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What is Hoffa’s Fat Pad Syndrome?

Hoffa’s fat pad syndrome also called fat pad impingement, infrapatellar fat pad syndrome, and Hoffa's disease, is a condition characterized by anterior knee pain, pain in the center, and front of your knees, due to inflammation of the Hoffa’s fat pad.

Hoffa’s fat pad is one of three pads of fatty tissue present under the patella (kneecap). It acts as a protective layer that separates the patella from the thigh and shin bones. If Hoffa’s fat pad is compressed or injured, it swells leading to inflammation and soreness. It also tends to increase in size leading to further pinching.  As this continues, pain develops in the front of the knee which is difficult to treat.

What are the Causes of Hoffa’s Fat Pad Syndrome?

The common causes of Hoffa’s fat pad syndrome include:

  • Chronic knee osteoarthritis
  • Sudden injury, such as a direct hit to the knee
  • Tight quadricep muscles
  • Hyperextension or over-straightening the knee

Hoffa’s fat pad syndrome develops gradually if the knee is repeatedly extended beyond its fully straightened normal position.

What are the Signs and Symptoms of Hoffa’s Fat Pad Syndrome?

The common signs and symptoms of Hoffa’s fat pad syndrome include pain at the front and side of the knee. The other symptoms include:

  • Pain when straightening the knee
  • Pain with prolonged walking
  • Pain during climbing the stairs and sitting with the knee bent
  • Swelling below and around the knee
  • Occasional jolts of sharp pain

How is Hoffa’s Fat Pad Syndrome Diagnosed?

You must visit an orthopedic specialist, a sports medicine specialist, or a physiotherapist to get yourself checked. Your symptoms will be examined, and your medical records will be reviewed.

You need to undergo a Hoffa’s test. For this test, you will lie on your back and bend your knees. Then, you will slowly straighten your leg while your therapist/doctor presses your patella and contracts the quadriceps muscles in order to locate your pain.

What are the Treatment Options for Hoffa’s Fat Pad Syndrome?

Treatment for Hoffa’s fat pad syndrome involves reducing inflammation and controlling nerve pinching in your knees.

First line of treatment involves rest and medications. Other conservative treatments include taping the knee, performing strengthening exercises, and anti-inflammatory injections.

The anti-inflammatory injections soothe inflammation and help to shrink the Hoffa’s fat pad.

In rare cases, a minor surgery may be performed to remove a portion of the inflamed Hoffa’s fat pad.

  • American Academy of Orthopaedic Surgeons
  • American Association of Hip and Knee Surgeons
  • International Congress for Joint Reconstruction
  • American Society for Surgery of the Hand
  • Orthopaedic Trauma Association