Arthroscopic Treatment of Infrapatellar Fat Pad Impingement between the Patella and Femoral Trochlea: Comparison of the Clinical Outcomes of Partial and Subtotal Resection
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: To compare the clinical outcomes of arthroscopic partial and subtotal resection of the impinged infrapatellar fat pad (IFP).Materials and Methods: This study enrolled 55 patients with IFP impingement who underwent partial resection (n=29, P group) or subtotal resection (n=26, S group). Clinical outcomes at least 2 years postoperatively were evaluated using a visual analog scale (VAS) for pain, the International Knee Documentation Committee (IKDC) 2000 subjective knee score, and the Lysholm score.Results: In the P group, the preoperative mean VAS, IKDC 2000, and Lysholm scores were 5.6±0.61, 47.5±7.41, and 42.5±7.17, respectively, which improved significantly to 1.4±0.63, 70.9±6.15, and 82.2±7.61, respectively (all, p≤0.001). In the S group, the preoperative mean VAS, IKDC 2000, and Lysholm scores were 5.7±0.43, 47.7±9.09, and 45.2±4.18, respectively, which improved significantly to 1.8±0.77, 71.9±9.33, and 82.3±6.01, respectively (all, p≤0.001). There were no significant differences in any outcome measure between the groups at the final followup.Conclusions: Arthroscopic resection of the impinged IFP between the patella and femoral trochlea resulted in favorable clinical outcomes regardless of whether the resection was partial or subtotal. Thus, partial resection can be an appropriate treatment option, considering partial resection was as effective as subtotal resection and retained more of the IFP.
Abstract
Purpose: To compare the clinical outcomes of arthroscopic partial and subtotal resection of the impinged infrapatellar fat pad (IFP).Materials and Methods: This study enrolled 55 patients with IFP impingement who underwent partial resection (n=29, P group) or subtotal resection (n=26, S group). Clinical outcomes at least 2 years postoperatively were evaluated using a visual analog scale (VAS) for pain, the International Knee Documentation Committee (IKDC) 2000 subjective knee score, and the Lysholm score.Results: In the P group, the preoperative mean VAS, IKDC 2000, and Lysholm scores were 5.6±0.61, 47.5±7.41, and 42.5±7.17, respectively, which improved significantly to 1.4±0.63, 70.9±6.15, and 82.2±7.61, respectively (all, p≤0.001). In the S group, the preoperative mean VAS, IKDC 2000, and Lysholm scores were 5.7±0.43, 47.7±9.09, and 45.2±4.18, respectively, which improved significantly to 1.8±0.77, 71.9±9.33, and 82.3±6.01, respectively (all, p≤0.001). There were no significant differences in any outcome measure between the groups at the final followup.Conclusions: Arthroscopic resection of the impinged IFP between the patella and femoral trochlea resulted in favorable clinical outcomes regardless of whether the resection was partial or subtotal. Thus, partial resection can be an appropriate treatment option, considering partial resection was as effective as subtotal resection and retained more of the IFP.
참고문헌 (23)
- Hoffa A, "The influence of the adipose tissue with regard to the pathology of the knee joint", JAMA, 43, pp.795~796 (1904)
- Saddik D, "MRI of Hoffa's fat pad", Skeletal Radiol, 33, pp.433~444 (2004)
- von Engelhardt LV, "Hoffa's fat pad impingement treated arthroscopically : related findings on preoperative MRI in a case series of 62 patients", Arch Orthop Trauma Surg, 130, pp.1041~1051 (2010)
- Dye SF, "Conscious neurosensory mapping of the internal structures of the human knee without intraarticular anesthesia", Am J Sports Med, 26, pp.773~777 (1998)
- Biedert RM, "Sources of anterior knee pain", Clin Sports Med, 21, pp.335~347 (2002)
- Duri ZA, "The fat pad : clinical observations", Am J Knee Surg, 9, pp.55~66 (1996)
- Magi M, "Hoffa disease", Ital J Orthop Traumatol, 17, pp.211~216 (1991)
- Crossley K, "Physical therapy for patellofemoral pain : a randomized, double-blinded, placebo-controlled trial", Am J Sports Med, 30, pp.857~865 (2002)
- McConnell J, "The physical therapist's approach to patellofemoral disorders", Clin Sports Med, 21, pp.363~387 (2002)
- Metheny JA, "Hoffa disease : chronic impingement of the infra-patellar fat pad", Am J Knee Surg, 1, pp.134~139 (1988)
- Kumar D, "Impingement of infrapatellar fat pad(Hoffa's disease) : results of high-portal arthroscopic resection", Arthroscopy, 23, pp.1180~1186 (2007)
- Ogilvie-Harris DJ, "Hoffa's disease : arthroscopic resection of the infrapatellar fat pad", Arthroscopy, 10, pp.184~187 (1994)
- Morini G, "Hoffa's disease of the adipose pad : magnetic resonance versus surgical findings", Radiol Med, 95, pp.278~285 (1998)
- Emad Y, "Liposynovitis prepatellaris in athletic runner(Hoffa's syndrome) : case report and review of the literature", Clin Rheumatol, 26, pp.1201~1203 (2007)
- Carlsson AM, "Assessment of chronic pain. I: aspects of the reliability and validity of the visual analogue scale", Pain, 16, pp.87~101 (1983)
- Irrgang JJ, "Development and validation of the international knee documentation committee subjective knee form", Am J Sports Med, 29, pp.600~613 (2001)
- Lysholm J, "Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale", Am J Sports Med, 10, pp.150~154 (1982)
- Patel SJ, "Anatomy and clinical significance of the horizontal cleft in the infrapatellar fat pad of the knee : MR imaging", AJR Am J Roentgenol, 170, pp.1551~1555 (1998)
- Doner GP, "Arthroscopic resection of fat pad lesions and infrapatellar contractures", Arthrosc Tech, 3, pp.e413~e416 (2014)
- Gallagher J, "The infrapatellar fat pad : anatomy and clinical correlations", Knee Surg Sports Traumatol Arthrosc, 13, pp.268~272 (2005)
- Huberti HH, "Patellofemoral contact pressures : the influence of q-angle and tendofemoral contact", J Bone Joint Surg Am, 66, pp.715~724 (1984)
- Bohnsack M, "Biomechanical and kinematic influences of a total infrapatellar fat pad resection on the knee", Am J Sports Med, 32, pp.1873~1880 (2004)
- Liu YP, "Infrapatellar fat pad may be with tendon repairing ability and closely related with the developing process of patella Baja", Med Hypotheses, 77, pp.620~623 (2011)