Fat pad impingement has been recognized as a cause of anterior knee pain. However, outcomes with management by arthroscopic fat pad resection, particularly in the athlete, are poorly understood.
The aim of this study was to describe the clinical outcome of a cohort of athletes diagnosed with infrapatellar fat pad (IFP) impingement who fail conservative treatment and treated with partial arthroscopic infrapatellar fat pad excision.
A retrospective study was performed on high school and collegiate level athletes who underwent arthroscopic fat pad debridement for IFP impingement after failed conservative treatment. Patient reported outcomes, return to sport, and complications were recorded at 3 ,6, 12 and 24 months following surgery.
A total of 28 athletes were included in the study. IKDC scores improved from 42.7 preoperatively to 77.6 at 2 years follow up. Lysholm scores improved from 42.2 preoperatively to 83.2 at 2 years. Twenty-seven athletes (96.4%) were able to return to play at an average of 9.6 weeks after surgery. Return to sport at the same or higher level occurred in 82.1% of the athletes in this study. Recurrent anterior knee pain occurred in 2 (7.1%) of the participants. No patient required revision fatpad debridement. Complications included 2 patients with arthrofibrosis of the ipsilateral knee, both of which required manipulation under anesthesia between 6 and 9 weeks from primary surgery. No infections or other complications occurred.
Surgical debridement of the fat pad in patients with IFP impingement can lead to good patient reported outcomes in short-term follow up. A high return to sport was found with 96.4% of athletes returning at an average of 9.6 weeks, with 82.1% able to return to sport at the same or higher level. The procedure appears to be safe with a low complication rate.