The posterior extension of Hoffa's infrapatellar fat pad occupies the space between the patellar tendon and the anterior tibia, extending into the knee joint space around the anterior horns of the menisci. This posterior fat pad component may become impinged in Hoffa's disease and fat pad fibrosis syndromes.
The posterior infrapatellar fat pad is the component impinged in Hoffa's fat pad syndrome, where fibrosis and hypertrophy of the fat pad produces anterior knee pain worsened by extension loading. MRI demonstrates fat pad oedema and fibrosis on fluid-sensitive sequences. Arthroscopic partial fat pad resection, targeting the impinging posterior components, provides lasting pain relief in refractory cases.
Fibrosis and impingement of the posterior infrapatellar fat pad between the patellar tendon and femoral condyles producing anterior knee pain with full extension, confirmed by MRI fat pad oedema and treated by arthroscopic fat pad debridement.
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