Tumour-like lesions of the infrapatellar fat pad

Nouri, H.; Hmida, Ferjani Ben; Ouertatani, M.; Bouaziz, Mouna Chelli; Abid, Leïla; Jaafoura, H.; Zehi, K.; Mestiri, M.

doi:10.1007/s00167-009-1034-3

Cited by 13 publications

(12 citation statements)

References 18 publications

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“…Rodriguez- Peralto et al ., [6] emphasize a possible metaplastic origin of the tumor, due to a traumatic event of Hoffa’s fat pad. Other authors [9, 13] reported a relation between this type of osteochondroma of the knee and a chronic impingement of the infrapatellar fat pad; they conclude that this lesion is the end-stage of Hoffa’s disease. Neither of our cases reported any history of significant trauma or symptomatic impingement of the infrapatellar fat pad, although both patients had noticed the mass many years before our first observation.…”

Section: Discussionmentioning

confidence: 91%

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Giant Intra-Articular Extrasynovial Osteochondroma of the Knee: A Report of Two Cases

Maio¹,

Bisicchia²,

Potenza³

et al. 2011

TOORTHJ

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We report two cases of a giant extrasynovial osteochondroma of the knee located in the infrapatellar fat pad region, in two females who were 58 and 71 years old respectively. Both patients had noticed the mass many years before our first clinical observation. In both patients, at physical examination a solid, firm and hard mass was palpable in the anterior part of the knee in Hoffa’s fat pad region, and the range of motion of the knee was severely restricted and painful. CT scan examination with 3D-reconstruction showed two large, calcified neoformations behind the patellar tendon, between the apex of the patella and the proximal third of the tibia. In both cases, the mass was completely resected surgically through an anterior longitudinal approach. At histological examination, the excised masses consisted of an outer layer of hyaline cartilage without significant chondrocyte atypia and an inner region of bone trabeculae formed by endochondral ossification. At follow-up, 8 and 4 years after the operation, both patients were pain-free, with complete recovery of the range of motion of the knee and without any clinical or radiographic evidence of recurrence. The authors believe that intra-articular extrasynovial osteochondroma of the knee is a primary metaplasia of Hoffa’s fat pad. Usually, the tumor develops slowly and asymptomatically over many years. The treatment of choice is a marginal resection of the mass, although a biopsy should be considered in some cases. Recurrences are extremely rare.

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Section: Discussionmentioning

confidence: 91%

“…We believe that a biopsy is absolutely indicated when a significant diagnostic doubt exists. Magnetic resonance (MR) may be helpful for the diagnosis [8, 13], but in both our patients it was contraindicated, in one case owing to the presence of a pacemaker and in the other case for psychiatric problems.…”

Section: Discussionmentioning

confidence: 99%

Giant Intra-Articular Extrasynovial Osteochondroma of the Knee: A Report of Two Cases

Maio¹,

Bisicchia²,

Potenza³

et al. 2011

TOORTHJ

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“…Pathological involvement could be due to intrinsic factors or extrinsic factors. Intrinsic causes are due to primary pathology of HFP such as intracapsular chondroma,18 localized villonodular synovitis,19 post arthroscopy, shear injury, and post surgery 3. Extrinsic factors are synovial or intra-articular pathologies which secondarily involve HFP 320…”

Section: Discussionmentioning

confidence: 99%

“…Repetitive microtrauma leads to alteration in the metabolism of cells leading to release of vasoactive substances that sensitize synovium and fat tissue, causing necrosis of adipocytes 130. Fibrocartilagenous metaplasia of HFP was considered as the end stage of Hoffa's disease by many authors 17–19. Wicham et al .…”

Section: Discussionmentioning

confidence: 99%

Tumor like swellings arising from Hoffa’s fat pad: A report of three patients

Ghate

Deokar

Samant

et al. 2012

IJOO

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We report three rare cases of tumor-like conditions arising from Hoffa's fat pad (HFP). Patients were having persistent knee pain, the cause of which was not diagnosed by the general physician, and then were referred to us for knee pain. Magnetic resonance imaging revealed the lesions to be arising from HFP (ganglion cysts and hemangioma), as was suggested by clinical findings. Anatomy, pathology, and radiological features of the Hoffa's disease are described here to increase awareness in orthopedic community of this rare but interesting disease which is often misdiagnosed as meniscal pathology. These cases illustrate that increased cognizance can facilitate timely intervention which will prevent morbidity of the patient.

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“…It is considered that synovial osteochondroma rarely arises in the infrapatellar fat pad. Benign lesions have been treated by excision or marginal resection via arthrotomy [6-12]. In this case, we were able to identify the extent of the tumor on MRI and subsequently resect it under arthroscopic guidance.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic resection of multiple ossifying tumors in the infrapatellar fat pad

Oshigiri

Watanabe

Otsubo

et al. 2012

BMC Sports Sci Med Rehabil

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A 49 year-old male visited a nearby clinic five years back with a complaint of pain in the right knee during exercise. Plain radiographs revealed absence of any anomalies. He began to feel a lumpy mass in his right knee two years back. The pain worsened, on imaging, an anomaly was identified in the infrapatellar fat pad of his right knee, and he was subsequently referred to our department where he was hospitalized. On examination, a mass extending on either side of the patellar tendon was identified along with rigid tenderness in that area. The knee’s range of motion was 0degrees-130degrees, and knee flexion was accompanied by pain. The results of blood tests were normal. A plain radiograph of the knee revealed multiple ossifying tumors at a site consistent with the infrapatellar fat pad. T1-weighted MRI exhibited low-signal intensity, while T2-weighted MRI exhibited a mosaic-shaped tumor. We performed arthroscopic surgery to excise the tumor. The patient resumed work shortly after surgery and did not experience any pain during the two year postoperative observation period. The joint’s range of motion improved to the extent that it was comparable with that of the left knee. No recurrence was observed on radiographic examination. In past studies, resection of similar tumors has been performed with an arthrotomy; however, we performed arthroscopic resection on our patient, who demonstrated a quick improvement in symptoms and range of motion after surgery. We believe that arthroscopic surgery is a feasible option to consider while treating such cases.

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Tumour-like lesions of the infrapatellar fat pad

Cited by 13 publications

References 18 publications

Giant Intra-Articular Extrasynovial Osteochondroma of the Knee: A Report of Two Cases

Giant Intra-Articular Extrasynovial Osteochondroma of the Knee: A Report of Two Cases

Tumor like swellings arising from Hoffa’s fat pad: A report of three patients

Arthroscopic resection of multiple ossifying tumors in the infrapatellar fat pad

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