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Hoffa's fat pad resection during total knee arthroplasty does not affect functioning and gait: a double-blind
Joyce L Benner1,2, Kirsten D S Boerma-Argelo3, Myrthe D Simon-Konijnenburg3
1Department of Orthopaedic Surgery, Centre for Orthopaedic Research Alkmaar (CORAL), Northwest Clinics, Wilhelminalaan 12, Alkmaar, 1815 JD, The Netherlands. jl.benner@nwz.nl.
Archives of Orthopaedic and Trauma Surgery
|August 28, 2024
Summary
Resecting Hoffa's fat pad during total knee arthroplasty (TKA) does not impact overall functional outcomes or gait quality. Both surgical approaches yield similar results, indicating preservation is a viable option.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Rehabilitation Science
Background:
- Hoffa's fat pad is a potential source of anterior knee pain and can affect prosthetic knee function.
- The role of Hoffa's fat pad resection in total knee arthroplasty (TKA) remains controversial regarding functional outcomes and gait quality.
Purpose of the Study:
- To compare functional recovery between TKAs with Hoffa's fat pad resection versus preservation.
- To assess the correlation between self-reported function and objective gait-related outcomes post-TKA.
Main Methods:
- A double-blind randomized controlled trial involving 85 patients undergoing TKA for osteoarthritis.
- Patients were randomized to either fat pad resection or preservation.
- Subjective (KOOS, Kujala, VAS) and objective (gait analysis, range-of-motion) measures were collected over 12 months.
Main Results:
- No significant differences in minimal clinical important difference (MCID) or patient acceptable symptom state (PASS) between groups at 3 and 12 months.
- Resection group showed poorer initial quality of life scores but better knee extension post-3 months.
- Subjective function improved early (3 months), while objective outcomes improved later (3-12 months).
Conclusions:
- Similar functional outcomes, including gait quality, are achieved with or without Hoffa's fat pad resection in TKA.
- Preserving the fat pad does not compromise functional recovery and may be beneficial for surgical exposure.
- Discrepancies between subjective and objective recovery highlight the importance of utilizing both outcome measures.
