Note: To access the supplementary Table 2 accompanying this report, visit the November 2007 issue of Arthroscopy at www.arthroscopyjournal.org.
Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticleImpingement of Infrapatellar Fat Pad (Hoffa’s Disease): Results of High-Portal Arthroscopic Resection
Section snippets
Methods
We performed a retrospective analysis of a consecutive series of patients with the diagnosis of isolated Hoffa’s disease treated with high-portal arthroscopic resection of the infrapatellar fat pad between January 1993 and December 2001, with prospective data collection. Patients with additional intra-articular pathologies were excluded.
All of the patients in this series had been treated with oral analgesics or nonsteroidal anti-inflammatory drugs (or both) and had undergone physiotherapy for
Results
In this study 34 patients (22 men and 12 women) were diagnosed and treated for isolated Hoffa’s disease. The mean age at presentation was 38 years (range, 19 to 62 years), and the mean duration of symptoms before surgery was 10 months (range, 1 to 26 months). The right knee was involved in 19 patients and the left in 15. Of the patients, 32 performed regular sporting activities, but only 23 (67%) described a definite injury to the knee precipitating their symptoms (their mechanism of injury is
Discussion
Metheny and Mayor4 described the anatomy of the infrapatellar fat pad based on their cadaveric study and were the first investigators to report its arthroscopic resection, in 4 patients. Jacobson et al.9 and Saddik et al.10 described the MRI appearance of the infrapatellar fat pad in various disorders, stressing the importance of this diagnostic tool. We did not use MRI in patients clinically suspected to have isolated Hoffa’s lesions, because awake patients in the scanner do not fully extend
Conclusions
Patients with symptomatic impingement of the fat pad without any other concomitant pathology can expect resolution or long-term improvement in their symptoms and function after arthroscopic resection.
Acknowledgment
The authors thank Anna Taylor for help in collection and compilation of data, Dr. Korostoff for histologic analysis, and Dr. Herman-Kuiper for statistical advice. They also thank the illustration departments of Royal Glamorgan Hospital, Flantrisant, and Morriston Hospital, Swansea.
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Study conducted at Hemel Hempstead General Hospital, St. Albans City Hospital, and BUPA Hospital, Harpenden, England. The authors report no conflict of interest.