Effects on patellar chondromalacia of the size of the infrapatellar fat pad

Infrapatellar fat tissue (IPFP), which is placed in the anterior compartment, has a vital role in the biomechanics of knee. It is thought that infrapatellar fat pad, which also functions as a storage for repair cells after injury, has a protective effect in mechanical and inflammatory knee pain. In this study, the relationship between patellar chondromalacia, which is among significant causes of anterior knee pain, and the sizes of IPFP was investigated. MRI images of patients over 18 years of age, who underwent MRI examination in June 2017 - December 2017, were examined retrospectively by recovering from the electronic patient registration system in the hospital. Eighty-three cases had patellar chondromalacia with normal-healthy IPFP tissue in the examination of knee MRI, and 53 cases without chondromalacia were included in the study. The average age of all evaluated 134 patients was 37.8 (22-68) years. The degree of chondromalacia patella was made according to Outerbridge classification. The height and depths of IPFP in all cases were measured from the widest site on the T1-weighted MRI images in the sagittal plane. The relationship among age, gender, the degree of patellar chondromalacia and IPFP sizes were evaluated. While the average of 51 patients without patellar chondromalacia was 29.04 (22-51) years, the average of 83 patients with chondromalacia was 43.20 (27-68) years. According to Outerbridge classification, patellar chondromalacia grade 3 in 14 patients, grade 2 in 41 patients, grade 1 in 26 patients and grade 4 in 2 patients were observed. It was not seen a significant difference between the groups in terms of gender (p = 0.78). It was seen a significant increase in between patellar chondromalacia and increasing age (p

PDF

___

Clockaerts S, Bastiaansen-Jenniskens YM, Runhaar J, et al. The infrapatellar fat pad should be considered as an active osteoarthritic joint tissue: a narrative review. Osteoarthritis Cartilage. 2010;18:876-82.

Dragoo JL, Johnson C, McConnell J. Evaluation and treatment of disorders of the infrapatellar fat pad. Sports Med. 2012;42:51-67.

Gallagher J, Tierney P, Murray P, et al. The infrapatellar fat pad : anatomy and clinical correlations. Knee Surg Sports Traumatol Arthrosc. 2005;13:268-72

Habusta SF, Griffin EE. Chondromalacia Patella. In:StatPearls. Internet. Treasure Island (FL): StatPearls Publishing; 2018.

Salehi-Abari I, Khazaeli S, Niksirat A. Chondromalacia patella and new diagnostic criteria. Open Sci J Clin Med. 2015;3:126-8.

Draghi F, Ferrozzi G, Urciuoli L, et al. Hoffa’s fat pad abnormalities, knee pain and magnetic resonance imaging in daily practice. Insights Imaging. 2016;7:373-83.

Outerbridge RE. The etiology of chondromalacia patellae. 1961.Clin Orthop Relat Res. 2001;389:5-8.

Hinman RS, Crossley KM. Patellofemoral joint osteoarthritis: an important subgroup of knee osteoarthritis. Rheumatology (Oxford). 2007;46:1057-62.

Loeser RF. Aging and osteoarthritis. Curr Opin Rheumatol. 2011;23:492-6.

Hunter DJ, Spector TD. The role of bone metabolism in osteoarthritis. Curr Rheumatol Rep. 2003;5:15-9.

Hinman RS, Lentzos J, Vicenzino B, et al. Is patellofemoral osteoarthritis common in middle-aged people with chronic patellofemoral pain? Arthritis Care Res. 2014;66:1252-7.

Cowan SM, Hart HF, Warden SJ, et al. Infrapatellar fat pad volume is greater in individuals with patellofemoral joint osteoarthritis and associated with pain. Rheumatol Int. 2015;35:1439-42.

Kohn D, Deiler S, Rudert M. Arteria blond supply of the infrapatellar fat pad. Anatomy and clinical consequences. Arch Orthop Trauma Surg. 1995;114:725.

Pan F, Han W, Wang X, et al. A longitudinal study of the association between infrapatellar fat pad maximal area and changes in knee symptoms and structure in older adults. Ann Rheum Dis. 2015;74:1818-24.

Ioan-Facsinay A, Kloppenburg M. An emerging player in knee osteoarthritis: the infrapatellar fat pad. Arthritis Res Ther. 2013;15:225.

Han W, Cai S, Liu Z, Jin X, Wang X, Antony B, et al. Infrapatellar fat pad in the knee: is local fat good or bad for knee osteoarthritis? Arthritis Res Ther. 2014;16:145.

Saddık D, McNally EG, Richardson M. MRI of Hoffa’s fat pad. Skeletal Radiol. 2004;33:433-44.

Culvenor AG, Cook JL, Warden SJ, Crossley KM. Infrapatellar fat pad size, but not patellar alignment, is associated with patellar tendinopathy. Scand J Med Sci Sports. 2011;21:405-11.

Kumar D, Alvand A, Beacon JP. Impingement of infrapatellar fat pad (Hoffa’s disease): results of high-portal arthroscopic resection. Arthroscopy. 2007;23:1180,1186.e1

Favero M, El-Hadi H, Belluzzi E, Granzotto M, Porzionato A, Sarasin G, et al. Infrapatellar fat pad features in osteoarthritis: a histopathological and molecular study. Rheumatology (Oxford). 2017;56:1784-93.

Klein-Wieringa IR, Kloppenburg M, Bastiaansen-Jenniskens YM, Yusuf E, Kwekkeboom JC, El-Bannoudi H, et al. The infrapatellar fat pad of patients with osteoarthritis has an inflammatory phenotype. Ann Rheum Dis. 2011;70:851-70.

Gierman LM, Wopereis S, van El B, Verheij ER, Werff-van der Vat BJ, Bastiaansen-Jenniskens YM, Metabolic profiling reveals differences in concentrations of oxylipins and fatty acids secreted by the infrapatellar fat pad of end-stage osteoarthritis and normal donors. Arthritis Rheum. 2013;65:2606-14.

Bennell K, Hodges P, Mellor R, Bexander C, Souvlis T. The nature of anterior knee pain following injection of hypertonic saline into the infrapatellar fat pad. J Orthop Res. 2004;22:116-21.

Ballegaard C, Riis RG, Bliddal H, Christensen R, Henriksen M, Bartels EM, et al. Knee pain and inflammation in the infrapatellar fat pad estimated by conventional and dynamic contrast-enhanced magnetic resonance imaging in obese patients with osteoarthritis: a cross-sectional study. Osteoarthritis Cartilage. 2014;22:933-40.

Paduszyński W, Jeśkiewicz M, Uchański P, Gackowski S, Radkowski M, Demkow U. Hoffa’s Fat Pad Abnormality in the Development of Knee Osteoarthritis. Adv Exp Med Biol. 2018;1039:95-102.