Skip to main content
SpringerLink
Log in

Infrapatellar fat pad pressure and volume changes of the anterior compartment during knee motion: possible clinical consequences to the anterior knee pain syndrome

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

This biomechanical study was performed to measure tissue pressure in the infrapatellar fat pad and the volume changes of the anterior knee compartment during knee flexion–extension motion. Knee motion from 120° of flexion to full extension was simulated on ten fresh frozen human knee specimens (six from males, four from females, average age 44 years) using a hydraulic kinematic simulator (30, 40, and 50 Nm extension moment). Infrapatellar tissue pressure was measured using a closed cell sensor. Infrapatellar volume change in the anterior knee compartment was evaluated subsequent to removal of the fat pad using a water-filled bladder. We found a significant increase of the infrapatellar tissue pressure during knee flexion, at flexion angles of <20° and >100°. The average tissue pressure ranged from 343 (±223) mbar at 0° to 60 (±64) mbar at 60° of flexion. The smallest volume in the anterior knee compartment was measured at full extension and 120° of flexion, whereas the maximum volume was observed at 50° of flexion. In conclusion, the data suggest a biomechanical function of the infrapatellar fat pad at flexion angles of <20° and >100°, which suggests a role of the infrapatellar fat pad in stabilizing the patella in the extremes of knee motion.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Abe T, Morgan DA, Guttermann DD (1997) Protective role of nerve growth factor against postischemic dysfunction of sympathetic coronary innervation. Circulation 95:213–220

    CAS  PubMed  Google Scholar 

  2. Bermann AT, Bosacco SJ, Israelite C (1991) Evaluation of total knee arthroplasty using isokinetic testing. Clin Orthop 271:106–113

    PubMed  Google Scholar 

  3. Bray RC, Roth JH (1987) Clinical evaluation of anterior knee pain. Diagnosis October:69–96

    Google Scholar 

  4. Davidson K (1993) Patellofemoral pain syndrome. Am Fam Physician 48:1254–1262

    CAS  PubMed  Google Scholar 

  5. Fuchs S, Tibesku CO, Floren M, Thorwesten L (2000) Interdependence of clinical and isokinetic results after bicondylar knee prostheses with special emphasis on quality of life results. Int Orthop 24:268–271

    Article  CAS  PubMed  Google Scholar 

  6. Garrick JG (1989) Anterior knee pain (chondromalacia patella). Physician Sportsmed 17:75–84

    Google Scholar 

  7. Gerrard B (1989) The patello-femoral pain syndrome: a clinical trial of the McConnell programme. Aust J Physiother 35:71–80

    Google Scholar 

  8. Goldberg B (1991) Chronic anterior knee pain in the adolescent. Pediatr Ann 20:186–193

    CAS  PubMed  Google Scholar 

  9. Hille E, Schulitz KP, Heinrichs C, Schneider T (1985) Pressure and contact surface measurements within the femoropatellar joint and their variations following lateral release. Arch Orthop Trauma Surg 104:275–282

    CAS  PubMed  Google Scholar 

  10. Hoffa A (1904) The influence of the adipose tissue with regard to the pathology of the knee joint. JAMA 43:795–796

    Google Scholar 

  11. Huberti HH, Hayes WC (1984) Patellofemoral contact pressures. J Bone Joint Surg 66-A:715–724

    CAS  PubMed  Google Scholar 

  12. Insall J (1982) Patellar pain. J Bone Joint Surg 64-A:147–152

    CAS  PubMed  Google Scholar 

  13. Kohn D, Deiler S, Rudert M (1995) Arterial blood supply of the infrapatellar fat pad. Arch Orthop Trauma Surg 114:72–75

    CAS  PubMed  Google Scholar 

  14. Lee TH, Kato H, Kogure K, Itoyama H (1996) Temporal profile of nerve growth factor-like immunoreactivity after transient focal cerebral ischemia in rats. Brain Res 713:199–210

    Article  CAS  PubMed  Google Scholar 

  15. Lorentzen J, Petersen MM, Brot C, Madsen OR (1999) Early changes in muscle strength after total knee arthroplasty. Acta Orthop Scand 70:176–179

    CAS  PubMed  Google Scholar 

  16. Magi M, Barca A, Bucca C (1991) Hoffa disease. Ital J Orthop Traumatol 17:211–216

    CAS  PubMed  Google Scholar 

  17. Malcangio M, Bowery NG (1999) Peptide autoreceptors: does an autoreceptor for substance-P exist? Trends Pharmacol Sci 20:405–407

    Article  CAS  PubMed  Google Scholar 

  18. Malek MM, Mangine RE (1981) Patellofemoral pain syndromes: a comprehensive and conservative approach. Orthop Sports Phys Ther 2:108–116

    Google Scholar 

  19. Matthews LS, Sontesgard AD, Henke JA (1977) Load bearing characteristics of the patellofemoral joint. Acta Orthop Scand 48:511–516

    CAS  PubMed  Google Scholar 

  20. Müller W, Wirz D (2000) Anatomie, Biomechanik und Dynamik des Patellofemoralgelenks. In: Wirth CJ, Rudert M (eds) Das patellofemorale Schmerzsyndrom. Steinkopff, Darmstadt, pp 3–19

    Google Scholar 

  21. Nimon G, Murray D, Sandow M, Goodfellow J (1998) Natural history of anterior knee pain: a 14- to 20 year follow-up of nonoperative management. J Ped Orthop 18:118–122

    Article  CAS  Google Scholar 

  22. Ogilvie-Harris DJ, Giddens J (1994) Hoffa’s disease: arthroscopic resection of the infrapatellar fat pad. Arthroscopy 10:184–187

    PubMed  Google Scholar 

  23. Patel SJ, Kaplan PA, Dussault RG, Kahler DM (1998) Anatomy and clinical significance of the horizontal cleft in the infrapatellar fat pad of the knee: MR imaging. AJR Am J Roentgenol 170:1551–1555

    CAS  PubMed  Google Scholar 

  24. Ralis ZA (1989) Freezing of orthopaedic specimens before mechanical testing. J Bone Joint Surg 71-B:55–57

    CAS  Google Scholar 

  25. Roush MB, Sevier TL, Wilson JK, Jenkinson DM, Helfst RH, Gehlsen GM, Basey AL (2000) Anterior knee pain: a clinical comparison of rehabilitation methods. Clin J Sports Med 10:22–28

    Article  CAS  Google Scholar 

  26. Sandow MJ, Goodfellow JW (1985) The natural history of anterior knee pain in adolescents. J Bone Joint Surg 67-B:36–38

    CAS  Google Scholar 

  27. Smillie IS (1963) Lesions of the infrapatellar fat pad and synovial fringes: Hoffa’s disease. Acta Orthop Scand 33:371–377

    Google Scholar 

  28. Steiner ME, Grana WA (1988) The young athlete’s knee: recent advances. Clin Sports Med 7:527–546

    CAS  PubMed  Google Scholar 

  29. Stukenborg-Colsman C, Ostermeier S, Wenger KH, Wirth CJ (2002) Relative motion of a mobile bearing inlay after total knee arthroplasty—dynamic in vitro study. Clin Biomech 17:49–55

    Article  CAS  Google Scholar 

  30. Stukenborg-Colsman C, Ostermeier S, Hurschler C, Wirth CJ (2002) Tibiofemoral contact stress after total knee arthroplasty: comparison of fixed and mobile-bearing inlay designs. Acta Orthop Scand 73:638–646

    Article  PubMed  Google Scholar 

  31. Vahlensiek M, Linneborn G, Schild H, Schmidt HM (2002) Hoffa’s recess: incidence, morphology and differential diagnosis of the globular-shaped cleft in the infrapatellar fat pad of the knee on MRI and cadaver dissections. Eur Radiol 12:90–93

    Article  CAS  PubMed  Google Scholar 

  32. Whitelaw GP, Rullo DJ, Markowitz HD, Marandola MS, DeWaele MJ (1989) A conservative approach to anterior knee pain. Clin Orthop 246:234–237

    PubMed  Google Scholar 

  33. Wilson SA, McCann PD, Gotlin RS (1996) Comprehensive gait analysis in posterior-stabilized knee arthroplasty. J Arthroplasty 11:359–367

    CAS  PubMed  Google Scholar 

  34. Witonski D, Wagrowska-Danielewicz M (1999) Distribution of substance-P nerve fibers in the knee joint in patients with anterior knee pain syndrome. Knee Surg Sports Traumatol Arthrosc 7:177–183

    Google Scholar 

  35. Woolf CJ, Allchorne A, Safieh-Garabedian B, Poole S (1997) Cytokines, nerve growth factor and inflammatory hyperalgesia: the contribution of tumor necrosis factor alpha. Br J Pharmacol 121:417–424

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Hannover Medical School, Anna-Von-Borries-Strasse 1-7, 30625, Hannover, Germany

    Michael Bohnsack, Christof Hurschler, Taskin Demirtas, Oliver Rühmann, Christina Stukenborg-Colsman & Carl-Joachim Wirth

Authors
  1. Michael Bohnsack
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christof Hurschler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Taskin Demirtas
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Oliver Rühmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Christina Stukenborg-Colsman
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Carl-Joachim Wirth
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael Bohnsack.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bohnsack, M., Hurschler, C., Demirtas, T. et al. Infrapatellar fat pad pressure and volume changes of the anterior compartment during knee motion: possible clinical consequences to the anterior knee pain syndrome. Knee Surg Sports Traumatol Arthrosc 13, 135–141 (2005). https://doi.org/10.1007/s00167-004-0561-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-004-0561-1

Keywords

Search

Navigation