The management of solitary tumours of Hoffa's fat pad

• Published in: The knee Vol. 18; no. 2; pp. 67 - 70
• Main Authors: Dean, B.J.F, Reed, D.W, Matthews, J.J, Pandit, H, McNally, E, Athanasou, N.A, Gibbons, C.L.M.H
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-03-2011; Elsevier Limited
• Subjects: Adipose Tissue - pathology; Adipose Tissue - surgery; Adolescent; Adult; Aged; Child; Female; Ganglion Cysts - complications; Ganglion Cysts - diagnosis; Ganglion Cysts - surgery; Hoffa's fat pad; Humans; Knee Joint - pathology; Knee Joint - physiopathology; Knee Joint - surgery; Magnetic Resonance Imaging; Male; Management; Middle Aged; Orthopedics; Pain - diagnosis; Pain - etiology; Pain - surgery; Patella - pathology; Patella - physiopathology; Patella - surgery; Soft Tissue Neoplasms - complications; Soft Tissue Neoplasms - diagnosis; Soft Tissue Neoplasms - surgery; Solitary tumours; Synovitis, Pigmented Villonodular - complications; Synovitis, Pigmented Villonodular - diagnosis; Synovitis, Pigmented Villonodular - surgery; Treatment Outcome; Young Adult; Hoffa's fat pad; Solitary tumours; Management
• ISSN: 0968-0160; 1873-5800
• DOI: 10.1016/j.knee.2010.02.002

Abstract Hoffa's fat pad (HFP) of the knee is affected by a variety of tumours and tumour-like conditions. HFP can be affected by diffuse or solitary, focal disease. This paper reports a consecutive series of 19 cases of solitary symptomatic HFP tumours. The commonest presenting symptom was anterior knee pain. All patients underwent open excision after diagnostic magnetic resonance imaging (MRI). Histology revealed varied diagnoses with the commonest being pigmented villonodular synovitis (PVNS) and ganglia. American Knee Society scores improved from 76 pre-operatively to 96 post-operatively with an improvement in functional scores from 92 to 100. In conclusion the majority of solitary HFP tumours are benign and may be either cystic or solid. MRI and plain radiographs are the imaging of choice. The definitive treatments of both cystic and solid tumours should be selective arthrotomy and excision biopsy. All patients in this series reported substantial improvement in symptoms following surgery.