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    Hoffa disease: Results of arthroscopic treatment of anterior knee pain
    (2020) Turhan, Sadullah; Gülcü, Anıl
    Objective: Hoffa disease is characterized by impingement between the patellofemoral or femorotibial joints because of hypertrophy and fibrosis owing to inflammation triggered by acute trauma (85% of the cases) or recurrent micro-traumas (15% of the cases) of the infrapatellar fat pad (IFP) and causes anterior knee pain. We aimed to evaluate the clinical and functional results of the treatment of painful infrapatellar fat pad (Hoffa disease) with arthroscopic resection. Material and Methods: Arthroscopy was performed in 22 patients with anterior knee pain and Hoffa disease as an isolated lesion. A standard anteromedial working portal and a high anterolateral imaging portal was used in all cases. The patients were treated by resecting the affected part of the fat pad. The Lysholm knee and Tegner activities of the patients were compared pre-operatively and post-operatively at 3 months and 1 year. Results: The average age of the patients was calculated as 34 years (19-49). The average preoperative symptom period was 14 months (7-22). The mean follow-up period was 18 months (14-30). Nine patients were involved in regular sports activity. Three patients had a history of knee sprain. Three patients were actively involved in sports, and had a history of occasional recurrent sprain. Ten patients had no history of trauma. The Lysholm score was calculated as 56.76 preoperatively, 65.68 at the post-operative 3rd month and 73.97 at the post-operative 1st year. According to the Tegner activity score level, the symptoms improved in all patients except three and they returned to pre-injury status. Conclusion: Conservative treatments such as non-steroidal inflammatory drugs, physiotherapy, and local anesthetic or steroid injections can reduce the complaints. However, conservative treatments have been reported to be generally ineffective. Partial resection of the fat pad is indicated when conservative treatment is ineffective. We believe Hoffa disease should be arthroscopically treated as recovery of the symptoms and functions can be expected after arthroscopic resection of the fat pad.