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Author Topic: Bad Case of Fat Pad Impingement...  (Read 3728 times)

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Offline lilayZee

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Bad Case of Fat Pad Impingement...
« on: November 17, 2014, 03:20:17 AM »
Hey everyone,

This is a long story that has been spanning over the course of 6 months with little to no improvement. I have been on this site constantly looking for answers during my whole ordeal trying to learn as much as possible and I've finally decided to post my story on here hoping to get a reply from someone going through something similar to myself or just to put it out there if there is anyone else who is looking for answers and is going through the same thing as I am. I would love to hear from all you fellow geeks out there.

On May 13th this year i slipped in indoor soccer while turning and heard about 5 pops which ended up being a large bucket handle tear in my right knee which was first misdiagnosed as two small tears. I had a second MRI taken at the 13th week mark which showed it was a large bucket handle tear with floaters and i got told by my surgeon that it was obvious from the first MRI that it was a bucket handle tear. I lived in complete agony for 13 weeks before i had the partial meniscectomy, but i was to stubborn to get the surgery done as I'm a massive believer in the bodies own ability to heal itself. I eat extremely well, look after myself, very fit, and am a very spiritual and grounded person. During this time i could not stand, walk, or do anything really, i quit my job and was basically sitting down for 15 hours a day being cared constantly trying to let my body recover.

I'm from Adelaide, South Australia and had my partial meniscectomy done mid august by Dr Roger Paterson who is one of the better surgeons and got told i would be back to running within 4 weeks. After the surgery my OS told me he removed about 70% of my medial meniscus and that my fat pad just a bit swollen but besides that my knee looked perfect. So he said all my anterior knee pain was probably coming from the fat pad because the displaced piece of my meniscus was in a position where it was irritating it constantly. He said the fat pad would settle after a month or so and everything would be good. After the surgery my knee was extremely swollen and it took about 2-3 weeks for the swelling to go down. After the surgery i lost the pinchy feeling below my kneecap that i had been dying from for 3 months prior and was optimistic. But after my knee swelling started disappearing the pinch became more and more painful up to the point where its basically only the bottom of my kneecap that has swelling, i have a little residual swelling around elsewhere. I have no pain anywhere in my knee besides the pinch that never goes away, i wake up and its there and its there till i close my eyes at night. I also have on and off swelling in my calf and foot which is massive. My os says I've been hit with a very bad case of fat pad impingement but he was suprised because my fat pad was only slightly swollen when he did the scope. He doesnt believe i have scar tissue formation since its the exact same pain i had before the surgery and its so localised.

Since the surgery i still cant walk or do anything without pain. If i go for 10 minute walks around my block the pinch just slams me and I'm in 11/10 pain for days and it takes 2-3 weeks to settle so i had to stop all my walking all together. I was trying to do the physio exercises but it just did the same thing, any exercise i would do from shallow wall squats, glute bridges, leg raises just to name a few would get me in 11/10 pain for days. All i do is sit for 15 hours a day and have been essentially doing this for 5-6 months. I cant do anything because any slight activity i do puts me out for weeks, Ive been resting my knee completely for a month now not doing anything with it and its still not going away. im running out of options, Ive been doing acupuncture twice a week for 3 months, am perfect with my diet, using fat pad offloading with tape, tried hydrotherapy, cycling, walking, physio exercises, PEFT therapy, chiro, mobic, herbs, topical creams, foam rolling, stretching. I cant even pick up a book and read it or play my playstation because when i move my hands and hold something the pain in my knee worsens straight away too. So all i basically do is sit and watch tv. I am going to try cortisone at my next OS appointment in a few weeks but feel that is my last option before a revision surgery to trim the fat pad, which from the other threads doesnt sound like is a good idea due to the scar tissue formation. Because my right knee hasnt been functioning for 6 months now i've got pains in my left knee all time, tight muscles everywhere, tight itb's, neck and shoulder pain from overusing arms, sore back from sitting too much, achilles tendinopathy on my left leg, developing pressure sores from sitting down all day (have to sit on a roho wheel chair cushion at all times otherwise extremely painful), have bursitis under my sit bone. I'm only 24 years old and i was an extremely fit person playing indoor soccer for 2 comps and outdoor soccer and now i feel like im a living zombie not being able to do anything.

Has anyone had a case of fat pad impingement as serious as this. Has anyone gotten over a bad stint of fat pad impingement? I really feel like im the only person on the planet who has it this bad, ive read lots of forums and never come across anyone who is in pain like me.
May 2014 - Medial Meniscus Tear
August 2014 - Partial meniscectomy ~70% removal of medial meniscus

Offline Scubagrl4

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Re: Bad Case of Fat Pad Impingement...
« Reply #1 on: November 17, 2014, 05:22:43 AM »
Hi lilay,
I am so sorry to hear of your knee troubles. I do not have the exact problem that you do, but I did want to let you know that you are not alone in your frustration with a knee that won't behave. I too was very active before my knee injury 7 months ago, and I understand how hard this all is. I really hope that this cortisone injection works for you. Have you had another MRI since your surgery? If not, it sounds like it is about time you had some more testing done...especially to rule out arthrofibrosis and rsd. With the amount of pain you are having, it just sounds like you really need to know what is going on. If your doctor doesn't seem to want to find out what is going on, I would get a new doctor if I were you.
I hope you start feeling better soon. (((Hugs)))
4/14/14 L ACL rupture, grade 2+ MCL tear
6/6/14 ACLr allograft
9/4/14 MUA
10/6/14 LOA/AIR, synovectomy, lateral/medial retinacular release, partial lateral menisectomy, chondroplasty, deep tissue
biopsies.
11/20/14 insufflation, MUA
10/19/15: LOA/air, PLM, chondro, synovectomy, med/lat releases

Offline lilayZee

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Re: Bad Case of Fat Pad Impingement...
« Reply #2 on: November 20, 2014, 05:20:08 AM »
Thanks for the kind words. Am getting another MRI done to take into the next os appointment. os is pretty certain its just the fat pad because i had this exact same pain for months before the surgery and when he went in he said my knee was perfect besides the fat pad and meniscus. and the pain is no where near the meniscus area. just a never ending pinch right underneath my patella towards the bottom of it.
Sounds like you have had a tough last 7 months...hopefully you are getting some sort of improvement in your recovery.
May 2014 - Medial Meniscus Tear
August 2014 - Partial meniscectomy ~70% removal of medial meniscus

Offline Scubagrl4

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Re: Bad Case of Fat Pad Impingement...
« Reply #3 on: November 21, 2014, 01:44:34 AM »
Thank you lilay,
I hope so too, but it's too soon to tell at this point.
Keep us posted on your MRI results. I really hope it is something that can be fixed without more surgery.
4/14/14 L ACL rupture, grade 2+ MCL tear
6/6/14 ACLr allograft
9/4/14 MUA
10/6/14 LOA/AIR, synovectomy, lateral/medial retinacular release, partial lateral menisectomy, chondroplasty, deep tissue
biopsies.
11/20/14 insufflation, MUA
10/19/15: LOA/air, PLM, chondro, synovectomy, med/lat releases

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
Re: Bad Case of Fat Pad Impingement...
« Reply #4 on: November 27, 2014, 05:04:38 PM »
Hi Lilay,

Sorry for the late reply, after having read through what you have been through so far your knee problems sounds very much like how my knee was pre op before I having exploratory scope #1 four years ago in November 2009.

Pre op to scope #1 I was getting anterior knee pain with pain and swelling only at the bottom of my right knee and was also experiencing pinching and catching inside the knee. At 1st I thought it must be a torn cartilage and had an MRI done that surprisingly turned out to be clear with just signs of swelling and fluid around the fat pad.

I had a cortisone injection into the fat pad in the hope that it would reduce the pain and swelling as it was not just the catching and pain causing me problems I was not able to run due to the knee pain while trying to attempt to run. I also had the usual routine of PT and ultra sound therapy that made no difference! I had no option left in the end but to go for an exploratory scope.

My OS did pre warn me and even said are you sure you still want to go ahead still with the exploratory surgery when I signed the consent form as he may go inside my knee for nothing before going into theatre. I of course signed the consent from as I would do anything to stop the catching and being able to run again at a competitive level.

When my OS was looking inside my right knee he had to remove my medial plica that was large and inflamed and so was my fat pad that he trimmed and did not remove the fat pad completely. When I woke up despite the strong pain killers given could feel pain around the portals at the bottom of the kneecap.

It took 18 months till I was able to run again at a competitive rate and had to go to the pain clinic as I was still getting pain and swelling at the bottom of my kneecap and was given another cortisone injection into the medial portal that was the area that was most painful. Also had IMS dry needling done that did help for a while only!

I was ok again for a further 18 months and was running long distance again at a good rate and managed to run 9 miles in just under 1 hour. In was pre training to take part in my very 1st ever half marathon in March 2013 and had just joined a running club and was already one of the top club runners.

The good old British weather managed to ruin my training and hard work when I slipped on black ice in January 2013 while I was walking as running would have been irresponsible. I also slipped before I had exploratory scope #1 in October 2007 when I slipped over on an untied shoelace while I was running falling hard onto my right knee. I managed to do the same again falling onto my right knee with momentum. This was 6 weeks before the half marathon and was gutted when I had to pull out.

Since then all down hill and not been able to run again and went through PT and even had a Botox injections into tensor fascia lata as my OS thought it was my tightness around IT band causing PFS. Again was not really doing much and once again opted to have another exploratory scope #2.

This is when my OS did anterior interval release surgery and removed an excessive amount of scar tissue inside my right knee that was caused from scope #1 when the medial plica was removed and fat pad was trimmed! I had AIR surgery in July of this year and I am just over 4 months post op.

I hate sounding negative as I am only be honest! My right knee pain is worse now than it was pre-op with more intense pain and swelling at the bottom of my kneecap with the main pain and tightness around the medial portal. I am certain AF has returned again!

I apologies for such a long post hence the late reply as I have not had the time until now to give a reply back again. I hope what I have had to go through so far will give you a better understand towards 'Fat Pad Impingement' and 'AF' of the knee.

Good luck trying to get your knee sorted that is going to be a long stressful process to go through, you will have good and bad knee days, It is also ok and normal to get upset at times and feel frustrated. I am glad I have KG for moral support and guidance.

It is good to be able to share our own personal experiences and being able to help and guide one another through our ongoing knee problems!

[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 pelin

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Re: Bad Case of Fat Pad Impingement...
« Reply #5 on: December 08, 2019, 03:58:12 PM »
Hi Lilay,

I came across with your post in this forum and wanted to know what happened with your injury afterwards. This post is 5 years old and hope that you feel ok by now. Please update us with your news.

I am also having a fat pad impingement injury myself. Although mine is not as bad as yours but still affecting my life big time. Knowing that this will all go away one day will really cheer me up right now tbh.

Looking forward to your reply.

Thanks.

Pelin


-----------------------------------------------------------------------------------------------------------

Hey everyone,

This is a long story that has been spanning over the course of 6 months with little to no improvement. I have been on this site constantly looking for answers during my whole ordeal trying to learn as much as possible and I've finally decided to post my story on here hoping to get a reply from someone going through something similar to myself or just to put it out there if there is anyone else who is looking for answers and is going through the same thing as I am. I would love to hear from all you fellow geeks out there.

On May 13th this year i slipped in indoor soccer while turning and heard about 5 pops which ended up being a large bucket handle tear in my right knee which was first misdiagnosed as two small tears. I had a second MRI taken at the 13th week mark which showed it was a large bucket handle tear with floaters and i got told by my surgeon that it was obvious from the first MRI that it was a bucket handle tear. I lived in complete agony for 13 weeks before i had the partial meniscectomy, but i was to stubborn to get the surgery done as I'm a massive believer in the bodies own ability to heal itself. I eat extremely well, look after myself, very fit, and am a very spiritual and grounded person. During this time i could not stand, walk, or do anything really, i quit my job and was basically sitting down for 15 hours a day being cared constantly trying to let my body recover.

I'm from Adelaide, South Australia and had my partial meniscectomy done mid august by Dr Roger Paterson who is one of the better surgeons and got told i would be back to running within 4 weeks. After the surgery my OS told me he removed about 70% of my medial meniscus and that my fat pad just a bit swollen but besides that my knee looked perfect. So he said all my anterior knee pain was probably coming from the fat pad because the displaced piece of my meniscus was in a position where it was irritating it constantly. He said the fat pad would settle after a month or so and everything would be good. After the surgery my knee was extremely swollen and it took about 2-3 weeks for the swelling to go down. After the surgery i lost the pinchy feeling below my kneecap that i had been dying from for 3 months prior and was optimistic. But after my knee swelling started disappearing the pinch became more and more painful up to the point where its basically only the bottom of my kneecap that has swelling, i have a little residual swelling around elsewhere. I have no pain anywhere in my knee besides the pinch that never goes away, i wake up and its there and its there till i close my eyes at night. I also have on and off swelling in my calf and foot which is massive. My os says I've been hit with a very bad case of fat pad impingement but he was suprised because my fat pad was only slightly swollen when he did the scope. He doesnt believe i have scar tissue formation since its the exact same pain i had before the surgery and its so localised.

Since the surgery i still cant walk or do anything without pain. If i go for 10 minute walks around my block the pinch just slams me and I'm in 11/10 pain for days and it takes 2-3 weeks to settle so i had to stop all my walking all together. I was trying to do the physio exercises but it just did the same thing, any exercise i would do from shallow wall squats, glute bridges, leg raises just to name a few would get me in 11/10 pain for days. All i do is sit for 15 hours a day and have been essentially doing this for 5-6 months. I cant do anything because any slight activity i do puts me out for weeks, Ive been resting my knee completely for a month now not doing anything with it and its still not going away. im running out of options, Ive been doing acupuncture twice a week for 3 months, am perfect with my diet, using fat pad offloading with tape, tried hydrotherapy, cycling, walking, physio exercises, PEFT therapy, chiro, mobic, herbs, topical creams, foam rolling, stretching. I cant even pick up a book and read it or play my playstation because when i move my hands and hold something the pain in my knee worsens straight away too. So all i basically do is sit and watch tv. I am going to try cortisone at my next OS appointment in a few weeks but feel that is my last option before a revision surgery to trim the fat pad, which from the other threads doesnt sound like is a good idea due to the scar tissue formation. Because my right knee hasnt been functioning for 6 months now i've got pains in my left knee all time, tight muscles everywhere, tight itb's, neck and shoulder pain from overusing arms, sore back from sitting too much, achilles tendinopathy on my left leg, developing pressure sores from sitting down all day (have to sit on a roho wheel chair cushion at all times otherwise extremely painful), have bursitis under my sit bone. I'm only 24 years old and i was an extremely fit person playing indoor soccer for 2 comps and outdoor soccer and now i feel like im a living zombie not being able to do anything.

Has anyone had a case of fat pad impingement as serious as this. Has anyone gotten over a bad stint of fat pad impingement? I really feel like im the only person on the planet who has it this bad, ive read lots of forums and never come across anyone who is in pain like me.
Hey everyone,

This is a long story that has been spanning over the course of 6 months with little to no improvement. I have been on this site constantly looking for answers during my whole ordeal trying to learn as much as possible and I've finally decided to post my story on here hoping to get a reply from someone going through something similar to myself or just to put it out there if there is anyone else who is looking for answers and is going through the same thing as I am. I would love to hear from all you fellow geeks out there.

On May 13th this year i slipped in indoor soccer while turning and heard about 5 pops which ended up being a large bucket handle tear in my right knee which was first misdiagnosed as two small tears. I had a second MRI taken at the 13th week mark which showed it was a large bucket handle tear with floaters and i got told by my surgeon that it was obvious from the first MRI that it was a bucket handle tear. I lived in complete agony for 13 weeks before i had the partial meniscectomy, but i was to stubborn to get the surgery done as I'm a massive believer in the bodies own ability to heal itself. I eat extremely well, look after myself, very fit, and am a very spiritual and grounded person. During this time i could not stand, walk, or do anything really, i quit my job and was basically sitting down for 15 hours a day being cared constantly trying to let my body recover.

I'm from Adelaide, South Australia and had my partial meniscectomy done mid august by Dr Roger Paterson who is one of the better surgeons and got told i would be back to running within 4 weeks. After the surgery my OS told me he removed about 70% of my medial meniscus and that my fat pad just a bit swollen but besides that my knee looked perfect. So he said all my anterior knee pain was probably coming from the fat pad because the displaced piece of my meniscus was in a position where it was irritating it constantly. He said the fat pad would settle after a month or so and everything would be good. After the surgery my knee was extremely swollen and it took about 2-3 weeks for the swelling to go down. After the surgery i lost the pinchy feeling below my kneecap that i had been dying from for 3 months prior and was optimistic. But after my knee swelling started disappearing the pinch became more and more painful up to the point where its basically only the bottom of my kneecap that has swelling, i have a little residual swelling around elsewhere. I have no pain anywhere in my knee besides the pinch that never goes away, i wake up and its there and its there till i close my eyes at night. I also have on and off swelling in my calf and foot which is massive. My os says I've been hit with a very bad case of fat pad impingement but he was suprised because my fat pad was only slightly swollen when he did the scope. He doesnt believe i have scar tissue formation since its the exact same pain i had before the surgery and its so localised.

Since the surgery i still cant walk or do anything without pain. If i go for 10 minute walks around my block the pinch just slams me and I'm in 11/10 pain for days and it takes 2-3 weeks to settle so i had to stop all my walking all together. I was trying to do the physio exercises but it just did the same thing, any exercise i would do from shallow wall squats, glute bridges, leg raises just to name a few would get me in 11/10 pain for days. All i do is sit for 15 hours a day and have been essentially doing this for 5-6 months. I cant do anything because any slight activity i do puts me out for weeks, Ive been resting my knee completely for a month now not doing anything with it and its still not going away. im running out of options, Ive been doing acupuncture twice a week for 3 months, am perfect with my diet, using fat pad offloading with tape, tried hydrotherapy, cycling, walking, physio exercises, PEFT therapy, chiro, mobic, herbs, topical creams, foam rolling, stretching. I cant even pick up a book and read it or play my playstation because when i move my hands and hold something the pain in my knee worsens straight away too. So all i basically do is sit and watch tv. I am going to try cortisone at my next OS appointment in a few weeks but feel that is my last option before a revision surgery to trim the fat pad, which from the other threads doesnt sound like is a good idea due to the scar tissue formation. Because my right knee hasnt been functioning for 6 months now i've got pains in my left knee all time, tight muscles everywhere, tight itb's, neck and shoulder pain from overusing arms, sore back from sitting too much, achilles tendinopathy on my left leg, developing pressure sores from sitting down all day (have to sit on a roho wheel chair cushion at all times otherwise extremely painful), have bursitis under my sit bone. I'm only 24 years old and i was an extremely fit person playing indoor soccer for 2 comps and outdoor soccer and now i feel like im a living zombie not being able to do anything.

Has anyone had a case of fat pad impingement as serious as this. Has anyone gotten over a bad stint of fat pad impingement? I really feel like im the only person on the planet who has it this bad, ive read lots of forums and never come across anyone who is in pain like me.

Offline Robitgeern

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Re: Bad Case of Fat Pad Impingement...
« Reply #6 on: June 11, 2020, 11:29:30 AM »
Thanks for the info

Offline plant

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Re: Bad Case of Fat Pad Impingement...
« Reply #7 on: June 13, 2020, 02:31:57 PM »
Hi lilayZee/ Pelin
I also have this issue - did anyone get surgery in the end? I had it 3 months ago and am still very much in the healing phase. Just looking to see if anyone has had a similar experience!