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Author Topic: Hoffas fat pad impingement?  (Read 1746 times)

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Offline AzJohn

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Hoffas fat pad impingement?
« on: August 12, 2011, 07:01:48 PM »
I had a patellar dislocation 9 weeks ago. It was my 3rd, I'm 39 yo. Male. The first two I walked of very minor and were years ago. This was more traumatic, I couldn't bear weight for almost a month. Well it seems after 2 weeks of pt. Im progressing ok with the dislocation rehab. Os says patella feels stable during apprehension test. Good. However, I Cannot bend my leg much past 90 degrees without feeling ALOT of torque in my patella and patellar tendon area. My swelling is not too bad though. I think my patella is pushed up on the bottom portion and it feels full under there. My MRI said I had impingement of fat pad. 
        I was wondering if it's possible to have scar tissue from that already causing me to not bend my knee fully. I also have a muscle like maybe plica on the lateral side that has gotten inflamed and is clicking and moving on the outside of my knee, very creepy feeling. It was there for a month went away for a few days then I tried to wear a brace and reaggravated it. Not sure if it's because of fat pad? The areas around my patellar tendon feel very firm.
   Should I do my pt? Or will that make it worse? I don't want to cause more scar tissue if that's what it is. I've been icing and ibuprofen. Any safe exercises I need to strengthen vmo for patella tracking but read extending knee is bad for fat pad I'mpingement. How long will this take to resolve conservatively if it works?   
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Offline Clarkey

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Re: Hoffas fat pad impingement?
« Reply #1 on: August 13, 2011, 04:02:13 PM »
Hi There,

I use to get pain and catching on the lateral side of my knee pre op, after my right knee was scoped the catching and sharp pain was no longer there. While the OS was inside my knee he had to trim the fat pad that was too large and removed my medial plica. My MRI also showed up fat pad impingement but my OS was not concerned about it as knee looks healthy on the MRI. My knee did click as well but had to be in a silent room to hear it.

Have you been back again to see your OS recently to do a proper assessment of your knee again. Scar tissue is another possibility as it can also cause a lot of catching and clicking, good luck in trying to get your knee sorted out.

Nick :) {2011} :)
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RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline AzJohn

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Re: Hoffas fat pad impingement?
« Reply #2 on: August 15, 2011, 04:41:32 AM »
Thanks for answering Nick. I was also wondering to any one who knows, if an inflamed fat pad can block flexion I know it can block extension from impingement. I can't get full flexion back and it feels like there is ALOT of pressure under kneecap and torque on patellar tendon when I try. I can get full extension passively but tightening quads it's stiffer. I'm a little concerned that after 9 weeks of not bending it it developed scar tissue. If it did does that mean it necessarily will scar up everything around it or just the fat pad and it can then be removed if necassary? Also will an MRI show this process of scarring? My os says he thinks is my muscles that need stretching out but my kneecap is pushed up on the low end and fat pad is swollen. My patella is moving ok still.
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