The fat pad syndrome is a set of symptoms associated with nipping ('impingement') of the fat pad between the patella and the femoral condyle.

fat pads of the knee
The infrapatellar fat pad or Hoffa fat pad is the main fat pad of the knee, but there are other fat pads also above the patella.


Symptoms relating to fat pad syndrome

Symptoms include pain in the front of the knee which is generally chronic (long standing), and with sharper episodes exacerbated by knee extension, eg straight leg raise exercises or hyperextension, eg kicking or wearing high heels. 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. 


Causes of fat pad syndrome

fat pad

The condition may occur after direct trauma to the knee, or after surgical interference with the fat pad.


Treatment of fat pad syndrome

With regard to treatment, conservative (non-operative treament) is tried first, but it may become necessary to excise the fat pad.

Hoffa's syndrome
Fat pad impingement syndrome

The patella - important anatomical relationships

The kneecap or patella is part of a chain of structures that help to straighten the knee.

Fat pad syndrome

A syndrome is a collection of signs and symptoms that tend to occur in association.



Infrapatellar fat pad syndrome : a review of anatomy, function, treatment and dynamics. Mace J, Bhatti W and Anand S. Acta Orthop. Belg., 2016, 82, 94-101.

Evaluation and treatment of disorders of the infrapatellar fat pad. Dragoo JL, Johnson C and McConnell J. Sports Med. 2012 Jan 1;42(1):51-67.

MRI Findings Consistent with Peripatellar Fat Pad Impingement: How Much Related to Patellofemoral Maltracking? Jarraya M, Diaz LE, Roemer FW, Arndt WF, Goud AR and Guermazi A. Magn Reson Med Sci. 2018; 17(3): 195–202.

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