What Does Hoffa's Syndrome Or Hypertrophic Fat Pad Mean?

Posted on Mon, 2 Jun 2014

Question: My mri says I have a medial meniscus tear not what kinda or to what degree and says I have something called Hoffa' s syndrome or hypertrophic fat pad . What in the world is this and what does it mean ? I 've never had any arthroscopic surgery before so how did this occur and what does this mean for me surgically I'm due for surgery next Thursday I'm scared and I don't know what they are going to do to me....please someone explain should I have surgery or no??

Answered by Dr. Vaibhav Gandhi (21 hours later)

Brief Answer:
Excision of impinging fat pad is a very safe proce

Detailed Answer:
Hi,

I have studied your case with diligence

Fat pad is one of the most sensitive structures in the knee; Hoffa’s condition is known to be extremely painful. The knee pain is situated anteriorly on either side of the lower kneecap and is worsened by straightening (extension) of the knee joint. Hence the fat pad comes under constant irritation and may become significantly inflamed.
It is also termed Hoffa’s Syndrome.

Excision of impinging fat pad is a very safe procedure. The surgeon will attempt to remove the impinging portion of the fat pad only. The rest of the fat pad behind the patellar tendon should not be excised.

The quadriceps muscle will need to build up again over time.
Most patients return to work within a week of the surgery.

So not to worry you can do arthroscopic surgery.
Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Take care.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Vaibhav Gandhi (8 hours later)

Thank you for your time and I just wanted to know is this what causes that deep ache I have on each side of my knee it's very painful I ice it regularly and rest quite a bit. Is there anything else I can do to help with the pain? Will the pain go away after surgery?

Answered by Dr. Vaibhav Gandhi (7 hours later)

Brief Answer:
Explained below

Detailed Answer:
Hello XXXXXXX

Yes this fat impingement can lead to pain.
There can be associated meniscus degeneration that may lead to pain ,while doing arthroscopy he may check them and treat it if required.

Pain arising from fat impingement will go after surgery.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vaibhav Gandhi (3 hours later)

When I wake up in the morning usually one shoulder or the other is in great pain at first I can't move it at all then as I force myself to gently make circles with it or put it over my head and pull like I'm trying to pop it back into place it hurts so bad usually it's the left but I woke up tonight and its my right the pain is almost unbearable what can I do ? What is this? Do I have arthritis? Or something else on a scale of 1-10 it's about an 8 I wake up and cry and generally most things don't do that to me. However after so stretching and time it fades away but when I wake up my word the pain is excruciating what could it be?

Answered by Dr. Vaibhav Gandhi (41 minutes later)

Brief Answer:
possibility of frozen shoulder/pericapsulitis.

Detailed Answer:
Hello,

Thanks for writing to us,
I have studied your case with diligence.

As per your history and symptoms there is possibility of frozen shoulder/pericapsulitis.
For frozen shoulder physiotherapy and exercises are very important.
You can take medication before doing exercises to avoid stretch pain.
If stiffness increases then intra-articular injection shot can be taken.
For severe cases we do manipulation of shoulder joint under anaesthesia.

Another possibility of rotator cuff partial injury leading to persistent pain.
Physiotherapist can help you to improve strength of muscles.
Shoulder arthritis is less likely at early age unless there is some familial arthritis.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vaibhav Gandhi (25 minutes later)

To be more specific it hurts to raise my right arm straight up or down I can go out with it just up or down the pain is just unbearable it wakes me up at night it's four am where I am I took a hydrocodone and I waiting for it to work so I can get some rest I have pre-op for my knee tomorrow morning, ok so frozen shoulder you say well what's the treatment and cause of that , I've been reading on web md while awaiting your responses it sounds to me like this rotator cuff problem it's both shoulders a couple of weeks ago it was my left shoulder twice in a week and now my right and every time it's awoke me from sleep panicking not being able to move your arm is scary then after the medicine kicks in or I gently move it around it goes away so it's fixable you say no surgeries I hate those, well I'll await your response thank you sir,XXXX

Answered by Dr. Vaibhav Gandhi (27 hours later)

Brief Answer:
Consult physiotherapist for exercises.

Detailed Answer:
Hello,

I have studied your case.
For frozen shoulder
You may consult physiotherapist for exercises, manual therapy, and rehabilitation
He may start TENS ,or ultrasound which is helpful in your case.

If no relief with therapy then,
you may need manipulation under anaesthesia or arthroscopic adhesion release.
If there is suspicion of rotator cuff injury then MRI will help in diagnosis.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar