior suprapatellar (quadriceps) fat pad.
What is the Hoffa fat pad?
Hoffa's (infrapatellar) fat pad (HFP) is one of the knee fat pads interposed between the joint capsule and the synovium. Located posterior to patellar tendon and anterior to the capsule, the HFP is richly innervated and, therefore, one of the sources of anterior knee pain.
Does fat pad impingement require surgery?
If non-invasive treatments don't help recovery, surgery may be your only option. This will involve full or partial removal of the fat pad through arthroscopy. Most patients recover within six weeks of surgery.
How many fat pads are in your knee?
There are three distinct fat pads located around the extensor mechanism of the knee joint: the infrapatellar fat pad, also called Hoffa fat pad, the pre-femoral fat pad, and the quadriceps fat pad [1] (Fig.
Do you need your fat pad in your knee?
It is attached to the knee cartilage (menisci) at the front of the knee. Hoffa's fat pad is a normal part of human anatomy, and acts as a shock-absorber to cushion the patella and stop it from hitting off the femur (thigh bone) in the event of a direct blow to the front of the knee.
What causes edema in Hoffa's fat pad?
These findings suggest that the edema signal observed in the superolateral portion of Hoffa's fat pad is the result of abnormal friction and mechanical impingement of the fat pad between the lateral femoral condyle and the patellar tendon, as previously postulated by Chung et al.
How do I tape my knee for fat pad impingement?
2:374:36Knee taping for fat pad irritation - YouTubeYouTubeStart of suggested clipEnd of suggested clipOnce again reach trying to visualize that you're pulling that fat pad up and out just a little bit.MoreOnce again reach trying to visualize that you're pulling that fat pad up and out just a little bit. And then putting a strip of tape underneath it.
What are fat pads?
Fat pads are masses of adipose tissue that are sited throughout the human body. Fat pads can be classified based upon their structure and function, as either: (1) a weight-bearing fat pad, or a (2) a non-weight-bearing fat pad. The human calcaneal (heel) pad is an example of a weight-bearing fat pad.
How do you treat a knee fat pad?
“Generally, ice — a lot of ice — will help bring down the swelling that results from the impingement. Rest, over-the-counter anti-inflammatories, and strength-building and stretch exercises are also usually advocated. Sometimes, the area can be taped so that the fat pad is not impinged on.
How do you heal Hoffa's fat pad?
Treatment for Hoffa's fat pad syndrome involves reducing inflammation and controlling nerve pinching in your knees. First line of treatment involves rest and medications. Other conservative treatments include taping the knee, performing strengthening exercises, and anti-inflammatory injections.
What is the fat pad made of?
The Infrapatellar fat pads (IFP) are two wedge shaped fatty structures situated below the kneecap (patella), lying either side of the patellar tendon, first described by Hoffa in 1904. The IFP consist of fat cells (adipose tissue) packed closely together and separated from other tissues by fibrous septa.
Anatomy and Orthopaedic Surgery
Fred R.T. Nelson MD, FAAOS, Carolyn Taliaferro Blauvelt, in A Manual of Orthopaedic Terminology (Eighth Edition), 2015
Noninflammatory Musculoskeletal Pain
Claire LeBlanc, Kristin Houghton, in Textbook of Pediatric Rheumatology (Seventh Edition), 2016
Medial and Anterior Knee Anatomy
Alvin Detterline, ... Frank R. Noyes, in Noyes' Knee Disorders: Surgery, Rehabilitation, Clinical Outcomes (Second Edition), 2017
Regional complications in joint hypermobility syndrome
Anju Jaggi, ... Alan J. Hakim, in Hypermobility, Fibromyalgia and Chronic Pain, 2010
Benign Soft Tissue Tumors
Hoffa's disease is a post-traumatic reactive condition of the synovium, clinically most often seen in the knee and characterized by enlargement of the infrapatellar fat pad on either side of the patellar tendon. Rarely, the condition may occur in any joint.
Intra-articular Analgesia
Anil Gupta, Kjell Axelsson, in Raj's Practical Management of Pain (Fourth Edition), 2008
Intraarticular Analgesia
A summary of the articles published and the conclusions drawn by the authors during knee surgery is presented in Table 57.2.
What is an Infrapatellar Fat Pad?
The infrapatellar fat pad is also known as the Hoffa Pad after being discovered by Albert Hoffa in 1904. It is one of three fat pads in the front of your knee. It is located below the knee cap and above the patellar tendon, enclosed by the thigh bone and shin bone, and resting between the knee joint capsule and connective tissues of your knee. It is composed of fat lobules separated by thin fibrous cords, making it a flexible soft tissue structure which can accommodate the mobility of your knee. In addition, the infrapatellar fat pad is rich in nerve structures, having branches of the femoral, peroneal and saphenous nerves, which make it one of the most sensitive areas of the knee.
Which nerves are involved in the infrapatellar fat pad?
In addition, the infrapatellar fat pad is rich in nerve structures, having branches of the femoral, peroneal and saphenous nerves, which make it one of the most sensitive areas of the knee.
What is a Hoffa fat pad?
Hoffa’s Fat Pad is your knee bones cushioning shock absorber. It reduces the friction between your patella (knee cap), patella tendon, and the boney structure of your knee. It also prevents pinching of the connective tissues that encapsulate your knee joint.
What is the Hoffa test?
They will perform the Hoffa’s test, an assessment technique which involves movement of the knee cap during contraction of the quadriceps muscle. Although an MRI can be used to diagnose the source of inflammation, it cannot indicate the root of the problem and why it is that the Hoffa’s pads is being irritated.
Can osteoarthritis cause Hoffa's pad syndrome?
This is especially true for osteoarthritis in the knee as there is often repeated flare ups of knee inflammation. Obesity is also a risk factor for Hoffa’s pad syndrome as inflammation is triggered by the ongoing strain to the knee joint.
Can a fat pad be pinched?
The infrapatellar fat pad can also be pinched by the knee cap and shin bone. Once trauma has occurred, the resulting swelling and inflammation alters the knees’ movement pattern making it more likely for the micro trauma or pinching to reoccur. This is especially true for osteoarthritis in the knee as there is often repeated flare ups ...
What is the infrapatellar fat pad?
There are various fat pads, but the one at the knee that causes a lot of problems is the infrapatellar fat pad, also known as Hoffa’s fat pad after the man who first described it. The fat pad has been shown to be very pain sensitive.
Is fat pad metabolic?
There are also non-mechanical sources of problem in the fat pad, and these should be referred to as metabolic. This is seen with obesity and osteoarthritis of the knee. Let’s take obesity. When someone is carrying excess fat they will have systemic inflammation.
Can a fat pad hurt?
The fat pad gets a trauma to it. Now this may be an obvious one off blow to the knee, or where the patient straightens their knee at speed and feels an immediate very sharp pain in the fat pad. Or, as is seen more commonly the fat pad may get nipped between the patella and the tibia, and microtrauma leads to a macro problem.
Is a fat pad painful?
The fat pad has been shown to be very pain sensitive. It is rich with nerve endings that can fire off messages of pain to the brain, and it is therefore of no surprise that people with fat pad problems are often in a lot of pain. The fat pad is often overlooked, with clinicians concentrating on joint surfaces, cartilage, ligaments and tendons, ...
Is fat pad bad for knees?
The good news here is that any efforts to reduce the inflammatory state of the fat pad will have a positive effect on the inflammatory state of the whole knee. To conclude, as weird as it is, this little pad of fat under the kneecap can be a very painful and persistent source of problem.
Where is the infrapatellar fat pad located?
Infrapatellar fat pad. The infrapatellar fat pad ( Hoffa's fat pad) is a cylindrical piece of fat that is situated under and behind the patella bone within the knee.
Is fat pad a problem?
The fat pad is a normal structure but it can sometimes become a problem: It can become damaged and painful. It can be deliberately removed at arthroscopic surgery to make it easier for the surgeon to see what they are doing - but this can also lead to scarring and pain. It can become hypertrophic and may become impinged between the patella and ...
Why is the infrapatellar fat pad important?
One of the reasons is because the large amount of adipose tissue secretes some factors, which can promote the occurrence of arthritis. As an important structure of the knee joint, the infrapatellar fat pad (IPFP) is actually a piece of adipose tissue.
Is IPFP a fat stem cell?
At the same time, with the development of adipose derived stem cells in the treatment of OA, owing to its special advantages, the IPFP is becoming a kind of important, minimally invasive fat stem cell source, providing a new approach for the treatment of OA.
Where is the infrapatellar fat pad located?
The infrapatellar fat pad is one of the three pads located on the anterior knee together with quadriceps and prefemoral fat pads. [ 2] . It is a tissue with known biomechanical functions. However, its endocrine functions are not fully understood. [ 3]
What is the function of Hoffa's fat pad?
Infrapatellar fat pad becomes impinged on the anterior knee, leading to Hoffa's disease, which presents with pain, dysfunction and effusion. [ 2] The main function of the Hoffa's fat pad is not fully understood. It is considered to be associated with knee kinetics and patellar biomechanics, [ 3] express algesic molecules such as the substance P, and cause pain in the anterior knee compartment. [ 8]
What is Hoffa syndrome?
Being one of the conditions presenting with patellar pain, Hoffa's syndrome is characterized with inflammation of the fat tissue in the patellar region. In advanced stage, this may lead to transformation of the fibrocartilage tissue and ossification of the infrapatellar fat pad. Some cases can be associated with tumors or tumor-like conditions. In this article, we describe a 72-year-old female case suffering from knee pain for a long time and discuss the end-stage Hoffa's disease and function of the infrapatellar fat pad in the light of literature.