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Author Topic: Synovial or Hoffas fat pad?  (Read 326 times)

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Offline James NZ

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Synovial or Hoffas fat pad?
« on: June 04, 2018, 06:09:59 PM »
Are the synovial and hoffas fat pad different things or the same thing?

Offline Vickster

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Re: Synovial or Hoffas fat pad?
« Reply #1 on: June 04, 2018, 06:42:07 PM »
Different. Synovium is lining of joint, fat pad below kneecap

Anatomy of knee explained here

http://www.kneeguru.co.uk/KNEEnotes/primers/knee-anatomy

Chapter on fat pad in here

http://www.kneeguru.co.uk/KNEEnotes/primers/patella
« Last Edit: June 04, 2018, 06:50:15 PM by Vickster »
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
More tears and wear, scope planned in Jan 2019 to tidy up

Offline Clarkey

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Re: Synovial or Hoffas fat pad?
« Reply #2 on: June 04, 2018, 09:54:05 PM »
Your post has brought back memories when my fat pad impingement problems were at the early stages before it worsened over a period of 3 years that lead to my scope #1 of trimming of the fat pad and medial plica excision in November 2009. It might have made it worse rather than making it better, will never know?

Hoffa's fat pad herniation is defined as herniation of infrapatellar fat through a defect in the lateral retinaculum. It is an uncommon cause of an anterolateral knee mass often detected at the fully flexed knee 1.


https://radiopaedia.org/articles/hoffas-fat-pad-herniation

My post from February 2006 after my very 1st MRI scan was taken in 2003, when my right anterior knee pain started. At the time seemed like the radiologist was eager to give a diagnoses of 'Anterior herniation of synovium into Hoffas fat'

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

         
         No worries
                        But i thought i should add, that ive heard it often said, that one of the main functions of the synovial fluid is that it acts as a lubricant in the joint,and when you have been inactive for a while due to an injurey, it thickens up making joint movement seem more stiff, or so i heard. The idea that it's encapsulation in the synoviam has a function of providing the joint line with a kind of dynamic suspension, is somthing of a creative leap on my part. But in my case it would explain alot about why my knee feels like there is no 'give' in the sense that when i walk it feels like my good leg is walking on grass while the bad leg is walking on concreat, if that makes any sense. So questions to ask are like, is it possible for the synovium to bleed synovial fluid, and is this herniation into the hoffas an example of synovial bleeding. Can the synovium heal itself, and what are the degenerative consequences of not having a properly functioning synovium< or indeed synovectomy >.... again just some ideas, but ive found that asking questions has to be positive and really the best way to learn about ones problem and i hope that would be welcomed by members of the proffession... very sadly thats not always the case.. Personally im just fascinated by it all :P

Above is a good explanation of synovial fluid and herniation of the fat pad.

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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 James NZ

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Re: Synovial or Hoffas fat pad?
« Reply #3 on: June 07, 2018, 08:28:31 PM »
Thanks vickster, would you recommend the fat pad excision?

Offline James NZ

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Re: Synovial or Hoffas fat pad?
« Reply #4 on: June 07, 2018, 08:29:59 PM »
Clarkey how r u recovering from your latest ok?

Offline Clarkey

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Re: Synovial or Hoffas fat pad?
« Reply #5 on: June 09, 2018, 08:12:30 PM »
Clarkey how r u recovering from your latest ok?

Hi James,

Still early days to say if my 3rd surgery has worked or not, I am only coming up to 5 months post-op. So far knee is feeling good compared to scope 1 and 2 as I not aggravated the knee this time round took it slow and easy with my physio exercises increasing it gradually making sure I do not overdo it. Would say my knee is about the same as it was pre-op to scope #3 walking the same distances at same pace again. At least I am not worse off trying all the available options with surgery as the last option after 14 months of conservative methods of treatment options without any success for the anterior knee pain. 

Would still be weary and cautious having a fat pad excision not worth the risk being so close to the nerves and patella tendon you are asking for trouble. Most OS would avoid fat pad excision, too risky ending in a failure. If the fat pad is badly impinging would trim the fat pad rather than removing it completely. This can lead to scar tissue build up, have had to go through anterior interval release surgery twice during scope 2 and 3.

[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