The condition may occur after direct trauma to the knee, or after surgical interference with the fat pad. The pain is generally chronic (long standing), and exacerbated by knee extension, eg straight leg raise exercises. The soft tissue under the kneecap is tender to palpation, and the bottom of the kneecap may be tilted backwards by contracted scar tissue in the fat pad. With regard to treatment, conservative (non-operative treament) is tried first, but it may become necessary to excise the fat pad.
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