Anterior Knee Pain and Oedema-Like Changes of The Suprapatellar Fat Pad: Correlation of The Symptoms with MRI Findings

2021 ◽  
Vol 17 ◽  
Author(s):  
Yasemin Kucukciloglu ◽  
Ozum Tuncyurek
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
Signal Intensity ◽  
Control Group ◽  
Fat Pad ◽  
Mri Findings ◽  
Relative Signal Intensity ◽  
Significant Difference ◽  
Anterior Knee ◽  
Fat Pads

Objective: To evaluate the role of oedema like changes of the suprapatellar fat pad in the development of anterior knee pain. Methods: Total 156 knee MRIs of 150 patients from December 2015 to July 2019 were retrospectively evaluated by a radiologist with 13 years of MRI experience for the configuration of the suprapatellar fat pads. Population was divided into two groups according to referring physicians’ notes for presence of anterior knee pain. The study group consisted of the patients with complaints of anterior knee pain. The control group consisted of patients without anterior knee pain. Maximum craniocaudal, anteroposterior and oblique diameters and relative signal intensity indexes of the suprapatellar fat pads were measured and compared between the groups. Configurations of the fat pads were recorded (triangular shaped vs convex posterior bordered suprapatellar fat pads), and measurements of the triangular shaped and convex posterior bordered suprapatellar fat pads were compared. Student t test was used for statistical analysis. Statistically significant differences and correlations were defined as p<0.05. Results: The diameters and relative signal intensity indexes of the fat pads showed no significant difference between the groups (p=0.588, 0.744, 0.874 and 0.201, respectively). Anteroposterior and oblique diameters and relative signal intensity indexes of the suprapatellar fat pads were correlated with convex posterior border (p=0.001, 0.003 and 0.000, respectively). Conclusion: Oedema-like changes of the suprapatellar fat pad seen at knee MRIs are correlated with the configuration of the fat pad, but are rarely associated with anterior knee pain.

scholarly journals Patelloplasty with and without circumpatellar denervation in reducing anterior knee pain in primary total knee arthroplasty: a comparative prospective study

2020 ◽  
Vol 6 (2) ◽  
pp. 270
Author(s):  
Sandeep Kumar Kanugula ◽  
Mallesh Rathod ◽  
Venugopal S. M.
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Anterior Knee Pain ◽  
Intervention Group ◽  
Control Group ◽  
Significant Difference ◽  
Total Knee ◽  
Anterior Knee

<p class="abstract"><strong>Background:</strong> Anterior knee pain (AKP) following total knee arthroplasty (TKA) ­­­­­­is one of the complication which cause dissatisfaction in patients. Incidence estimated to be 4-49%. The aim of our study is to know the efficacy of patelloplasty with circumpatellar denervation with diathermy in reducing AKP in primary TKA.</p><p class="abstract"><strong>Methods:</strong> A total of 130 unilateral TKAs’ are divided into 2 groups. Group I (control) includes 65 patients in which only patelloplasty was done. Group II (intervention) includes 65 patients in which both patelloplasty and circumpatellar denervation with diathermy was done and analysed. Mean follow up period was 18 months. Patients were assessed both preoperatively and postoperatively at final follow up.<strong></strong></p><p class="abstract"><strong>Results:</strong> The overall incidence of AKP at follow up (18 months) was 16.9%, with 7.7% in the intervention group and 26.1% in the control group (p&lt;0.05).  Western Ontario and McMaster Universities osteoarthritis index scores were significantly  better in intervention group when compared to control group (28.71±3.948 vs 31.40±3.860). Better results were also found in knee society scores for intervention group compared to control group (166.57±7.941 vs 161.23±11.219); Feller patellar score of  intervention group was significantly better when compared to control group (23.28±2.546 vs 20.69±3.729); the range of knee flexion was similar in both the groups (94.62±12.6 vs 93.54±10.7). In terms of pain referred by the patient at 72 hrs postoperatively, there was statistically significant difference observed according to visual analogue scale.</p><p class="abstract"><strong>Conclusions:</strong> There is statistically significant difference with respect to AKP in patients who have undergone patelloplasty with circumpatellar denervation using diathermy compared with patelloplasty alone.</p><p> </p>

Suprapatellar Fat-Pad Mass Effect: MRI Findings and Correlation With Anterior Knee Pain

2013 ◽  
Vol 200 (3) ◽  
pp. W291-W296 ◽  
Author(s):  
Nikolaos Tsavalas ◽  
Apostolos H. Karantanas
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
Mass Effect ◽  
Fat Pad ◽  
Mri Findings ◽  
Anterior Knee

scholarly journals Fat Chance for Hidden Lesions: Pictorial Review of Hoffa's Fat Pad Lesions

2021 ◽  
Author(s):  
Suvinay Saxena ◽  
Drushi D. Patel ◽  
Ankur Shah ◽  
Mrugesh Doctor
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
Fat Pad ◽  
Specific Diagnosis ◽  
Hoffa’S Fat Pad ◽  
Pictorial Review ◽  
Anterior Knee ◽  
Fat Pads

AbstractHoffa's fat pad (HFP) is the most commonly afflicted among all the knee fat pads. Anterior knee pain is common in various pathologies of HFP, as it is richly innervated. A potpourri of the intrinsic and extrinsic pathologies and the tumors and tumor-like conditions affect HFP, and MRI remains the fundamental modality to assess them and provide a specific diagnosis.

Infrapatellar Fat Pad Impingement: A Systematic Review

2017 ◽  
Vol 30 (07) ◽  
pp. 639-646 ◽  
Author(s):  
Jason Genin ◽  
Mhamad Faour ◽  
Prem Ramkumar ◽  
George Yakubek ◽  
Anton Khlopas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Clinical Presentation ◽  
Infrapatellar Fat Pad ◽  
Lateral Side ◽  
Imaging Findings ◽  
Fat Pad ◽  
Knee Pathology ◽  
Anterior Knee

AbstractInfrapatellar fat pad impingement represents a source of anterior knee pain that is often overlooked. Due to the scarcity of reports related to this disorder, we conducted a systematic review of the literature related to infrapatellar fat pad impingement in evaluating the following: (1) clinical presentation, (2) imaging, (3) management, and (4) clinical outcomes. A systematic review was conducted investigating all available primary literature related to the clinical presentation, imaging, management, and outcomes of infrapatellar fat pad impingement syndrome. A total of 15 studies (9 case reports, 1 case series, and 5 retrospective studies) comprising 167 patients met eligibility criteria for this review. Patients with infrapatellar fat pad impingement were found to most often present with anterior knee pain that worsened with activity, and was frequently associated with trauma. Anterior knee pain, tenderness to palpation over the patellar tendon, loss in terminal extension, and pain with direct pressure on the medial or lateral side of the patella with the knee extended was often found on examination. Although patients may have classic imaging findings on magnetic resonance imaging (localized edema of the infrapatellar fat pad, deep fluid-filled infrapatellar bursa, nonvisualization of clefts, fibrosis, and calcifications), not all patients had positive imaging findings, thus making infrapatellar fat pad impingement a clinical diagnosis. Treatment begins with nonoperative management, but in recalcitrant cases, patients can be surgically treated with arthroscopic fat pad resection. Most patients who undergo operative treatment report improvement or complete resolution of symptoms in terms of pain and range of motion, and are able to return to work. To the best of our knowledge, this is the first comprehensive review on infrapatellar fat pad impingement to better aid the orthopaedic surgeons in diagnosing, treating, and managing patient expectations for this often overlooked knee pathology.

scholarly journals Solitary synovial chondromatosis as a cause of Hoffa’s fat pad impingement

2015 ◽  
Vol 68 (1-2) ◽  
pp. 49-52 ◽  
Author(s):  
Mirsad Maljanovic ◽  
Vladimir Ristic ◽  
Predrag Rasovic ◽  
Radmila Matijevic ◽  
Vukadin Milankov
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
Distal Femur ◽  
Histopathological Examination ◽  
Synovial Chondromatosis ◽  
Fat Pad ◽  
En Bloc ◽  
Superior Part ◽  
Shoulder Joints ◽  
Anterior Knee

Introduction. Synovial chondromatosis is a benign disease of synovial membrane usually affecting knee, elbow and shoulder joints. It rarely appears as a solitary formation and exceptionally within Hoffa?s fat pad. Case Report. We report a case of solitary synovial chondromatosis within Hoffa?s fat pad as a cause of its impingement in a female patient aged 63. At first, the patient had anterior knee pain with limited extension of the knee. Standard radiogram showed only mild patellofemoral osteoarthritic changes. Magnetic resonance of the knee showed ovoid solitary formation within Hoffa?s fat pad repressing its superior part between the kneecap and distal femur. Histopathological examination confirmed a case of extra-articular synovial chondromatosis. The tumorous mass was extracted surgically en bloc. Conclusion. Solitary synovial chondromatosis is an uncommon cause of Hoffa?s fat pad impingement and anterior knee pain in elderly female patients and can easily be misinterpreted as a different diagnosis.

The fat pad and its relationship to anterior knee pain

The Knee ◽  
1997 ◽  
Vol 4 (4) ◽  
pp. 227-236 ◽  
Author(s):  
Zaid A.A. Duri ◽  
Paul M. Aichroth ◽  
George Dowd ◽  
Howard Ware
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
Fat Pad ◽  
Anterior Knee

scholarly journals Does patellar denervation prevent anterior knee pain and improve patient-reported outcomes in patients undergoing non-resurfaced total knee arthroplasty? an updated meta-analysis of randomized controlled trials.

2020 ◽  
Author(s):  
Hongzhi Liu ◽  
Zhaohui Liu ◽  
Qidong Zhang ◽  
Wanshou Guo
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Anterior Knee Pain ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Significant Difference ◽  
Patient Reported ◽  
Total Knee ◽  
Anterior Knee

Abstract Background Anterior knee pain (AKP) is the most common complication of total knee arthroplasty (TKA). It is unclear which procedure of addressing AKP is preferable. Some data suggest patellar denervation (PD) provides effective AKP prevention. The purpose was to assess the effectiveness and safety of PD in primary TKA.Methods A meta-analysis was performed of randomized clinical trials (RCTs) from inception to March 26, 2020, using PubMed, Embase, Web of Science and Cochrane Library. Study-specific RR and MD were aggregated using random or fixed effects models. The outcomes were incidences of AKP, PS (patellar scores), VAS (visual analogue scale), ROM (range of motion), KSS knee (American Knee Society knee scores), KSS function (American Knee Society function scores), incidence of complications and revisions.Results Ten RCTs involving 1196 knees were included. The meta-analysis showed no significant in PD group on the incidence of AKP (RR = 0.64; 95% CI 0.37, 1.11; p = 0.11) with moderate heterogeneity (P < 0.01, I2 = 84%). Our results indicated PD had a significantly better VAS (MD = − 0.25; 95% CI -0.41, -0.09; p < 0.01), ROM (MD = 7.68; 95% CI 0.34, 15.20; p = 0.04) and PS (MD = 0.91; 95% CI 0.36, 1.46; p < 0.01). However, there was no significant difference no matter in KSS knee, KSS function, complications or revisions.Conclusions This meta-analysis showed that no difference in AKP between PD and NPD in patients undergoing non-resurfaced TKA. PD could improve clinical outcome in VAS, post-operative ROM and PS.

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