Infrapatellar Fat Pad Inflammation

Treatment

Restoring the biomechanics of the knee is considered a fundamental basis of physical therapy intervention when treating anterior knee pain.  Influencing correct patellar tracking through active interventions and passive realignment management like bracing or taping can aid in decreased impairment (3).  Stabilization of proximal structures including the hip and pelvis can be addressed in the intervention of anterior knee pain cause by fat pad irritation.

Other nonoperative treatments options include:

·         Quadriceps and gluteal muscle training

·         Gait training

·         Steroidal or anesthetic or alcohol ablation

Surgical interventions are considered when above treatment options result  in none or negative improvements.

·         Fat pad excisions

·         Partial resection

·         Debridement of fibrosis

·         Anterior interval release

·         Synovectomy

·         Infrapatellar plica relaes

·         Denervation of inferior pole of the patella

Prevention

Maintaining optimal knee biomechanics with individual activities preformed will decrease the risk of infrapatellar fat pad irritation. Activity modifications that reduce the risk of excessive mechanical load and management of activity that provokes pain will aid in IFP integrity. 

Education

Education of anatomical structures, activity modification recommendations, and treatment options are most beneficial.

References

(1) Eivazi M, Selfe J. Infrapatellar fat pad lesions: theoretical considerations and practical implications. Physical Therapy Reviews [serial online]. February 2008;13(1):11-16.
Paulos, L., Wnorowski, D., Greenwald, A., , , & , (1994). Infrapatellar contracture syndrome. diagnosis, treatment, and long-term followup. Am J Sports Med, 22(4), 440-449.
(3) Dragoo J, Johnson C, McConnell J. Evaluation and Treatment of Disorders of the Infrapatellar Fat Pad. Sports Medicine [serial online]. 2012;42(1):51-67.