Arthroscopic Resection of the Infrapatellar Fat Pad in Athletes: A 10-Year Experience and Long-Term Follow-Up Results

Yıl 2025, Cilt: 27 Sayı: 3, 345 - 349, 25.12.2025

Abdullah Yener İnce , Nurşah Büyükçamsarı Şanlıer , Tolgahan Korkmaz , Erkan Özyılmaz

https://doi.org/10.24938/kutfd.1732779

Öz

Objective: The Infrapatellar fat pad (IFP) impingement syndrome, also known as Hoffa’s disease, is a significant cause of anterior knee pain. Surgery is often preferred due to inadequate symptom relief with conservative treatment options. This study aims to evaluate the outcomes of arthroscopic resection of the impinged IFP in athletes with anterior knee pain.
Material and Methods: A retrospective analysis was conducted on 26 athlete patients (32 knees) diagnosed with infrapatellar fat pad (IFP) impingement syndrome who underwent arthroscopic resection. Pain levels were evaluated using the Numeric Rating Scale (NRS) preoperatively and at the 3rd postoperative month, and active joint range of motion (ROM) was recorded preoperatively and at the 12th postoperative month.
Results: The median age of the patients was 27 years (IQR: 22.25-31.75). The preoperative median NRS score was 7 (IQR: 5.75-8), which significantly decreased to 1 (IQR: 1-2) at the 3rd postoperative month (p<0.001). Twenty-five of the 26 patients (96.2%) achieved full knee joint ROM at the 12th postoperative month, while one patient (3.8%) had persistent extension limitation. All patients returned to their sports activities.
Conclusion: Arthroscopic resection for IFP impingement syndrome led to improved clinical outcomes in athletes who had not responded to conservative treatment and had no other related knee pathologies.

Anahtar Kelimeler

Infrapatellar fat pad , Hoffa’s disease , anterior knee pain , arthroscopic resection

SPORCULARDA İNFRAPATELLAR YAĞ YASTIĞININ ARTROSKOPİK REZEKSİYONU: 10 YILLIK DENEYİM VE UZUN DÖNEM TAKİP SONUÇLARI

Öz

Amaç: İnfrapatellar yağ yastığı (İYY) sıkışma sendromu, diğer adıyla Hoffa hastalığı, diz önü ağrısının önemli nedenlerinden biridir. Konservatif tedaviyle semptomların yeterince giderilemediği durumlarda cerrahi tedavi tercih edilmektedir. Bu çalışmanın amacı, diz önü ağrısı olan sporcularda infrapatellar yağ yastığının artroskopik rezeksiyonunun sonuçlarını değerlendirmektir.
Gereç ve Yöntemler: İYY sıkışma sendromu tanısı alarak artroskopik rezeksiyon uygulanan 26 sporcu hasta (32 diz) retrospektif olarak analiz edildi. Ağrı düzeyleri Sayısal Derecelendirme Skalası (NRS) ile ameliyat öncesi ve postoperatif 3. ayda değerlendirildi; aktif eklem hareket açıklığı (EHA) ameliyat öncesinde ve postoperatif 12. ayda kaydedildi.
Bulgular: Hastaların median yaşı 27 (IQR: 22,25-31,75) idi. Ameliyat öncesi median NRS skoru 7 (IQR: 5,75-8) iken, postoperatif 3. ayda bu değer istatistiksel olarak anlamlı düzeyde azalarak 1 (IQR: 1-2)’e geriledi (p<0,001). Yirmi altı hastanın 25’i (%96,2) ameliyat sonrası 12. ayda tam eklem hareket açıklığına ulaştı. Bir hastada (%3,8) ekstansiyon kısıtlılığı devam etti. Tüm sporcular spor aktivitelerine geri döndü.
Sonuç: Konservatif tedaviye yanıt vermeyen ve eşlik eden başka diz patolojisi bulunmayan sporcularda, infrapatellar yağ yastığı sıkışma sendromuna yönelik artroskopik rezeksiyon, klinik sonuçlarda belirgin iyileşme sağlamıştır.

Anahtar Kelimeler

İnfrapatellar yağ yastığı , Hoffa hastalığı , diz önü ağrısı , artroskopik rezeksiyon

Kaynakça

• Biedert RM, Sanchis-Alfonso V. Sources of anterior knee pain. Clin Sports Med. 2002;21(3):335-347.
• Ogilvie-Harris DJ, Giddens J. Hoffa’s disease: arthroscopic resection of the infrapatellar fat pad. Arthroscopy. 1994;10(2):184-187.
• Kumar D, Alvand A, Beacon JP. Impingement of infrapatellar fat pad (Hoffa’s Disease): Results of high-portal arthroscopic resection. Arthroscopy. 2007;23(11):1180-1186.e1.
• Duri ZA, Aichroth PM, Dowd G. The fat pad. Clinical observations. Am J Knee Surg. 1996;9(2):55-66.
• Hannon J, Bardenett S, Singleton S, Garrison JC. Evaluation, Treatment, and rehabilitation ımplications of the infrapatellar fat pad. Sports Health. 2016;8(2):167-171.
• Von Engelhardt LV, Tokmakidis E, Lahner M, et al. Hoffa’s fat pad impingement treated arthroscopically: related findings on preoperative MRI in a case series of 62 patients. Arch Orthop Trauma Surg. 2010;130(8):1041-1051.
• Abelleyra Lastoria DA, Benny CK, Hing CB. Predisposing factors for Hoffa’s fat pad syndrome: a systematic review. Knee Surg Relat Res. 2023;35(1):17.
• Park YC, Kim YM, Joo YB. Arthroscopic Resection of ınfrapatellar fat pad ımpingement syndrome: Long-Term clinical results at minimum 10-year follow-up. Medicina (Kaunas). 2025;61(6):997.
• von Engelhardt LV, Tokmakidis E, Lahner M, et al. Hoffa’s fat pad impingement treated arthroscopically: related findings on preoperative MRI in a case series of 62 patients. Arch Orthop Trauma Surg. 2010;130(8):1041-1051.
• Bousquet BA, O’Brien L, Singleton S, Beggs M. Post-operative criterion based rehabilitatıon of ACL repairs: A clinical commentary. Int J Sports Phys Ther. 2018;13(2):293-305.
• Hysing-Dahl T, Inderhaug E. Rehabilitation after surgery for patellar instability. J Exp Orthop. 2024;11(3):e12062.
• Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole MR. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001;94(2):149-158
• Kim YM, Joo YB. Arthroscopic treatment of ınfrapatellar fat pad ımpingement between the patella and femoral trochlea: Comparison of the clinical outcomes of partial and subtotal resection. Knee Surg Relat Res. 2019;31(1):54-60.
• Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985;198(198):43-49.
• Rooney A, Wahba AJ, Smith TO, Donell ST. The surgical treatment of anterior knee pain due to infrapatellar fat pad pathology: A systematic review. Orthopaedics & Traumatology: Surgery & Research. 2015;101(4):469-475.
• Bohnsack M, Wilharm A, Hurschler C, Rühmann O, Stukenborg-Colsman C, Wirth CJ. Biomechanical and kinematic influences of a total infrapatellar fat pad resection on the knee. Am J Sports Med. 2004;32(8):1873-1880.
• Wu H, Xu Q, Zhou W. Hoffa disease: diagnosis and arthroscopic treatment. Zhonghua Wai Ke Za Zhi. 1995;33(10):581-583.
• Liu YP, Li SZ, Yuan F, et al. Infrapatellar fat pad may be with tendon repairing ability and closely related with the developing process of patella Baja. Med Hypotheses. 2011;77(4):620-623.
• Doner GP, Noyes FR. Arthroscopic Resection of Fat Pad Lesions and Infrapatellar Contractures. Arthrosc Tech. 2014;3:e413-e416.
• DuBose M, Taqi M. Hoffa Pad Impingement Syndrome. StatPearls. Published online February 22, 2023. Accessed March 5, 2025.
• Theisen BJ, Larson PD, Chambers CC. Optimizing rehabilitation and return to sport in athletes with anterior knee pain using a biomechanical perspective. Arthrosc Sports Med Rehabil. 2022;4(1):e199-e207.