A Source of Anterior Knee Pain is Fat Pad Impingement Syndrome

Fat Pad Impingement: What is it?

The fat pad can occasionally get impinged (pinched) between the distal thigh bone (femoral condyle) and the kneecap following a direct blow to the kneecap (patella).

Since the fat pad is one of the knee's most delicate components, this ailment is well recognized to be excruciatingly painful. The anterior knee discomfort is located on either side of the lower kneecap and is made worse by extending (straightening) the knee joint. As a result, the fat pad is constantly irritated and may experience considerable inflammation.

Another name for it is Hoffa's Syndrome.

What Fat Pad Impingement Symptoms Are There?

Around the bottom and around the kneecap, there may be pain or swelling.

Patients might have a history of hyperextended knees (called genu recurvatum)

Positive Hoffa's test (pain and/or apprehension of the patient is considered a positive sign for fat pad impingement; the patient lies with their knee bent while the examiner presses both thumbs along either side of the patellar tendon, just below the patella; the patient is then asked to straighten their leg)

Fat pad impingement treatment

The usual course of treatment for this illness is conservative, like:

Take a break, refrain from stressful activities, and stop running.

Pain and inflammation can be reduced by ice or cryotherapy.

physiotherapy techniques using TENS and ultrasound.

Exercises that build muscle preserve the health and strength of the surrounding muscle groups.

The patella may benefit from tape. One technique entails taping the patella's upper surface to create more room for the components beneath the lower surfaces, such as the fat pad. Less strain and impingement are placed on the fat pad as a result.

Surgery may be recommended if more conservative measures fail. The fat pad itself may need to be removed whole or in part as a result.

Fat pad impingement surgery

In order to do this, key-hole arthroscopy surgery is used.

The surgeon can see the issue using a camera system and a small motorized shaver to remove the impinging fat pad through two tiny holes on either side of the bottom portion of the kneecap.

Here is an illustration of a patient I recently saw. For the previous three to four months, he had soreness in the front of his knee. After roughly ten minutes of running, the agony started. He managed to finish his one-hour run, but for the next one to two days he would experience soreness and a slight limp. He could no longer run for more than ten minutes as the issue grew worse.

Upon clinical examination, it was discovered that there was pain at the front of the knee, just below and next to the kneecap. The more he straightened his knee, the worse the agony became.

This patient had an arthroscopic procedure to remove an impinging fat pad. After the procedure, the pain disappeared right away.

I have a surgical video of the arthroscopic fat pad procedure, but I am unable to display it here owing to current Ministry of Health regulations. Please get in touch with me if you want to see it.

Dr. HC Chang is a leading orthopaedic specialist in singapore in the field of anterior knee pain. He has been practicing for over 30 years and has helped many patients overcome their anterior knee pain. Dr. Chang has written extensively on the topic of anterior knee pain and his work has been published in many journals, newspapers, and magazines.

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