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Author Topic: Hoffa's Pad  (Read 1883 times)

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Offline stateofplay

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Hoffa's Pad
« on: October 08, 2012, 09:21:16 PM »
Hi,

My name is Mark, and I am new to this forum.

I found this forum when I was searching google for information on a fat pad impingement.

I have been in quite a lot of pain with my right knee for over a year, and haven't been able to do any running in that same period. I switched to swimming for a while, but even that started to hurt, and got worse and worse. I was pushing it a bit, swimming for 1 mile every morning before work.

But I was getting Physio, and was informed thart swimming would really help, as would cycling and walking. However, the pain just got more intense until about 4 months ago it was waking me up in the middle of the night.

I was able to get a referral through my private medical, and the first thing they did was an MRi. The result showed a lot of fluid in the knee, but nothing damaged or broken. The specialist consultant diagnosed a fat pad impingement. I had never heard of it, so I searched google, and here I am.

I have had a cortisone injection into the fat pad, and I have stopped all forms of exercise to allow plenty of rest for the knee. However, this hasnt worked as I thought it would, the pain is still as bad, and after reading on here and other sites, I now know that every time I straighten my leg or walk on it, I am rubbing against the inflamed fat pad.

Apart from icing the knee, taking anti inflammatory tablets, and wearing a knee brace, is there any other way to repair this damage that doesn't involve surgery?

Thanks

Mark.

Offline joanfan123

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Re: Hoffa's Pad
« Reply #1 on: October 09, 2012, 02:26:27 AM »
If the cortisone injection in to the knee didn't work then you might want to investigate other causes. The only way to definitively diagnose fat pad impingement is through a scope. And if the injection did not help there's a good chance that is not what is going on. 
May '10- PT LK
June '11- PT LK
October '11- Cortisone LK
11/8/11- Arthroscope Fat Pad trimmed LK

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
Re: Hoffa's Pad
« Reply #2 on: October 09, 2012, 05:16:13 PM »
Hi Mark,

I was in a similar situation that you are in at the moment and have copied and pasted some of my old posts that you may like to read. I ended up with an exploratory scope in November 2009 and had an inflamed fat pad and enlarged plica. The fat pad was trimmed and my medial plica was removed that did stop the catching on the lateral side of my right knee.

I now having scar tissue problems from the surgery as medial plica excision is fairy invasive and can cause a lot of scar tissue build up.

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=24287.0

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=45351.0

Good luck.

[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

Offline stateofplay

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Re: Hoffa's Pad
« Reply #3 on: October 09, 2012, 06:48:25 PM »
Thank you for your replies.

I am getting treatment from a knee specialist at Pinehill Hospital in Hitchin.

He told me it would take 6 to 8 weeks after the cortisone injection to clear up.

I am now at that point, so will have to make another appointment.

He said it is difficult to do the scope, as soon as you go in, you have to try and look back, which he says is difficult.

He is hopeful that rest and Ibuprofen will negate the need for a scope.

I have bought some tape, looking at taping for a week to see if that helps.

Nick, thanks for the links to your previous threads, I see you have been suffering for a number of years. I do feel for you. 

If there was one bit of advice you would give me, bearing in mind all of your hands on experience, what would it be?

Offline joanfan123

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Re: Hoffa's Pad
« Reply #4 on: October 10, 2012, 01:56:25 AM »
A scope is a fairly simple procedure, so if an OS says they are difficult to do you might want to switch OSs, but again I don't think one would help you. You should defiantly try rest and ibuprofen before anything else, I am surprised that wasn't the very first thing you were told to do.
May '10- PT LK
June '11- PT LK
October '11- Cortisone LK
11/8/11- Arthroscope Fat Pad trimmed LK

Offline stateofplay

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Re: Hoffa's Pad
« Reply #5 on: October 10, 2012, 07:10:52 AM »
I have been suffering from this for over a year. My regular doctor advised me to go to Physio, which I did for several months, until it actually got worse.

I went back to the GP, who then suggested more Physio, rest, and anti inflammatory tablets.

So I eventually managed to get a referral through my Private Medical, and the knee specialist did an MRi first. Then I went back for the results, he said it was an unusual case as there is nothing showing as being wrong, but there is an awful lot of fluid in the knee, and it is visibly inflamed.

He did a cortsione injection there and then.

He said the scope is difficult because the area he wants to look at is right at the front of the knee, so he doesn't have a lot of room to move the scope around to see what is going on.

I am told he is good, he was recommended to me.

Offline stateofplay

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Re: Hoffa's Pad
« Reply #6 on: October 12, 2012, 08:05:36 PM »
Day 2 of taping, my wife has watched Youtube and has then transferred this learning to my knee.

Firstly, she enjoyed shaving my knee! Although she said she would rather have used an epilator.  :o

On goes the fixing tape, and then zinc oxide tape to lift the kneecap up away from the fatpad. Idea being to let the fatpad recover without irritating it when I straighten my leg.

I have to say, I rather laughed at her suggestion when she first mentioned it, but after 2 days I am starting to feel the benefit.

Fingers crossed. Or shoudl I say, knees nobbled?















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