Etiology:
The term "Hoffa's fat" originates from the surname of the German doctor Albert Hoffa, who identified it in the 19th century. The term "fat" refers to its adipose composition, while "Hoffa" honors the professional who described it. In etymological terms, "lipos" from ancient Greek denotes "fat," highlighting the fatty nature of the tissue.
Synonyms:
Some synonymous terms include:
- Infrapatellar fat pad
- Hoffa's fat pad
- Prepatellar adipose tissue
- infrapatellar fat pad (in English).
Definition:
Hoffa's fat is an accumulation of adipose tissue located in the prepatellar region of the knee joint. Functionally, it acts as a shock absorber and joint stabilizer. When this tissue undergoes pathological growth or inflammation, it is referred to as "pathological Hoffa's fat."
Symptoms:
Typical symptoms include:
- Prepatellar pain, exacerbated by joint movements and weight-bearing.
- Localized edema in the affected area.
- Restriction in knee range of motion.
Diagnoses:
Various diagnostic methods are used, such as:
- Physical assessment: Inspection and palpation to identify changes in morphology and prepatellar sensitivity.
- MRI: Provides detailed visualization of the anatomy, allowing detection of alterations in Hoffa's fat.
- Ultrasound: Useful for assessing the structure and vascularization of the prepatellar adipose tissue.
Etiology:
Etiological factors include:
- Chronic trauma: Repeated microtrauma can trigger a localized inflammatory response.
- Obesity: Excess adipose tissue increases the load on the knee, exacerbating inflammation in Hoffa's fat.
- Inflammatory conditions: Diseases like rheumatoid arthritis can cause an autoimmune response, contributing to inflammation in the prepatellar adipose tissue.
Treatments:
The therapeutic approach includes:
- Relative rest and physiotherapy: Reducing joint load followed by a rehabilitation program focused on strengthening and flexibility.
- Anti-inflammatory medication: Administration of NSAIDs to control inflammation and pain.
- Surgical intervention: In refractory cases, partial or total resection of the prepatellar adipose tissue may be considered through arthroscopic or open techniques.
Conclusions:
Pathological Hoffa's fat represents a clinical challenge that requires a comprehensive approach for management. The combination of conservative measures and, in selected cases, surgical interventions helps improve symptoms and restore joint function in affected patients. Early diagnosis and individualized treatment are crucial to minimize long-term complications and optimize clinical outcomes.
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