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Lipoma arborescens of the knee

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

Abstract

Purpose

Lipoma arborescens (LA) is a benign lesion described as replacement of mature fat cells with sub-synovial tissue, which causes the formation of villous projections. Underlying inflammatory conditions might predispose LA. This study demonstrates the treatment, post-operative survey and MRI demonstrations of this rare entity.

Methods

Five patients (6 knees) diagnosed and treated with arthroscopic (5/6) and open (1/6) synovectomy were reviewed retrospectively. An additional mini-transquadricipital incision is used for excision of the extensive suprapatellar lesions. The patients had post-operative follow-ups at first and sixth months and then yearly. Radiographs and MRI of the affected knees were taken at the final follow-up.

Results

The median follow-up was 59 (4–105) months. Major symptom was painless swelling of the joint. The presenting age was under 18 years in four patients. Recurrent lesions were detected in MRI scan of three patients with JRA, ARF and Tbc. Two out of three were located adjacent to the posterior capsule. The median of the Kujala questionnaire scores was 88 (74–95), and the median of the Knee Society Clinical Rating System scores was 95 (80–100) at the final follow-up.

Conclusions

Lipoma arborescens should be considered in the differential diagnosis of paediatric patients who have painless swelling of the knee joint. The lesion is totally curable. However, underlying persistent disease might aggravate the inflammatory process and might cause recurrent lesions. Although resecting the lesion adjacent to the posterior capsule of the knee joint is technically demanding, arthroscopic treatment is an effective procedure and transquadricipital approach may help resection of the extensive lesions in suprapatellar pouch.

Level of evidence

Case series, Level IV.

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Acknowledgments

The authors would like to thank A. Ozgur Atay, M.D., for his help during the surgeries and Defne Kaya, PT, for managing the post-operative rehabilitation.

Conflict of interest

Authors declare no conflict of interest. Authors received no financial support for this study.

Author information

Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Faculty of Medicine, Hacettepe University, Sihhiye, 06100, Ankara, Turkey

    Saygin Kamaci, M. Nedim Doral & Altug Yucekul

  2. Department of Radiology, Faculty of Medicine, Hacettepe University, Sihhiye, 06100, Ankara, Turkey

    F. Bilge Ergen

  3. Department of Orthopaedics, University of Missouri-Kansas City, 2301 Holmes Street, Kansas City, MO, USA

    Akin Cil

Authors
  1. Saygin Kamaci
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  2. M. Nedim Doral
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  3. F. Bilge Ergen
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  4. Altug Yucekul
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  5. Akin Cil
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Corresponding author

Correspondence to M. Nedim Doral.

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Kamaci, S., Doral, M.N., Ergen, F.B. et al. Lipoma arborescens of the knee. Knee Surg Sports Traumatol Arthrosc 23, 2196–2201 (2015). https://doi.org/10.1007/s00167-014-2996-3

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  • DOI: https://doi.org/10.1007/s00167-014-2996-3

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