An unusual cause for anterior knee pain: strangulated intra-articular lipoma

Keser, Selçuk; Bayar, Ahmet; Numanoğlu, Gamze

doi:10.1007/s00167-004-0595-4

Cited by 10 publications

(14 citation statements)

References 13 publications

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“…[12][13][14][15][16][17][18][19] A localized mass of fat in some patients undoubtedly represents a true neoplasm, whereas in others it may be simply a prolapse of normal fat through a deficiency in the enveloping fascia. Trauma is one of the most implicated etiological factors in lipoma formation, although its pathogenesis is not known.…”

Section: Discussionmentioning

confidence: 99%

Lipoma Due to Chronic Intermittent Compression as an Occupational Disease

Çoban

Üzel

Gumus

2006

Annals of Plastic Surgery

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A total of 15 coppersmiths who do the job as a traditional profession in Kahramanmaras Province were retrospectively analyzed for revealing a possible relationship of lipoma formation and chronic compression, as the work characteristic related to mechanical pressure to the right thoracal and shoulder region. The workers were examined and their historical data were noted. Chronic compression sites in the patients were also evaluated by magnetic resonance imaging and ultrasonography. The ages were between 30 and 52 years. Body mass index ranged from 18.6 to 38.8. Five were operated for visible lipomatous masses at their injured sites. All of the specimens were reported as containing mature adipocytes. An increased subcutaneous fat thickness at the injured sides of the patients was seen when compared with the uninjured contralateral sides using ultrasonography. At the magnetic resonance images, no capsule intensity was observed in the lipomatose masses. Subcutaneous fat of injured right mammarial regions was thicker than the other contralateral sides in all of the cases. The most prominent lipomas were seen in obese workers, and strong evidence for chronic trauma and lipoma formation as an occupational disease was obtained from the study.

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Section: Discussionmentioning

confidence: 99%

Lipoma Due to Chronic Intermittent Compression as an Occupational Disease

Çoban

Üzel

Gumus

2006

Annals of Plastic Surgery

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“…In the past it was believed that it only provided a blood supply to the patellar tendon. While it has been proposed that the volume and configuration of the fat pad is important to knee function 16 , other studies have suggested that the fat pad may be a source of anterior knee pain 17,18 . Importantly, recent studies provide evidence of the local production of adipokines by cells of the infrapatellar fat pad 19–21 .…”

Section: Introductionmentioning

confidence: 99%

Age‐associated increases in the size of the infrapatellar fat pad in knee osteoarthritis as measured by 3T MRI

Chuckpaiwong

Charles

Kraus

et al. 2010

Journal Orthopaedic Research

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Obesity, as a primary risk factor for osteoarthritis, has been shown to alter joint loading, but may also result in metabolic changes characterized by chronic, low-level inflammation due to increased circulating levels of adipose-derived cytokines, or “adipokines”. The presence of the infrapatellar fat pad in the knee suggests that local changes in adipokine concentrations may influence knee osteoarthritis. This study examined the hypotheses that the volume of the infrapatellar fat pad is correlated to the body mass index (BMI) of osteoarthritis patients, and that fat pad volume is greater in subjects with osteoarthritis. Fat pad volume was measured in sequential magnetic resonance images taken over one year in a cohort of 15 control and 15 knee osteoarthritis subjects. No differences were observed in the fat pad volume between the two groups at baseline, 3, 6, or 12 months. In control subjects, no significant correlations were present between any parameters (age, BMI, weight, volume of fat pad at any time point). However, in the osteoarthritic group, fat pad volume was correlated with age at every time point. One possible explanation is that local factors related to knee osteoarthritis may also induce enlargement of the fat pad with age. Alternatively, subjects who are prone to growth or enlargement of the fat pad may also be more prone to symptomatic osteoarthritis. These findings provide intriguing preliminary data on the potential role of the infrapatellar fat pad in osteoarthritis, although additional study is required to better understand the mechanisms of this relationship.

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“…Infrapatellar fat pad impingement presented primarily as anterior knee pain with a variable duration of symptoms (►Tables 1 and 2). The duration was in weeks in 5 of 14 patients in case reports, [13][14][15][16] from weeks to months in 2 of 14 patients 16,17 and years in 7 of 14 patients. 16,[18][19][20][21][22] Six of the 14 patients had worsening of the pain with activity.…”

Section: Clinical Presentationmentioning

confidence: 98%

“…16,[18][19][20][21][22] Six of the 14 patients had worsening of the pain with activity. [13][14][15][16]21,22 A total of six patients described a history of trauma that predated this condition: hyperflexion in two patients 15,19 as well as chronic repetition in four patients. 14,16,18 In retrospective studies, patients presented with both acute and chronic pain with a history of injury or doing regular sporting activities.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…21 Hoffa's test was positive in seven patients. 13,15,16,[18][19][20]22 Retrospective studies described pain and tenderness around the patella and painful terminal extension. 2,[23][24][25][26] One study reported a variation of Hoffa's test that considered the test positive if pain was elicited by fully extending the knee without applying pressure on both sides of the patella.…”

Section: Clinical Presentationmentioning

confidence: 99%

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Infrapatellar Fat Pad Impingement: A Systematic Review

et al. 2017

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Infrapatellar fat pad impingement represents a source of anterior knee pain that is often overlooked. Due to the scarcity of reports related to this disorder, we conducted a systematic review of the literature related to infrapatellar fat pad impingement in evaluating the following: (1) clinical presentation, (2) imaging, (3) management, and (4) clinical outcomes. A systematic review was conducted investigating all available primary literature related to the clinical presentation, imaging, management, and outcomes of infrapatellar fat pad impingement syndrome. A total of 15 studies (9 case reports, 1 case series, and 5 retrospective studies) comprising 167 patients met eligibility criteria for this review. Patients with infrapatellar fat pad impingement were found to most often present with anterior knee pain that worsened with activity, and was frequently associated with trauma. Anterior knee pain, tenderness to palpation over the patellar tendon, loss in terminal extension, and pain with direct pressure on the medial or lateral side of the patella with the knee extended was often found on examination. Although patients may have classic imaging findings on magnetic resonance imaging (localized edema of the infrapatellar fat pad, deep fluid-filled infrapatellar bursa, nonvisualization of clefts, fibrosis, and calcifications), not all patients had positive imaging findings, thus making infrapatellar fat pad impingement a clinical diagnosis. Treatment begins with nonoperative management, but in recalcitrant cases, patients can be surgically treated with arthroscopic fat pad resection. Most patients who undergo operative treatment report improvement or complete resolution of symptoms in terms of pain and range of motion, and are able to return to work. To the best of our knowledge, this is the first comprehensive review on infrapatellar fat pad impingement to better aid the orthopaedic surgeons in diagnosing, treating, and managing patient expectations for this often overlooked knee pathology.

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An unusual cause for anterior knee pain: strangulated intra-articular lipoma

Cited by 10 publications

References 13 publications

Lipoma Due to Chronic Intermittent Compression as an Occupational Disease

Lipoma Due to Chronic Intermittent Compression as an Occupational Disease

Age‐associated increases in the size of the infrapatellar fat pad in knee osteoarthritis as measured by 3T MRI

Infrapatellar Fat Pad Impingement: A Systematic Review

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