Fat Pad Syndrome ???.. Healing Time ???

Adhesions, internal scarring, fat pad syndrome, infrapatellar contracture, patella infera (baja)
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ecote
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Fat Pad Syndrome ???.. Healing Time ???

Post by ecote »

Hi,

I have been jumping from physiotherapist to doctor to sports doctors about this knee problem of mine. I have an appointment with an OS next week and would like some more information before I go in.

I am convinced my fat pad is "broken". My last physio was able to pinch under my patellar tendon (hoffa test) and it would produce some serious pain. In addition, standing for extended periods of time seems to make it worse, as does sitting and driving my standard car. My bad knee is a little "puffy" for lack of a better term and there/was is also some crepitus under my knee cap. Of course, my patella is tilted on the x-ray and on the MRI.

Previous MD's have all said patella femoral syndrome and my MRI report says chronodomalacia grade I. But did NOT say anything about the fat pad (maybe they didn't ask for that to be looked at??) They did not want to send me to a surgeon, but I insisted and made it happen, not because I want surgery, but because I want answers and options.

Here's the thing.. I have sneaking suspicion that 2 summers ago I walked into a concrete flower post while vacationing in Europe (alcohol was involved). I can't be sure.. but I think it was my L-knee that was banged up right under the knee cap and I remember having trouble walking for 2 wks after.

I'm continuing to work on physiotherapy exercises.. about 30-60 min day (while watching TV).. I think I am making some improvements there. I am/was running 15-20 min each 2nd day and swimming ~4 times week (I am an ex-varsity track/XC athlete). Is there anything else I can do.. I've already tried doing "nothing" (except swim) for 10 weeks, and that did absolutely nothing to help my cause. Should I give up, watch TV, play video games and spend my life on the couch for 6 months, 1 year, 2 years !?? until this clears up and try to get back to living??? Or do I try to be active, ie. bend down, do home renovations, play with kids, etc. and then dose up on Advil (or other) all week long while at work to be able to get the pain away in order to concentrate!?? What about a cortisone injection, or a knee brace ???

Thanks for the advice, I really do appreciate it, and I certainly sympathize that some of you are WAY worse off that I am.

All the best,

Ed
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Re: Fat Pad Syndrome ???.. Healing Time ???

Post by aliasgrace26 »

Hi, Ed,
Any progress with the fat pad healing?
I am experiencing a multitude of knee issues again (after an old injury), and both my PT and the PA who recently gave me a course of Hyalgan injections (and a cortisone shot a couple of weeks ago) recognize inflammation/swelling in the fat pad. My PA said, 'It's a very real condition and can cause a great deal of pain', but didn't offer much in the way of advice...I am following up with my OS in July, so I hope to get more info. out of him.

Let me know if you received any answers!

-Tiffany
Tibigal platea fx. 12/98
Subsequent poor medical care that did not detect fx. immediately
Rigorous PT once fx. was diagnosed
Arthroscopy in 11/99 to trim plica and remove scar tissue
Chronic pain for 5 years, then a reprieve for 3
Return of pain/stiffness 2/07, in pain mgt., awaiting answers
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Re: Fat Pad Syndrome ???.. Healing Time ???

Post by eab84 »

I've been having crepitus and diagnosed with PFS and possible fat pad impingement. I work on my feet most of the day and this tends to cause much stiffness and uncomfortable feelings of fullness, heat and some swelling in my knees. I recently began patella taping which seemed to help get rid of the "fullness feeling" but still have very tender feeling especially in the inferior/lateral portion near my patella. Just frustrated at how long my symptoms have persisted and want to get back to running, biking just normal activities w/o pain. Seeing a PT have seen numerous OS's and am open to any suggestions. Does anyone know how long of recovery this is. Also, is it okay to cycle and swim and walk because my knees seem to heat up and swell some even when i'm standing around. Just looking for thoughts. Thanks

Eric
BGM
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Re: Fat Pad Syndrome ???.. Healing Time ???

Post by BGM »

ecote wrote: Hi,

I have been jumping from physiotherapist to doctor to sports doctors about this knee problem of mine. I have an appointment with an OS next week and would like some more information before I go in.

I am convinced my fat pad is "broken". My last physio was able to pinch under my patellar tendon (hoffa test) and it would produce some serious pain. In addition, standing for extended periods of time seems to make it worse, as does sitting and driving my standard car. My bad knee is a little "puffy" for lack of a better term and there/was is also some crepitus under my knee cap. Of course, my patella is tilted on the x-ray and on the MRI.

Previous MD's have all said patella femoral syndrome and my MRI report says chronodomalacia grade I. But did NOT say anything about the fat pad (maybe they didn't ask for that to be looked at??) They did not want to send me to a surgeon, but I insisted and made it happen, not because I want surgery, but because I want answers and options.

Here's the thing.. I have sneaking suspicion that 2 summers ago I walked into a concrete flower post while vacationing in Europe (alcohol was involved). I can't be sure.. but I think it was my L-knee that was banged up right under the knee cap and I remember having trouble walking for 2 wks after.

I'm continuing to work on physiotherapy exercises.. about 30-60 min day (while watching TV).. I think I am making some improvements there. I am/was running 15-20 min each 2nd day and swimming ~4 times week (I am an ex-varsity track/XC athlete). Is there anything else I can do.. I've already tried doing "nothing" (except swim) for 10 weeks, and that did absolutely nothing to help my cause. Should I give up, watch TV, play video games and spend my life on the couch for 6 months, 1 year, 2 years !?? until this clears up and try to get back to living??? Or do I try to be active, ie. bend down, do home renovations, play with kids, etc. and then dose up on Advil (or other) all week long while at work to be able to get the pain away in order to concentrate!?? What about a cortisone injection, or a knee brace ???

Thanks for the advice, I really do appreciate it, and I certainly sympathize that some of you are WAY worse off that I am.

All the best,

Ed
I currently have the fat pad issue as well though mine is a result of a knee scope in December. The OS said my knee is in pristine shape (had Plica removed) but the fat pad can get irritated from the scope. I tried cold laser, therapy and ultra sound and I think he now wants to just scope it again and find out for sure. As far as a cortisone injection--the experts I have talked to said that is very dangerous since it's right next to the ligament.
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Re: Fat Pad Syndrome ???.. Healing Time ???

Post by helsbels »

hi bgm, i am in a similar situation to you. i had scope in 05 and has been swollen n very bad since and my latest mri san shows my fat pad is hypersensitive but they didnt say any more than that. i can not put weight on the leg at all so i am unable to walk without 2 crutches. ive had physio for bout 3 yrs, steriod injections also and am now having hydrotherapy which i dont see any difference apart from it hurts a hell of a lot. ive had 5 mri's the last being with dye and i keep getting told the knee is normal. i was told my results today by my physio who said all normal apart from fat pad is swollen and is hypersensitive but that was all that was said and i dont see my os til jan30th. what has happened wiv your knee since u were told it was a fat pad issue. i am very confused now as to what is going to happen or if anything can be done. i was told prior to my mri by my os if it is normal then theres nothing that can be done and i gota live wiv it. how can i live wiv it im 25yrs old and cannot walk!

regards helen xx
fell on knee aug 04
op jul 05 + physio
4 mri's between 05 + 07
5 steroid inj between 05 + 06
mri arthrogram 19th nov 07 - normal
3rd opinion os appt -aprl 11th 08
op jun 09
os discharged me aug 09!
physio 09-present
pain doc sendin me to pain management course-if get into it '2010
STILL CANT WALK!!!
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