Fat Pad Impingement
Fat pad impingement is among the many sports-related injuries and conditions treated by Augustana College's Sports Medicine Staff.
Fat Pad Anatomy Generalized pain in the front of the knee, also known as anterior knee pain, can have many causes. One of them is impingement of the fat pad. The fat pad is a mass of fatty tissue that lies below the kneecap (patella) and behind the patellar tendon. Its function is to provide a cushion from pressure or direct impact.
Fat Pad Impingement Signs and Symptoms Fat pad impingement can occur when the fat pad becomes swollen and inflamed due to a direct blow or chronic irritation. As a result, the bottom tip (or inferior pole) of the patella can pinch the fat pad. This is more likely to occur in a person who has a patella that is tilted posteriorly at the inferior pole. A person who has excessive hyperextension of the knee may also be more prone to this condition. Fat pad impingement can be easily confused with patellar tendonitis. However, patellar tendonitis tends to cause pain only at the patellar tendon, especially at the inferior pole of the patella. Fat pad impingement will cause pain on either side of the patellar tendon, where the fatty tissue sits. The pain may be worse with jumping, prolonged standing or any other position that causes the knees to hyperextend. Also, the area around the patellar tendon may be slightly swollen. Fat pad impingement is not associated with clicking, locking or instability.
Fat Pad Impingement Treatment Treatment of fat pad impingement is not difficult, although it can take a long time to fully recover. Applying an ice bag for 15 minutes or applying an ice cup for 8-10 minutes is a good place to start. Modifying or limiting positions and activities that increase pain is another key to recovery. Stretching the quadriceps and hip flexor muscles may help to lessen some of the downward pressure the patella applies to the fat pad. Anti-inflammatory medicines are also frequently used. Much less often, injections of corticosteroids to reduce inflammation or surgery to trim the fat pad are required.
(Chapter 24) Radiol Med (Torino). 1998 Apr;95 (4):278-85
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