Infrapatellar Fat Pad Preservation versus Resection in Total Knee Arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Radiology

Background:

• The infrapatellar fat pad (IPFP) quality during total knee arthroplasty (TKA) is debated.
• Preservation of normal IPFP is suggested, while abnormal IPFP are often resected.

Purpose of the Study:

• To investigate the impact of IPFP preservation versus resection on TKA outcomes.
• To compare postoperative results based on the preoperative quality of the IPFP.

Main Methods:

• Patients with knee osteoarthritis (OA) undergoing TKA were stratified by IPFP status (normal vs. abnormal) using MRI.
• Participants were randomly assigned to either IPFP preservation or resection.
• The primary outcome was the 12-month change in the Knee Injury and Osteoarthritis Outcome Score (KOOS₅).

Main Results:

• No significant difference in KOOS₅ improvement was observed between IPFP preservation and resection groups in both normal (1.9 difference) and abnormal (1.6 difference) IPFP groups.
• Both groups showed substantial improvements in KOOS₅ scores post-TKA.
• Adverse events were generally mild and similar between preservation and resection groups within each IPFP status category.

Conclusions:

• Neither preserving normal IPFP nor resecting abnormal IPFP improved 12-month postoperative outcomes after TKA.
• The findings suggest that IPFP management strategy may not significantly impact functional recovery in TKA patients.