scholarly journals Flexibility of infrapatellar fat pad affecting anterior knee pain 6 months after anterior cruciate ligament reconstruction with hamstring autograft

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Takashi Kitagawa ◽  
Junsuke Nakase ◽  
Yasushi Takata ◽  
Kengo Shimozaki ◽  
Kazuki Asai ◽  
...  

AbstractThis study aimed to identify factors affecting anterior knee pain (AKP) after anterior cruciate ligament reconstruction (ACLR) with hamstring tendon autograft using ultrasonography. Forty-two patients were evaluated by ultrasound, 6 months after ACLR. The thickness of the superficial part of the infrapatellar fat pad was measured, as well as the thickness change ratio between the two angles. Color Doppler evaluated the rate of blood flow in the fat pad. AKP was assessed with the Kujala Scale. The correlations between AKP and age, body mass index, the thickness change ratio, and the grade of increased blood flow were examined. Independent variables showing significant correlations with AKP were used for multiple linear regression analysis. There were significant correlations between AKP and age (r = − 0.68), body mass index (r = − 0.37), the thickness change ratio of the fat pad (r = 0.73) and the grade of increased blood flow (r = − 0.42), respectively. Age and the thickness change ratio of the fat pad affected the AKP score (R2 = 0.56). After ACLR, older age and a decrease in the thickness change ratio of the superficial area of the infrapatellar fat pad appear to affect post-operative AKP after 6 months.

Author(s):  
Kyle G. Wallace ◽  
Steven J. Pfeiffer ◽  
Laura S. Pietrosimone ◽  
Matthew S. Harkey ◽  
Xiaopeng Zong ◽  
...  

Context: Hypertrophy of the Infrapatellar Fat Pad (IFP) in idiopathic knee osteoarthritis has been linked to deleterious synovial changes and joint pain related to mechanical tissue impingement; yet, little is known regarding the IFP's volumetric changes following anterior cruciate ligament reconstruction (ACLR). Objective: To examine changes in IFP volume between 6 and 12 months following ACLR and determine associations between patient-reported outcomes and IFP volume at each time point, as well as volume change over time. In a subset of individuals, we examined inter-limb IFP volume differences 12 months post-ACLR. Study Design: Prospective cohort study Setting: Laboratory Patients or Other Participants: We included 26 participants (13 females, 13 males, 21.88±3.58 years, 23.82±2.21 kg/m2) for our primary aims and 13 of those participants (8 females, 5 males, 21.15±3.85 years, 23.01±2.01 kg/m2) for our exploratory aim. Main Outcome Measure(s): Using magnetic resonance imaging, we evaluated IFP volume change between 6 and 12 months post-ACLR in the ACLR limb and between-limb differences at 12 months in a subset of participants. International Knee Documentation Committee subjective knee evaluation (IKDC) scores were collected at 6-month and 12-month follow-ups and associations between IFP volume and patient-reported outcomes were determined. Results: IFP volume in the ACLR limb significantly increased from 6 (19.67±6.30 cm3) to 12 (21.26±6.91 cm3) months post-ACLR. Greater increases of IFP volume between 6 and 12 months significantly associated with better 6-month IKDC scores (r=0.44, P=0.03). IFP volume was significantly greater in the uninjured limb (22.71±7.87 cm3) compared to the ACLR limb (20.75±9.03 cm3) 12 months post-ACLR. Conclusions: IFP volume increased between 6 and 12 months post-ACLR; however, the IFP volume of the ACLR limb remained smaller than the uninjured limb at 12-months. Additionally, those with better knee function 6 months post-ACLR demonstrated greater increases in IFP volume between 6 and 12 months post-ACLR. This suggests greater IFP volumes may play a role in long-term joint health following ACLR.


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