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Infrapatellar fat pad impingement, also referred to as Hoffa’s Syndrome, is a common knee injury that causes anterior knee pain. Trauma or gradual wear and tear can cause the fat pad to become damaged causing discomfort. This can restrict the range of movement of the knee joint and cause pain to be intensified during or after any activity.

Anyone can be affected by infrapatellar impingement, but those who take part in sport or vigorous activities are more likely to suffer damage to the knee.

Symptoms of Infrapatellar Fat Pad Impingement

The condition is often misdiagnosed as patella tendonitis and patella femoral pain syndrome due to its position in the knee; however, there are a number of symptoms unique to the injury, which can help provide an accurate diagnosis. These include:

  • Swelling of the infrapatellar
  • Tender to the touch
  • Pain relief when the patella inferior pole is lifted off the fat pad

Your GP will carry out a test to diagnose infrapatellar fat pad impingement that involves examining the infrapatellar while contracting the quadricep muscle. If this causes you pain, the other conditions can be ruled out. To confirm a diagnosis, you will likely be sent for an X-ray, a magnetic resonance imaging (MRI) scan or a tissue biopsy.

Treatment

Once a full diagnosis has been made, the condition is quite straightforward to treat. Firstly, the swelling and inflammation must be dealt with by resting and applying an ice pack or ice wrapped in a towel on the affected knee for 15 to 20 minutes three to four times a day. Anti-inflammatory medication or a steroid injection may also be used, depending on your individual circumstances.

As the swelling goes down treatment becomes more about managing the joint by combining treatments such as strengthening exercises, flexibility training, cryotherapy and taping.

If non-invasive treatments don’t help recovery, surgery may be your only option. This will involve full or partial removal of the fat pad through arthroscopy. Most patients recover within six weeks of surgery.

Preventing further injury

There are a number of methods that can be used to prevent infrapatellar fat pad knee impingement from occurring again, including:

  • Stretching properly before and after exercising
  • Practising exercises to strengthen the muscles
  • Using knee padding and other protective gear
  • Taking a break from activities
  • Returning to activity gradually
  • Avoiding high heels

If symptoms persist, you should make an appointment with your GP.

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