Hoffa’s fat pad disease: A study

• Author Details:   
• Maruthi CV
• Venugopal N

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Introduction: German surgeon by name Albert Hoffa in 1904 described the condition which was producing severe anterior knee pain was called Hoffa’s fat pad disease. This disease is commonly encountered in athletes after the second decade. The lowest age present in the literature with symptomatic Hoffa’s fat pad disease is ten years.  Most common pathology in Hoffa’s fat pad disease is impingement of fat pad between anterior margin of tibia and intercondylar notch of femur. Here we are done an attempt to know the aetiology, diagnosis and management of the Hoffa’s fat pad disease.
Materials and methods: 150 cases of knee joint pain were evaluated in our institute. 107 cases were suffering from medial margin pain, twenty nine cases from lateral margin, seven over and adjacent to ligamentum patella, three from inferior pole of patella, three from tibial tuberosity and one had pain at superior pole of patella. We studied seven patients suffering from Hoffa’s fat pad disease from April 2011 to December 2014 in our hospital. Inclusion criteria were age group between ten to sixty years irrespective of sex suffering from anterior knee pain with tenderness and swelling over and adjacent to the ligamentum patella. The exclusion criteria were age less than ten and more than sixty, pain at the suprapatellar region, inferior pole, superior pole of patella, at tibial tuberosity only, along medial and lateral margin of knee, popliteal fossa were excluded from our study. We have done a study to know the causes, how to diagnose the problem and management.
Conclusion: Hoffa’s disease is common after second decade, rare in children. Usually it is seen in athletes. Squatting, running, climbing stairs, trauma and postsurgical scarring are the causes encountered in our study.  Diagnosis is by history, clinical examination and radiological investigations like X-ray and Magnetic resonance imaging. Conservative management is the first line of treatment for three to four months and if it fails most of them were treated by complete excision of Hoffa’s fat pad through anterior arthrotomy.

Keywords: Hoffa’s disease, Anterior knee pain, X-Ray, MRI, Arthrotomy