Influence of fat pad removal on patellar tendon length during growth

During various knee operations, the changes caused by the surgical invasion to the infrapatellar fat pad (IPF) is still unknown. If any changes exist, it will have great influence especially on growing generations. Eighty-four Japanese white rabbits (6-month-old) were divided into three groups: the resection group involving resection of the IPF, the graft group involving resection and reimplantation of the IPF, and the no-surgery group. All these surgical procedures were done in right knees. In all left knees, only arthrotomy was performed, serving as the sham side. After 3, 6, 12, and 24 weeks of the operation, the rabbits were killed. Lengths of the patellar tendon and patellar were measured in lateral X-ray. In order to eliminate individual differences in the patellar height, we defined a new index as percent patellar height (PPH) which indicated the percentage of the patellar height of surgery side compared with that of the sham side. The PPH was 90.6% (3 weeks), 83.0% (6 weeks), 73.6% (12 weeks), and 74.7% (24 weeks) in the resection group, while it was 88.4% (6 weeks), and 88.9% (24 weeks) in the graft group. Postsurgical scar tissue formation occurring where the IPF was removed prevented the normal growth of the patellar tendon. Reimplantation of the IPF lessened the adhesion of the patellar tendon to the surrounding tissue, and better growth of the tendon. These results showed that preservation of the IPF in young individuals could be crucial for the normal growth of the patellar tendon, and critical as well for the prevention of the degeneration of the articular surface.