The effect of Hoffa's fat pad resection in total knee arthroplasty.

Little is known about the function of Hoffa’s fat pad in both the normal knee as well as in case of a knee prosthesis. Literature indicates that the fat pad may play a, possibly detrimental, role in modulating inflammatory and destructive responses in knee osteoarthritis. However, in total knee arthroplasty all cartilage is removed and this role of Hoffa’s fat pad can therefore be considered irrelevant. Furthermore, Hoffa’s fat pad is considered to be a source of anterior knee pain and may limit the function of the prosthetic knee, possibly in association with the prevalence of fibrosis. Henceforth our hypotheses are that resection of Hoffa’s fat pad in total knee arthroplasty leads to 1) a greater range of motion and recovery of range of motion closer to the preoperative range of motion during follow-up, 2) less anterior knee pain during follow-up, 3) a faster recovery and enhanced values of gait parameters, such as preferred walking speed and variation in knee angle during walking.

It is hypothesized that Hoffa’s fat pad resection in total knee arthroplasty leads to a greater range of motion, a faster recovery of normal walking gait and preferred walking speed, less anterior knee pain, a higher KOOS score and better patient satisfaction post operatively and at follow-up.

Pre-op, day of discharge, 6 weeks post-op, 3 months post-op and 12 months post-op.

One group will undergo Hoffa’s fat pad resection and one group will not during implantation of a total knee prosthesis.