The fat pad syndrome is a set of symptoms associated with nipping ('impingement') of the fat pad between the patella and the femoral condyle.
Page updated June 2024 by Dr Sheila Strover (Clinical Editor)
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
The condition may occur after direct trauma to the knee, or after surgical interference with the fat pad.
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Quote from peer-reviewed paper:
"...has been defined as the impingement of Hoffa’s fat pad, occurring with concomitant pathology, leading to its oedema and fibrosis....can also be caused by repetitive micro trauma resulting in inflammation and fibrous changes to Hoffa’s fat pad"
Citation: Abelleyra Lastoria DA, Benny CK, Hing CB. Predisposing factors for Hoffa's fat pad syndrome: a systematic review. Knee Surg Relat Res. 2023 Jun 9;35(1):17. doi: 10.1186/s43019-023-00192-4. PMID: 37296488; PMCID: PMC10251569.
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.
Forum discussions
- UK Surgeons for arthrofibrosis/ Hoffa fat pad
Patient looking for a surgeon to deal with fat pad issues.
Synonyms:
Hoffa's syndrome
Fat pad impingement syndrome
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