|Illustration showing how the IPP-fat pad complex can be stretched during knee extension.|
Anterior knee pain related to the IPP-fat pad complex
In many patients - although not all - the infrapatellar plica or ligamentum mucosum is intimately connected to the Hoffa fat pad behind the patella and both are put on stretch when the knee is extended. Because the Hoffa fat pad is richly endowed with nerves, distortion of this structure can cause pain in the front of the knee.
Arthroscopic Untethering of the Fat Pad of the Knee: Release or Resection of the Infrapatellar Plica (Ligamentum Mucosum) and Related Structures for Anterior Knee Pain. Smallman TV, Portner OT, Race A, Shekitka K and Mann K. Arthrosc Tech. 2018 May; 7(5): e575–e588.