Advertisement - Hide this advert





Author Topic: Impending Hoffa's Fat Pad Surgery  (Read 17234 times)

0 Members and 1 Guest are viewing this topic.

Offline dyfanevans

  • MICROgeek (<20 posts)
  • *
  • Posts: 14
  • Liked: 0
Impending Hoffa's Fat Pad Surgery
« on: June 11, 2012, 10:25:18 AM »
Hi all,

I'll try and keep this short - I am due to have a trim of the hoffa's fat pad in my right knee in two days time.  I have been suffering with pain in the pad since november last year, and l have was due to go for surgery around two months ago, however the symptoms seemed to ease a few days before l was due to go into hospital, so l cancelled. Around three weeks ago, l visited the surgeon as the pain had flared, and to be honest l had had enough of it!

Now l am in a similar position again. After the last scheduled surgery appointment, the pain has become less acute (l guess due to rest), however l am left with a lingering painful ache, which comes and goes, and, just to add insult to injury, seems to have eased off to the point of barely hurting over the past few days.  I am now doubting whether or not to go through with the surgery.

My surgeon is a reknowned joint injury specialist, so l am not concerned about having the best possible person do the surgery. In addition l know that this situation has happened before - where the pain has gone away for a week only to come back after its too late to do anything about it.

My question is, should l leave the surgery, or go through with it and hope that it will be completely successful i.e. able to get back to training (l am a competitive cyclist) in 4-6 weeks?

HELP!!!

Offline joanfan123

  • Regular Poster
  • ***
  • Posts: 118
  • Liked: 0
Re: Impending Hoffa's Fat Pad Surgery
« Reply #1 on: June 11, 2012, 11:59:58 PM »
I had fat pad surgery and similar to you the pain would be off and on for a few weeks. The problem however progressed tom me not being able to straiten my knee, so I had surgery. Since I had wait so long my leg was atrophied and my recovery took a lot longer than it should have. In the end you should go with your instinct, but I hoped my experience can help you.
May '10- PT LK
June '11- PT LK
October '11- Cortisone LK
11/8/11- Arthroscope Fat Pad trimmed LK

Offline dyfanevans

  • MICROgeek (<20 posts)
  • *
  • Posts: 14
  • Liked: 0
Re: Impending Hoffa's Fat Pad Surgery
« Reply #2 on: June 12, 2012, 10:50:03 AM »
Thanks JoanFan123.

Anyone else? Just need an idea of anyone's experience.

If it helps, my leg strength is excellent as l regularly cycle and attend the gym, so l'm not concerned about that.

Offline lorilove

  • MICROgeek (<20 posts)
  • *
  • Posts: 16
  • Liked: 0
Re: Impending Hoffa's Fat Pad Surgery
« Reply #3 on: June 12, 2012, 11:24:52 AM »
I have a very similar situation.  I don't exactly know what my issue is since I am not able to have an MRI (I am not MRI safe due to a previous surgery).  Possible meniscus tear 

I am scheduled for a knee scope tomorrow!  And sure enough after several months of discomfort and limited activity, the knee decides to act better.  10 days ago, I was miserable and could not wait for surgery and today I am questioning if the procedure is overkill.

At thsi point I am going forward with the surgery.  If I cancel it will easily be 4-6 weeks if I have to reschedule.  The pain in my knee that started this whole issue is still there it is just not limiting my activity as much as it originally did.  2 months ago, running was too uncomfortable and walking or standing too much would make my knee inflame for several days..

Suddently last week I am able to do so much more.  I did a run/walk (only 1-3 miles) several days last week.  This is not a great deal but more than I have been able to do in months.

If I did not have insurance and I could stand a sedentary lifestyle, the current discomfort is something I could live with.  But for me my quality of life is definitely negatively affected.  The knee problem has been going on for 4-5 months and although I have had good periods overall it has trended worse.  I am just ready for the healing to begin so I can start moving forward.  My real concern is that I could make it worse.

Offline AndyB

  • MICROgeek (<20 posts)
  • *
  • Posts: 6
  • Liked: 1
Re: Impending Hoffa's Fat Pad Surgery
« Reply #4 on: June 20, 2012, 05:21:00 PM »
Hi, just curious who is the surgeon?  I have terrible pain around that area also and was not aware of such a surgery. 

Offline joanfan123

  • Regular Poster
  • ***
  • Posts: 118
  • Liked: 0
Re: Impending Hoffa's Fat Pad Surgery
« Reply #5 on: June 20, 2012, 07:08:42 PM »
It is usually during a scope, I don't think most people know they will have it going in. I know personally after no luck with PT and two clean MRIs I had a scope and that it was discovered my fat pad was an issue, before then I did not even know what a fat pad was.

Dyfanevans- What did you end up doing? Hope everything works out for you.
May '10- PT LK
June '11- PT LK
October '11- Cortisone LK
11/8/11- Arthroscope Fat Pad trimmed LK

Offline Hiker girl

  • Regular Poster
  • ***
  • Posts: 97
  • Liked: 7
Re: Impending Hoffa's Fat Pad Surgery
« Reply #6 on: June 25, 2012, 09:20:38 PM »
I am on week 5 post op from fat pad trim.  I think everyone heals differently.  After surgery I couldn't seem to work my calf or quads.  And the instability is just not there.?  There are times I wonder what I was thinking, but then I remember this knee has held me back from my life so I am hoping to have 100% recovery.

My OS was quite frank and said the swelling will be problematic for a minimum of 3 months.
« Last Edit: April 19, 2017, 02:27:00 PM by The KNEEguru »
Rt. knee pain while hiking 08/10
Saw GP 04/11
PT 05/11  failed
MRI  clean 06/11
1st OS, nothing wrong, fired him.
2nd OS, cortisone shot 12/11 
Scope 05/12, fat pad impingement, cleaned and reshaped.
3rd and 4th OS think nerve problem
Nerve study June 2012, Femoral nerve damage

Offline Cvemuri

  • MICROgeek (<20 posts)
  • *
  • Posts: 2
  • Liked: 0
Re: Impending Hoffa's Fat Pad Surgery
« Reply #7 on: February 13, 2017, 09:18:01 AM »
I had fat pad surgery and similar to you the pain would be off and on for a few weeks. The problem however progressed tom me not being able to straiten my knee, so I had surgery. Since I had wait so long my leg was atrophied and my recovery took a lot longer than it should have. In the end you should go with your instinct, but I hoped my experience can help you.

Hi joanfan123, i am exact similar situation, i waited 10 months after injury to get hoffa pad trimmed, i got mu surgery in sep 2016, now after almost 5 months, my leg is not improved much wrt strength, unable to run . Basically my leg is atrophied similar to your case. How long it took in your case to get back to normal or close to normal. I have been doing exercises to build strength regularly but not much improvement. Your response will be helpfull.

Offline Vickster

  • Administrator
  • SuperKNEEgeek
  • *****
  • *
  • Posts: 4615
  • Liked: 372
  • Neelie knee!
Re: Impending Hoffa's Fat Pad Surgery
« Reply #8 on: February 13, 2017, 09:22:43 AM »
Joanfan last visited in early 2013 so it's highly unlikely you'll get a response

Are you working with a sports physio on strengthening and muscle balance?  You may unfortunately find that you never get back to where you were pre-op but a physio should be able to help you improve and function better
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Hiker girl

  • Regular Poster
  • ***
  • Posts: 97
  • Liked: 7
Re: Impending Hoffa's Fat Pad Surgery
« Reply #9 on: February 13, 2017, 04:33:46 PM »
Cvemuri,

Can you straighten your leg?  I am approaching year 6 post op and am finally up to walking 1 mile a day.  I wear a compression sock 20mhm as my vein valves blew out with too much swelling post surgery.  I keep my leg from atrophying by doing leg exercises in the pool. 

It sounds like you may need to have a neurologist look at your leg and do an emg study to see if your nerves are all functioning.



Rt. knee pain while hiking 08/10
Saw GP 04/11
PT 05/11  failed
MRI  clean 06/11
1st OS, nothing wrong, fired him.
2nd OS, cortisone shot 12/11 
Scope 05/12, fat pad impingement, cleaned and reshaped.
3rd and 4th OS think nerve problem
Nerve study June 2012, Femoral nerve damage

Offline Cvemuri

  • MICROgeek (<20 posts)
  • *
  • Posts: 2
  • Liked: 0
Re: Impending Hoffa's Fat Pad Surgery
« Reply #10 on: February 13, 2017, 05:10:28 PM »
I can straighten the leg, I was going with PT and that made it worse, PT gave me Squats and Step Climbs along with other exercises, Sqauts and Steps Up's put lot of stress on the knee and continues effusion, finally one friend said, squats and Stair climbs after surgery with weakened muscle may cause bone edema and effusion not to go away; I gave a break for those exercises and just did stretches and leg lifts for 2 weeks, finally effusion completely went away along with pain. but no change in muscle strength; before surgery, my doctor thought i will be back to pre-op condition in 3 months as this is only fat pad surgery due to injury and no other ligaments are affected; same with PT, he thought i will be like pre-injury in 3-4 months. nowhere close. I use to run regularly and caused the injury during one exercise due to over stretch without warm-up.

Offline The KNEEguru

  • Administrator
  • SuperKNEEgeek
  • *****
  • Posts: 2555
  • Liked: 96
  • The KNEEguru
    • The KNEEguru
Re: Impending Hoffa's Fat Pad Surgery
« Reply #11 on: April 19, 2017, 02:28:33 PM »
I am moving this post now to a general section.
--
KNEEguru

Offline Clarkey

  • SuperKNEEgeek
  • *****
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • Posts: 4177
  • Liked: 74
  • Neil TheElephant knee packed up carrying his trunk
Re: Impending Hoffa's Fat Pad Surgery
« Reply #12 on: April 21, 2017, 10:56:02 AM »
As this topic has recently been updated I can give you my own personal experiences with my fat pad issues. My 1st scope was done in November 2009 after experiencing anterior knee pain with with a pinching sensation. It looked like a cartilage tear that was not picked up on the MRI scan, fluid around the fat pad was picked up and had a cortisone injection into the fat pad region. Physio also was not successful, I opted for a diagnostic arthroscopy and had my fat pad trimmed and medial plica excision.

I had problems with excessive scar tissue build up and had to go through scope #2 in July 2014 to remove the scarring inside the knee. Anterior release surgery (AIR) was performed that made my knee even worse than it was pre-op. Now the MRI scan is showing problems with the fat pad with increase in joint effusion. It has had a negative effect on my patella tendon putting stain onto going through 3 cortisone injections in 2016 that made no difference to the pain and discomfort.

I now might need to have fat pad debridement surgery as the latest MRI scan shows that the fat pad is restricting movement inside the knee. My OS plays it safe using none surgical treatment options for nearly two years. The last option was a cortisone injection into my right hip that has impingement problems in the hope it will ease the knee pain. If this makes no difference my OS said he do scope #3 when I see him again in July for my next consultation.

It is a risk and gamble to have surgery on the fat pad as soft tissue problems can often lead to scarring problems post-op. Some patients can have the surgery and not have any problem post-op as they do not scar up excessively which causes long term problems leading to a chronic knee pain and discomfort rather than an acute knee condition.

[email protected]
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