Hoffa Fat Pad Impigement Syndrome


Hoffa's pad syndome also known as Infrapatellar fat syndrome is an intrinsic disease of Hoffa's fat pad and a problem of knee joint which causes the pain at the front of knee joint so this pain is known as anterior knee pain. Hoffa's fat pad contains pluripotent cells that can differentiate into osteoblasts and chondrocytes.

    Hoffa Fat Pad Impigement Syndrome

    Hoffa's pad becomes inflammed or Damaged by The crushing of the pad between the femur and tibia during extension, causes inflammation of Hoffa's fat pad.

    Nerve supply of fat pad is excellent( It receives branches of the femoral , common peroneal and saphenous nerves) so if it occurs any injury, causes a sharp anterior knee pain.

    Hoffa Fat Pad Impigement Syndrome

    The infrapatellar fat pad is a pad of adipose tissue underneath or deep to the patella tendon and the top of the fat pad attaches to the lower part of patella (knee cap).

    Hoffa's pad is a shock absorber ,when there is a direct force on the patella can result in pinching of the fat pad between femur and tibial plateau.The tibial plateau is the proximal tibial surface on which the femur rests.

    HFP is surrounded anteriorly by the patellar tendon and the joint capsule, superiorly by the inferior pole of the patella, inferiorly by the proximal tibia and the deep infrapatellar bursa, and posteriorly by the joint synovium.

    Causes of Hoffa's syndrome

    Fat Pad Impigement Syndrome

    Cause is usually due to single or repetitive traumatic episodes.

    When you extend your knee the fat pad act as a cushion and reduces friction between outer patella facets and quadriceps tendons . when you flex your knee, upper part of fat pad becomes tensioned, it moves backwards in the knee.

    Hoffa Fat Pad Impigement Syndrome

    It develops gradually over time if you repeatedly move your knee. This is when your knee is forced to move forward from its completely straight normal position. You may have always been able to over straighten your knee, which is called knee hyperextension or genu recurvatum  .hyperextension sports such as basketball, volleyball or high jumping may also cause inflammation of Hoffa's pad.

    Hoffa Fat Pad Impigement Syndrome

    Symptoms of Hoffa's syndrome

    Complaints of anterior knee pain occurs when playing hyperextension sports such as basketball ,volleyball or high jumping .effusion and inflammation may be occurs and decreses the ROM of joint, stair negotiation .

    Symptoms may worsen if the knee is overly straightened or bent for too long a period. Complications may include an inability to fully straighten the knee.

    Diagnosis Hoffa's Syndrome

    Hoffa's syndrome completely diagnosed by MRI .we have requirement of an experienced orthopedics to diagnose it. primary Assessment have to check the Active and Passive Range Of Motion(AROM/PROM) of Hip joint and Knee joint.can check strength of Quadricep musclesGluteal muscle.

    Treatment of Hoffa's Syndrome

    Initially, the aim of treatment for infrapatellar fat pad syndrome is to reduce pain and inflammation, which can with reduced by rest and medicines.Further treatments include taping the knee and strengthening exercises which provided by a physiotherapist or an orthopedic expert.

    Physiotherapy Management

    Hoffa Fat Pad Impigement Syndrome

    Your physiotherapist will asses you and will make a plan. Tapping may be used to offload the inferior pole of patella , strengthen of Quadriceps muscle throw painfree exercises and pain reduction by using Soft Tissue Management.

    Soft Tissue Management:- proper adjustment of physio hand can be use for Reducing Pain , Improving Muscle Relaxation, Re-educate proper joint movement and Improving the Ability of joints to move normally.

    Neuromuscular Re-education:- Improving muscle co-ordination,or Facilitating muscla firing in muscle that are or inhibited.

    Stabilization:- Exercises targeted to your specific goals, fitness, activities.

    Hoffa Fat Pad Impigement Syndrome

    Ultrasound:- Ultrasound can be effective to calm down irritable tissue that may not respond well to hands on techniques.it may also be used to reduce local swelling, relax tissue,improve blood flow for tissue healing and break down scar tissue.

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