Biomechanical and kinematic influences of a total infrapatellar fat pad resection on the knee

Am J Sports Med. 2004 Dec;32(8):1873-80. doi: 10.1177/0363546504263946.

Abstract

Background: This biomechanical study was performed to evaluate the consequences of total infrapatellar fat pad resection on knee kinematics and patellar contact pressure.

Hypothesis: Resection of the infrapatellar fat pad produces significant changes in knee kinematics and patellar contact pressure.

Study design: Biomechanical cadaveric study.

Methods: Isokinetic knee extension was simulated on 10 human knee cadaveric specimens (6 men, 4 women; mean age at death, 44 years). Joint kinematics were evaluated by an ultrasound-based 3D motion analysis system, and retro-patellar contact pressure was measured using an electronic pressure-sensitive film. All data were taken before and after resection of the infrapatellar fat pad and statistically analyzed.

Results: A total resection of the infrapatellar fat pad resulted in a significant decrease of the tibial external rotation relative to the femur between 63 degrees of flexion and full knee extension (maximum: 3 degrees rotation difference at 0 degrees knee flexion, P = .011), combined with a significant medial translation of the patella between 29 degrees and 69 degrees of knee flexion (range, 0.9-1.3 mm, P = .017-.028). Retro-patellar contact pressure was significantly reduced (from 20% to 25%, P = .008-.021) at all flexion angles.

Conclusion: A resection of the infrapatellar fat influences patellar biomechanics and knee kinematics.

Clinical relevance: The infrapatellar fat pad may have a biomechanical function and may play a role in anterior knee pain syndrome.

MeSH terms

  • Adipose Tissue / surgery*
  • Adult
  • Biomechanical Phenomena
  • Cadaver
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Knee Joint / diagnostic imaging
  • Knee Joint / physiology*
  • Knee Joint / surgery
  • Male
  • Patella / diagnostic imaging
  • Patella / physiology*
  • Patella / surgery
  • Pressure
  • Range of Motion, Articular / physiology
  • Rotation
  • Torque
  • Ultrasonography