What are the other Names for this Condition?

(Also known as/Synonyms)

Fat Pad Impingement Syndrome

Hoffas Fat Pad Disease

Infrapatellar Fat Pad Syndrome

What is Hoffa Disease? (Definition/Background Information)

Hoffa Disease is a benign disorder of the synovium (a protective layer surrounding

the joint space), caused as a response to injury. Hence, it is a post-traumatic reactive
condition

It is often seen around the knee joint. The disorder causes swelling below the patellar
bone, which is observed in front of the knee joint. Even though commonly seen
around the knee joint, other joints of the body may be affected too

Hoffa Disease is also known as Fat Pad Impingement Syndrome, because of the
impingement of the fat between the patella and the lower portion of the thigh bone

A tissue biopsy helps in a definitive diagnosis of the condition, which is treated using
both conservative methods and surgical procedures (if the signs and symptoms are
severe)

With appropriate treatment, the prognosis of Hoffa Disease is good

Who gets Hoffa Disease? (Age and Sex Distribution)

Hoffa Disease may occur in individuals of all ages, races, ethnic groups, and gender

However, it is more common in men than women

Generally, men who are physically active, have a high incident rate

What are the Risk Factors of Hoffa Disease? (Predisposing Factors)

Some of the risk factors associated with Hoffa Disease include:

Repeated physical activity involving sudden bending or straightening of the knee joint

Sports activity that cause repeated stress to the knee, such as football, beach
volleyball, gymnastics, soccer

Certain occupations that require prolonged kneeling, also increases the risk

It is important to note that having a risk factor does not mean that one will get the condition.
A risk factor increases ones chances of getting a condition compared to an individual without
the risk factors. Some risk factors are more important than others.
Also, not having a risk factor does not mean that an individual will not get the condition. It is
always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Hoffa Disease? (Etiology)

An acute injury or chronic repetitive stress can cause Hoffa Disease

Hoffa Disease (Infrapatellar Fat Pad Syndrome) occurs because of an impingement or

pinching of fat tissue between the kneecap (patella) and the lower portion (distal end)
of the thigh bone, called femoral condyle

What are the Signs and Symptoms of Hoffa Disease?

The signs and symptoms of Hoffa Disease include:

Restricted range of motion in the affected joints

It usually causes pain that increases with physical activity (like exercise), or while
stretching/straightening ones knee

Frequently, Hoffa Disease affects the knee joint; although, other joints may also be
affected

The condition can cause an accumulation of joint fluid, called a reactive joint
effusion, due to repeated injury of the synovial layer that surrounds a joint

How is Hoffa Disease Diagnosed?

A diagnosis of Hoffa Disease may involve:

A physical examination and evaluation of complete medical history by a healthcare

provider

X-ray of the affected joint

MRI scan of the affected joint

A tissue biopsy, where the tissue is examined by a pathologist under the microscope,
to arrive at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider
may perform additional tests to rule out other clinical conditions to arrive at a definitive
diagnosis.

What are the possible Complications of Hoffa Disease?

The possible complications from Hoffa Disease include:

If treatment is lacking or is not provided in a timely manner, then the condition can
progress to cause damage to the affected joint

Pain can be severe and decrease the quality of ones life

How is Hoffa Disease Treated?

Conservative methods of treatment of Hoffa Disease are employed initially and these may
include:

Rest and reduction in physical activity is the first choice

Ice pack can reduce inflammation

Physical therapy

Use of well-fitting shoes to reduce stress on the knee joint

Over-the-counter pain medication may be used to reduce inflammation

Steroid injection to the site of swelling

If the condition is recurrent causing significant pain and swelling, then surgery is
recommended.

A surgery involves the removal of extrasynovial fat tissue, which occurs as a reaction
to a repeated injury

Surgery to treat Hoffa Disease is performed using arthroscopy, a minimally-invasive

procedure

How can Hoffa Disease be Prevented?

A few preventive measures for Hoffa Disease include:

Perform appropriate warming-up or stretching exercises, before taking part in a

physical activity

Participants of intense physical and sports activities have to be physically fit, and
ensure that they maintain their stamina and strength

Use of suitable protective gear around the knee joint, like knee padding

If a diagnosis of Hoffa Disease is made, then a reduced (or a complete cessation of)
physical activity can help decrease progression of the condition

If there is repeated pain around the affected joint, do visit your physician immediately

What is the Prognosis of Hoffa Disease? (Outcomes/Resolutions)

The prognosis of Hoffa Disease is generally very good with surgical treatment, in
advance cases

In case of a knee joint injury, a complete recovery is encouraged, before returning to

any intense physical activities

A lack of treatment or delayed treatment may cause additional complications, such as

prolonged pain and joint damage

Additional and Relevant Useful Information for Hoffa Disease:

The following article link will help you understand arthroscopic surgical procedure.
http://www.dovemed.com/article/arthroscopy/

What are some Useful Resources for Additional Information?

DoveMed is currently working to bring you additional resources.
Please sign up by creating a DoveMed account to receive periodic notification on information
updates.

References and Information Sources used for the Article:

http://www.sw.org/misc/health/Hoffa's%20Disease%20(Infrapatellar%20Fat%20Pad
%20Syndrome)%20with%20Rehab-SportsMed.html (accessed on 05/08/2014)
http://www.bjjprocs.boneandjoint.org.uk/content/88-B/SUPP_II/254.1 (accessed on
05/08/2014)
http://www.ncbi.nlm.nih.gov/pubmed/9676203 (accessed on 05/08/2014)

Helpful Peer-Reviewed Medical Articles:

Turhan, E., Doral, M. N., Atay, A. O., & Demirel, M. (2008). A giant extrasynovial
osteochondroma in the infrapatellar fat pad: end stage Hoffa's disease. Arch Orthop Trauma
Surg, 128(5), 515-519. doi: 10.1007/s00402-007-0397-5
Wu, H., Xu, Q., & Zhou, W. (1995). [Hoffa disease: diagnosis and arthroscopic treatment].
Zhonghua Wai Ke Za Zhi, 33(10), 581-583.
Zhang, Q., Zhang, S., Fan, C. C., & Li, R. (2009). [Arthroscopic diagnosis and treatment of
Hoffa disease]. Zhongguo Gu Shang, 22(6), 468-469.

Reviewed and Approved by a member of the DoveMed Editorial Board

First uploaded: May 12, 2014
Last updated: Oct. 15, 2015
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