Fat Pad Impingement

Posted by Pete on October 19, 2009 in Self diagnosis | 0 comments

The infrapatellar fat pad (Hoffa’s pad) is located beneath the patella (kneecap) and on top of the femoral condyle (far end of thigh bone) .  It functions as a shock absorber to withstand direct impacts to the patella.  The fat pad can become impinged between the patella and femoral condyle due to repetitive direct impact to the kneecap.   The fat pad has many nerve endings and therefore impingement causes significant pain.  The fat pad is squeezed when the knee is extended (straightend) and is therefore liable to persistant irritation causing further inflammation and pain.  Individuals with knee hyperextension (genu recurvatum) are more susceptible to this condition.

Fat Pad Impingement Symptoms

• Swelling and or pain at the bottom of the kneecap
• Pain aggravated by extending (straightening) the knee
• Bottom of the kneecap may project outwards due to swelliing

What you can do

• Rest and avoidance of activities that aggravate the pain
• Cold therapy to alleviate inflammation

What we can do

• Confirm diagnosis using Hoffa’s test.  Patient lies down with the knee bent, examiner places thumbs just below kneecap on each side of patella ligament.  Positive test =  pain or and apprehension is illicited as patient attempts to straighten leg
• Prescritpion of muscle strengthening programme to improve function of supporting muscle groups
• Referral for surgery for complete or partial removal of the fat pad itself should conservative treatment fail