Skip to main content
SpringerLink
Log in

The infrapatellar fat pad: anatomy and clinical correlations

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

This study examined the anatomy of the infrapatellar fat pad (IFP) in relation to knee pathology and surgical approaches. Eight embalmed knees were dissected via semicircular parapatellar incisions and each IFP was examined. Their volume, shape and constituent features were recorded. They were found in all knees and were constant in shape, consisting of a central body with medial and lateral extensions. The ligamentum mucosum was found inferior to the central body in all eight knees, while a fat tag was located superior to the central body in seven cases. Two clefts were consistently found on the posterior aspect of the IFP, a horizontal cleft below the ligamentum mucosum in six knees and a vertical cleft above, in seven cases. Our study found that the IFP is a constant structure in the knee joint, which may play a number of roles in knee joint function and pathology. Its significance in knee surgery is discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Apostolaki E, Cassar-Pullicino VN, Tyrrell PN, McCall IW (1999) MRI appearances of the infrapatellar fat pad in occult traumatic patellar dislocation. Clin Radiol 54(11):743–747

    Google Scholar 

  2. Basadonna PT, Rucco V, Gasparini D, Onorato A (1999) Plantar fat pad atrophy after corticosteroid injection for an interdigital neuroma: a case report. Am J Phys Med Rehabil 78(3):283–285

    Google Scholar 

  3. Bendetto KP, Klima G (1986) Effect of the Hoffa fat pad on revascularization of the ruptured anterior cruciate ligament. A histologic study of the rabbit model. Z Orthop 124(3):262–265

    Google Scholar 

  4. Creamer P, Hochberg MC (1997) Osteoarthritis. Lancet 350(9076):503–508

    Google Scholar 

  5. Davies DV, White JEW (1961) The structure and weight of synovial fat pads. J Anat 45(A):30–36

    Google Scholar 

  6. Duri ZA, Aichroth PM, Dowd G (1996) The fat pad—clinical observations. Am J Knee Surg 9:55–66

    Google Scholar 

  7. Einhorn TA, Nielsen GP (2001) Case records of the Massachusetts General Hospital. N Engl J Med 344:124–131

    Google Scholar 

  8. Eriksson E, Sebik A (1980) A comparison between the transpatellar tendon and the lateral approach to the knee joint during arthroscopy. A cadaver study. Am J Sports Med 8(2):103–105

    Google Scholar 

  9. Haradker WT, Whipple TL, Bassett FH (1980) Diagnosis and treatment of Plica syndrome of the knee. J Bone Joint Surg Am 62A(2):221–225

    Google Scholar 

  10. Hardy P, Muller GP, Got C, Lortat-Jacob A, Benoit J (1998) Glomus tumor of the fat pad. Arthroscopy 14(3):325–328

    CAS  PubMed  Google Scholar 

  11. Hoffa A (1904) The influence of adipose tissue with regard to pathology of the knee joint. JAMA 42:795–796

    Google Scholar 

  12. Hollinshead WH (1966) Anatomy for surgeons, vol 3. Harper and Row, New York; Weatherhill, Tokyo

  13. Hughes SS, Cammarata A, Steinmann SP, Pellegrini VD (1998) Effect of standard total knee arthroplasty surgical dissection on human patellar blood flow in vivo. J South Orthop Assoc 7(3):198–204

    Google Scholar 

  14. Hur J, Damron TA, Vermont AI, Mathur SC (1999) Fibroma of tendon sheath of the infrapatellar fat pad. Skeletal Radiol 28(7):407–410

    Article  CAS  PubMed  Google Scholar 

  15. Jacobson JA, Lenchik L, Ruhoy MK, Schweitzer ME, Resnick D (1997) MR Imaging of the infrapatellar fat pad of Hoffa. Radiographics 17:675–691

    CAS  PubMed  Google Scholar 

  16. Jakob RP, Kipfewr W, Klaue K, Stuabli HU, Gerber C (1988) Critical study of the repair of the anterior cruciate ligament of the knee using a pedunculated flap to the Hoffa pad taken from the middle third of the patellar tendon. Rev Chir Orthop 74(1):44–51

    Google Scholar 

  17. Kang CN, Kim DW, Kim DJ, Kim SJ (1999) Intra-articular ganglion cysts of the knee. Arthroscopy 15(4):373–378

    CAS  PubMed  Google Scholar 

  18. Keiji Matsumoto, Hidetoshi Okabe, Michihito Ishizawa, Seiji Hiraoka (2001) Intra-articular lipoma of the knee joint. A case report. J Bone Joint Surg Am 83(1):101–105

    Google Scholar 

  19. Kennedy JC, Alexander IJ, Hayes KC (1982) Nerve supply of the knee joint and its functional importance. Am J Sports Med 10(6):329–335

    CAS  PubMed  Google Scholar 

  20. Kohn D, Deiler S, Rudert M (1995) Arterial blood supply of the infrapatellar fat pad—anatomy and clinical consequences. Arch Orthop Trauma Surg 114(2):72–75

    CAS  PubMed  Google Scholar 

  21. Krebs VE, Parker RD (1994) Arthroscopic resection of an extrasynovial ossifying chondroma of the infrapatellar fat pad: end-stage Hoffas disease? Arthroscopy 10(3):301–304

    CAS  PubMed  Google Scholar 

  22. Lundy DW, Aboulafia AJ, Otis JB, Fuller TR, Ogden JA (1997) Myxoid liposarcoma of the retropatellar fat pad. Am J Orthop 26(4):287–289

    Google Scholar 

  23. MacConaill MA (1950) The movements of bones and joints. J Bone Joint Surg Br 32B:244–252

    Google Scholar 

  24. Morini G, Chiodi E, Centanni F, Gattazzo D (1998) Hoffas disease of the adipose pad: magnetic resonance versus surgical findings. Radiol Med (Torino) 95(4):278–285

    Google Scholar 

  25. Ogilive-Harris DJ, Giddens J (1994) Hoffas disease: arthroscopic resection of the infrapatellar fat pad. Arthroscopy 10(2):184–187

    PubMed  Google Scholar 

  26. Patel SJ, Kaplan PA, Dussault RG, Kahler DM (1998) Anatomy and clinical significance of the horizontal cleft in the infrapatellar fat pad of the knee. AJR Am J Roentgenol 170:1551–1555

    CAS  PubMed  Google Scholar 

  27. Petersen W, Rafii M, Ellwanger S, Laprell H (1999) Synovial hemangioma within Hoffa’s fat pad as the cause of anterior knee pain. Orthop Ihre Grenzgeb 137(4):376–378

    Google Scholar 

  28. Robertson PL, Schweitzer ME, Bartolozzi AR, Ugoni A (1994) Anterior cruciate ligament tears: evaluation of multiple signs with MR imaging. Radiology 193:829–834

    CAS  PubMed  Google Scholar 

  29. Sakai H, Tamai K, Iwamoto A, Saotome K (1999) Para-articular chondroma and osteochondroma of the infrapatellar fat pad: a report of three cases. Int Orthop 23(2):114–117

    Article  CAS  PubMed  Google Scholar 

  30. Saliaris AP, McInerney D, Penney L, O’Brien M (1998) Anatomical study of the patellar attachment of the ligamentum patella. European Students Conference of the Charite, October 1998

  31. Scapinelli R (1997) Vascular anatomy of the human cruciate ligaments and surrounding structures. Clin Anat 10(3):151–162

    Google Scholar 

  32. Schweitzer ME, Falk A, Berthoty D, Mitchell M, Resnick D (1992) Knee Effusion: normal distribution of Fluid. AJR Am J Roentgenol 159:361–363

    Google Scholar 

  33. Smillie IS (1974) Diseases of the knee joint. Churchill Livingstone, London, 152 pp

  34. Tang G, Nikitsu M, Iheda K, Endo H, Itai Y (2000) Fibrous scar in the infrapatellar fat pad after arthroscopy. Radiat Med 18(1):1–5

    Google Scholar 

  35. Thorek P (1951) Anatomy in surgery. JB Lippincott, Philadelphia, 847 pp

  36. Wu H, Xu Q, Zhou W (1995) Hoffa disease: diagnosis and arthroscopic treatment. Zhonghua Wai Ke Za Zhi 33(10):581–583

    Google Scholar 

  37. Yamamoto Z, Fujita A, Minami G, Ishida R, Abe M (2001) Atraumatic hemarthrosis caused by a large mediopatellar plica. Arthroscopy 17(4):415–417

    Google Scholar 

Download references

Acknowledgements

All experiments were carried out in compliance with the laws regulating cadaveric prosection in Ireland.

Author information

Authors and Affiliations

  1. Department of Anatomy, Trinity College, Dublin 2, Ireland

    J. Gallagher, P. Tierney & M. O’Brien

  2. Cappagh Orthopaedic Hospital, Finglas, Dublin 2, Ireland

    P. Murray

Authors
  1. J. Gallagher
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Tierney
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Murray
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. O’Brien
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P. Tierney.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gallagher, J., Tierney, P., Murray, P. et al. The infrapatellar fat pad: anatomy and clinical correlations. Knee Surg Sports Traumatol Arthrosc 13, 268–272 (2005). https://doi.org/10.1007/s00167-004-0592-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-004-0592-7

Keywords

Search

Navigation