Preservation vs. resection of the infrapatellar fat pad during total knee arthroplasty Part I: A survey of current practice in the UK

Duren, Bernard H van; Lamb, Jonathan; Nisar, Sohail; Ashraf, Y.; Somashekar, N.; Pandit, Hemant

doi:10.1016/j.knee.2018.12.010

Cited by 11 publications

(11 citation statements)

References 12 publications

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“…These results are similar to the 2004 UK and Wales National Joint Registry report [19]. Similarly, in a survey of orthopedic surgeons in England conducted by van Duren et al [20] (n=173), 9.83% of the respondents stated that they completely preserve the IPFP. In addition, only 23%…”

Section: Discussionsupporting

confidence: 87%

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Current practices regarding the management of infrapatellar fat pad during total knee arthroplasty: A survey of orthopedic surgeons

Çapkın

Özmanevra

Demirkıran

et al. 2021

Turkish Journal of Clinics and Laboratory

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Aim:The aim of this study was to evaluate the current practices pertaining to the management of the infrapatellar fat pad (IPFP) during primary total knee arthroplasty (TKA) among orthopedic surgeons in Turkey. Material and Methods:A web-based survey of orthopedic surgeons registered in the database of the Turkish Orthopedics and Traumatology Association was conducted between June 2020 and July 2020. The survey questionnaire consisted of seven questions pertaining to the current practices regarding management of the IPFP (preservation of IPFP, partial resection, or total resection) during primary TKA.Results: Of the 1553 registered orthopedic specialists, 266 (17%) completed the questionnaire. A vast majority of orthopedic surgeons (75.2%) claimed that their decision making with regard to the management of IPFP during TKA was not based on evidence (p < 0.001). Conclusion:In a vast majority of respondents, the decision to resect or preserve the IPFP during TKA was not based on scientific reasons. The number of years of experience in the profession and academic position had a significant influence on this decision.

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Section: Discussionsupporting

confidence: 87%

“…In a survey of 173 orthopedic surgeons in the UK, 9.83% of respondents preferred total preservation of the IPFP, 23.12% preferred total resection, and 62.4% favored partial resection. Furthermore, only 23% of respondents were aware of any guidelines or evidence to support their surgical decision [20].…”

Section: Discussionmentioning

confidence: 99%

Current practices regarding the management of infrapatellar fat pad during total knee arthroplasty: A survey of orthopedic surgeons

Çapkın

Özmanevra

Demirkıran

et al. 2021

Turkish Journal of Clinics and Laboratory

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show abstract

“…Awareness about IFP role is extremely important also in clinical practice. In fact, IFP preservation or resection during TKA is still a matter of debate and no definitive guidelines are available [37]. Even though IFP resection during knee surgery allows easy access and visualization, evidence suggests that its preservation is advantageous [38].…”

Section: The Role Of the Ifp-synovial Membrane As A Functional Unimentioning

confidence: 99%

Contribution of Infrapatellar Fat Pad and Synovial Membrane to Knee Osteoarthritis Pain

Belluzzi

Stocco

Pozzuoli

et al. 2019

BioMed Research International

141

124

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Osteoarthritis (OA) is the most common form of joint disease and a major cause of pain and disability in the adult population. Interestingly, there are patients with symptomatic OA displaying pain, while patients with asymptomatic OA that do not experience pain but show radiographic signs of joint damage. Pain is a complex experience integrating sensory, affective, and cognitive processes related to several peripheral and central nociceptive factors besides inflammation. During the last years, the role of infrapatellar fat pad (IFP), other than the synovial membrane, has been investigated as a potential source of pain in OA. Interestingly, new findings suggest that IFP and synovial membrane might act as a functional unit in OA pathogenesis and pain. The present review discuss the role of IFP and synovial membrane in the development of OA, with a particular focus on pain onset and the possible involved mediators that may play a role in OA pathology and pain mechanisms. Inflammation of IFP and synovial membrane may drive peripheral and central sensitization in KOA. Since sensitization is associated with pain severity in knee OA and may potentially contribute to the transition from acute to chronic, persistent pain in knee OA, preventing sensitization would be a potentially effective and novel means of preventing worsening of pain in knee OA.

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“…Several studies demonstrated that IFP excision is associated with increased anterior knee pain: Macule et al reported increased pain 6 months following TKA, while in a study by Nisar et al elevated pain was observed at 1-2 months post-op [14,30]. Pinsornask et al demonstrated comparable pain intensity at 2 months, but increased pain in knees with IFP resection at 12 months; other authors also indicated anterior knee pain associated with Hoffa fat pad resection at follow-ups longer than 6 months [7,20,31].…”

Section: Discussionmentioning

confidence: 99%

Resection of Infrapatellar Fat Pad during Total Knee Arthroplasty Has No Impact on Postoperative Function, Pain and Sonographic Appearance of Patellar Tendon

Michalak

Łapaj

Witkowska-Łuczak

et al. 2022

JCM

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Routine resection of the infrapatellar fat pad (IFP) during total knee arthroplasty (TKA) is controversial, as it may result in shortening of the patellar tendon (PT) and anterior knee pain. This prospective study examined whether IFP excision during TKA affects joint function, anterior knee pain, PT dimensions and sonographic structure. A total of 65 consecutive patients undergoing TKA for osteoarthritis were randomized into two groups: IFP was resected in one and retained in the other. Patients were examined preoperatively, at 6 weeks and 6 months postoperatively: pain (Numerical Rating Scale—NRS), range of motion (ROM) and knee function (Knee Injury and Osteoarthritis Outcome Score—KOOS score) were evaluated; sonographic examination determined the length, structure and vascularity of the PTs. In both groups there were postoperative improvements in NRS and KOOS scores, although IFP resection did not influence clinical outcomes or sonographic parameters. At 6 weeks and 6 months postoperatively for both groups there were no differences between NRS scores (Mann–Whitney test, p = 0.511 and p = 0.579), ROM scores (Mann–Whitney test, p = 0.331, p = 0.180) or all KOOS subscores. IFP excision had no effect on sonographic parameters. This study suggests that IFP resection during TKA does not influence postoperative functional outcomes, pain scores, patellar tendon length and thickness, or sonographic structure.

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Preservation vs. resection of the infrapatellar fat pad during total knee arthroplasty Part I: A survey of current practice in the UK

Abstract: This is a repository copy of Preservation vs. resection of the infrapatellar fat pad during total knee arthroplasty Part I: A survey of current practice in the UK.

Cited by 11 publications

References 12 publications

Current practices regarding the management of infrapatellar fat pad during total knee arthroplasty: A survey of orthopedic surgeons

Current practices regarding the management of infrapatellar fat pad during total knee arthroplasty: A survey of orthopedic surgeons

Contribution of Infrapatellar Fat Pad and Synovial Membrane to Knee Osteoarthritis Pain

Resection of Infrapatellar Fat Pad during Total Knee Arthroplasty Has No Impact on Postoperative Function, Pain and Sonographic Appearance of Patellar Tendon

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