Hoffa's test

What does the Hoffa fat pad do?

The infrapatellar or Hoffa fat pad acts as a flexible cushion within the knee joint inside the capsule where it cushions the important structures of the front of the knee.

It contains blood vessels and nerves and is covered by the same layer of cells (synovium) that lines the rest of the capsule and which provides lubrication for the joint. It is intimately related anatomically to the ligamentum mucosum (infrapatellar plica).

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How to perform Hoffa's Test

With the patient lying on the couch, and the examiner standing by the patient's knee, the examiner takes up the bent knee, pressing the thumbs of both hands deeply along the sides of the patellar tendon just below the patella.

The patient is then instructed to straighten the leg. If there is inflammation of the fat pad, this causes pain in the fat pad region.

See YouTube video of a patient performing the Hoffa's test on themself.

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What is the fat pad syndrome?

The fat pad syndrome is irritation or inflammation of the fat pad, giving rise to pain in the front of the knee.

If the fat pad is swollen, part of it may impinge between the bones and lead to sudden acute pain. This may be reproducible during the Hoffa test.

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Other relevant links

Anterior interval, Anterior knee pain, Synovium, Capsule, Ligamentum mucosum, Hoffa's syndrome, Impingement

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Forum discussions

• Fat Pad Syndrome ???.. Healing Time ??? - Patients struggle for clarification regarding fat pad pain.

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