Infrapatellar fat pad syndrome, also called Hoffa’s disease, is an injury to the fatty cushioning tissue deep to the patellar tendon and below the patella (kneecap). Injury or repetitive trauma can cause this tissue to become impinged, trapped, or caught between structures in the knee.
The fat pad normally helps protect the deeper joint surfaces during kneeling and other direct pressure.
What Is Infrapatellar Fat Pad Syndrome?
Infrapatellar fat pad syndrome occurs when the fat pad beneath the kneecap becomes injured and catches or pinches between the patella and femur (thigh bone), or between the femur and tibia (leg bone).
The condition may result from a direct knee injury or repeated trauma during activities that require extreme bending or straightening of the knee.
Causes and Risk Factors
Infrapatellar fat pad syndrome can result from:
- A direct injury to the knee
- Repeated injury to the fat pad
- Activities that require maximal bending or straightening of the knee
Risk factors include:
- Sports that require repeated, forceful straightening or bending of the knee, such as kicking or jumping
- Repeated knee injuries
- Sports in which the knee may receive a direct injury, including volleyball, soccer, and football
- Activities that require prolonged kneeling
Symptoms
Common signs and symptoms include:
- Pain behind the kneecap that worsens with physical activity or when completely straightening the knee
- Occasional knee swelling
- Occasional tenderness and swelling on either side of the patellar tendon
Treatment
Initial treatment consists of medications and ice to relieve pain and reduce inflammation, stretching and strengthening exercises, and modifying the activity that causes symptoms.
Referral to a physical therapist or athletic trainer may be recommended. Occasionally, Dr. Chudik may recommend a corticosteroid injection to address inflamed tissue that is repeatedly becoming caught.
Surgery is generally reserved for cases in which symptoms continue despite conservative treatment. Surgery is usually performed arthroscopically to remove inflamed or chronically scarred fat tissue.
Recovery and Outcomes
Physical therapy and, in some cases, a corticosteroid injection can result in a full recovery. Some cases require arthroscopic surgery.
Recovery usually takes six to 12 weeks.
Potential complications include:
- Recurrence of symptoms, resulting in chronically inflamed tissue and potentially a chronic problem
- Disability severe enough to reduce an athlete’s competitive ability
- Delayed healing or resolution of symptoms, particularly if activity is resumed too soon
- Risks of surgery, including infection, injury to small nerves resulting in numbness or sensitivity, continued pain, and continued pinching of the fat pad
When to See Dr. Chudik
If you are concerned about infrapatellar fat pad syndrome or your symptoms worsen, schedule an evaluation with Dr. Chudik.
Call 630-324-0402, request an appointment online, or email contactus@chudikmd.com.