This is an example of a patient whom I treated recently. WEIGHT BEARING BRACE ROM EXERCISES PHASE I . Make sure you have very flexible quads on both legs, mobile kneecaps and you use a roller 2x/day. She had cortisone knee injections and countless rounds of physical therapy with no relief. Hoffa fat pad scarring can be seen as a result of injury and subsequent insufficiency of the ACL ligament. If activity modification, physiotherapy, taping and medication do not prove effective over an appropriate period, such as six months. I slipped and landed on both my knees, my left knee taking the most damage. I dont say that too often, as a physical therapist, but if long-term pain medicine and serious chronic pain in the outcome as-is, its time to change that plan. Am I at the chronic stage now that Ive waited too long? A giant extrasynovial osteochondroma in the infrapatellar fat pad: end stage Hoffa's disease. Serious frustration with the lack of progress after such a long time. Had two physics and been icing, resting, rebuilding with no change at all. [16] Go to: Comment on this article. Pain below and to the sides of the patella tendon with leg extension along with noticeable bulges to the sides of the patella tendon when the knee reaches full extension. I was seen by my family physician for knee pain and referred to physical therapy. There was no initial injury or hyperextension that caused it, just lots of running. I wish you well. Never long distance as knees wouldnt let me. 1. There are several issues that may result in Hoffa's fat pad impingement: Imbalance in the knee muscles Previous kneecap dislocation Previous trauma of the kneecap Hypermobility 1. Im also disabled and have seizures and dont drive, therefore I walk everywhere or take the local bus. Eventually I had another surgery that was effective. Also, do I go back to total rest? Can the scar tissue cause damage in my knee? My suggested plan: Any help is appreciated! Within a maximum of 3 months before arthroscopic surgery, patients had standardized MR imaging using a 1.5 Tesla unit with the following sequences: sagittal T1-TSE, coronal STIR-TSE, transversal fat-suppressed PD-TSE, and sagittal fat-suppressed PD-TSE (Siemens Magnetom Avanto syngo MR B 15). Acute injury or overuse: The fat pad may become inflamed following an increase in training, a single overuse event, trauma to another tissue (e.g. There are four main causes of Hoffas fat pad impingement: biomechanics, repeated hyperextension in sport, acute hyperextension with an injury, and direct trauma. Fast bowlers in cricket are an excellent example of this. 29873 - ARTHROSCOPY KNEE LATERAL RELEASE Balance out walking patterns = each side of your body (knee band, foot position, arm swing, trunk rotation, foot placement,..etc.) Wound debridement. So many of the fat pad impingement injury stories have painful outcomes. . However, in my stubbornness I didnt rest- I was still teaching spin, doing squats and lunges and high impact classes. Many knee injuries involve a blow to the front of the knee and the fat pad is an effective structure to buffer the forces on the vulnerable articular surfaces of the distal femur. When my knee is bent, I feel virtually nothing; however, when standing up and keeping my knee very straight, I feel TIGHTNESS and DISCOMFORT in the knee, in an area which I feel is hard to localize. It's a painful condition. and transmitted securely. I am worried I am chronic and the fat pad is permanently huge! Fat pad impingement of the knee, also called Hoffas syndrome, is a common cause of pain in the front of the knee. I then started PT and they did some hip strengthening exercises along with hamstrings (my hamstrings are extremely flexible and not strong). . However I went to the doctor for the pain being above my knee cap on the left side. The buccal fat pad is one of many ways to close an intraoral opening into the maxillary sinus. BURNSVILLE, Minn. Corinne Carrasco said she has been self-conscious of her "round . To answer your questions: Heres the key points to think about before you look at more rehab, another injection and/or surgery: You need to restore your knee range of motion (ROM), mechanics and strength. Question- I havent tried a steroid. However I seem to have more pain while normal bending of the knee to get into bed and other activities. 2. Actual Study Start Date : April 27, 2021. FOIA Your improvement will be baby steps so be consistent and avoid drastic changes in your knee activity. If youre getting sharp debridement, youll get local or general anesthesia. MRI is also a useful means of diagnosing fat pad impingement and other concomitant pathologies. Arthroscopic partial resection for IFP impingement and Hoffa's disease has showed favourable results; however, total excision of the IFP performed concomitantly with total knee arthroplasty (TKA) resulted in worse results when compared with TKA alone. Patella mobilizations regaining normal motion of your kneecaps is key. Hi Mike Dry Needling around the knee and patella tendon should help the pain. Example: Simple standing or prolonged sitting is returning you to a painful knee. Hopefully by that time, the knee mechanics and patella tracking patterns have been corrected. Thank you for the advice and reply so quickly! Warmup thoroughly before playing tennis. Seeing it has been 6 months, it is officially chronic so you need to at all your options. Infrapatellar fat pad inflammation or impingement can be very painful, and is most often felt locally at the site of the fat pad. Request the best knee PTs in your area to rehab your kneewithout injections. The bottom line is you need help now to ensure you benefit from the surgery. If youre getting mechanical debridement, you may receive pain medication. Are you seeing a physical therapist in Denmark? Really desperate and scared any advice? Training of the gluteus medius and stretching the anterior hip may help to decrease internal rotation of the hip and valgus force at the knee. Often, people find fat pad taping useful to reduce pain from fat pad impingement. My options are wait, PRP injection, surgery to trim. Surgery for fat pad irritation should be a last resort when all other treatments have been exhausted. Heres what you need to DO: The reason why your ROM is limited. If it is indeed fat pad infringement, what kind of recovery am I looking at, epecially since the injury is old and has been chronic? Im also getting pain in the back of my knee cap, I have to keep my leg straight whilst sitting down. The old tissue can also be cut off or removed with a mechanical force, like running water. Sounds easy, huh? Make sure you have your physical therapy scheduled before your surgery so you dont waste time during your recovery. Skilled surgical technique may minimize fad pad . I was in a walking cast for about a month and a half until the pain was gone. These are to be attached to the third strip running horizontally across the top of your knee. Surgery for Fat Pad Impingment This is done using key-hole arthroscopy surgery. This can occur if the fat pad is enlarged or swollen it can cause bulging around the bottom of the kneecap making it more susceptible to being pinched. Treatments include simple methods such as rest, ice and proper footwear to more advanced options such as fillers and fat grafting. Gangrene is when part of your body tissue dies. Make an appointment with your doctor to discuss your condition and dissatisfaction with your knee. To provide the best experiences, we use technologies like cookies to store and/or access device information. I really appreciate your time and advice and understand your position of knowing very little but wanting the best for me. How long after arthroscopic debridement surgery should your doctor do ulnar shortening? Epub 2022 Nov 17. The physical therapist also did similar external tests, and diagnosed me with fat pad impingement. -. Find out how to remove skin tags through home remedies and other options. Control your fat pad swelling with ice, no kneeling or hyper-bending, supportive shoes and limited ballistic quad loading. It is not clearly swollen. However, we should differentiate this condition from other causes like patellar tendonitis or kneecap arthritis. Compare the list of PTs with the local running clubs, track teams, high-level fitness clubs,etc. It sounds like you have run the conservative/non-surgery plan for a long time and now surgery is your best option. Have you seen cases like mine which improve, even after it has been 1 year? 2. From your assessment, your physical therapist should understand what has caused you to develop an inflamed fat pad. Hi Mike, in thearpy 4 days a week, had TFCC tear with DRUJ. Or would surgery be my better option now? Repeated fat pad impingement, personal biomechanics, and the individuals conditioning will affect recovery time. No doctors think the joint should be so irritated. 2019 Mar 1;31(1):54-60. doi: 10.5792/ksrr.18.026. That is a sad story Jackie and Im sorry to hear it. didnt seem like a big injury. She was due to start a new job 4 weeks ago as she got adviced crutches for 2 days then start to FWB. Based on the 6 month timeframe shes been dealing with this injury, it is chronic and now more difficult to treat. A 25-year-old female asked: How long is recovery from surgery for fat pad debridement? Knee flexion (bending) Its very common that a painful PFPS knee has very tight quad muscles. The procedure is essential for wounds that. Im now following a far more conservative PT program with the use of an e stims machine on the vmo. Make an appointment with your surgeon and take notes with his explanation of what he did during your surgery. Hi Laila, Sorry to hear about your injury. The procedure is useful if you havent had a dental cleaning for several years. What you describe if often referred to as patella femoral pain syndrome (PFPS) and its not an easy injury to manage as a runner..but Ive suffered from the same injury and I have some tricks to help you. Now 6 Weeks later I am still in so much pain. When bad tissue is removed, the wound can restart the healing process. They told me PT and taping. A positive test is a reproduction of the individuals symptoms. Many thanks. I have been dealing with this for a while and we have tried everything from physical therapy, immobilizing my knee and even a steroid shot into the knee. Forget the heat. Hi Mike my name is Dan. The information you provide is so incredibly informative. 2. It didnt hurt or swell right away, it wasnt until the next morning when I went to walk on it the next day that I knew something was wrong. As such, IFP pressure is greatest during <20 and >100 degrees flexion (Bohnsack et al., 2005). 3. Thanks so much for this blog! Hi Jeff, Im not too excited about your PT just pushing through painful ranges with you on squats and leg extensions. Typically, its used for old wounds that arent healing properly. went back in limping, hobbled about that evening with friends. In some cases, this can lead to severe complications. The https:// ensures that you are connecting to the Is there anything else I should do to accelerate my healing process (e.g. Thanks! Cyclist. If so should I commence taping techniques, voodoo flossing the area, or wearing neoprene knee sleeves? The .gov means its official. It affects my life, happieness and work massively and was not an easy choice to have surgery knowing there would need to be time off work and potential risks that could leave me without the same life or career. Your focus: Find a position with a knee angle/foot position which creates quad fatigue with MINIMAL knee pain. I definitely cant continue with my knee the way it is now, but I am afraid of surgery which could potential make things worse. National Clinical Guideline Centre. 7/11/16 ORTHO: hmm significant swelling and pain for it to be one month post injury ACL feels loose..get MRI eCollection 2015 Mar. PVNS of the Ankle | Sudden Acute AnklePain, Tear of the Rectus Femoris Direct Head SurgicalRepair, Pain and/or swelling around the bottom and under the kneecap, Patients may have a history of knee hyper-extension (called, Positive Hoffas test (with the patient in lying with their knee bent, the examiner presses both thumbs along either side of the patellar tendon, just below the patella. My knee has a strange problem, which looks like a severe nerve irritation from the joint. Im so sorry to hear about your pain and limitation after having your knee injected. This section outlines how to perform this operation. They should also understand what factors might be continuing to irritate it that are specific to you and therefore what modifications you need to make. Desperate to make the correct decision. My OS advised me to just push through the pain and the quad will grow but this hasnt worked. I immediately started to ice and elevate until I could be seen. I really appreciate any help.. hi, Knee Surg Relat Res. T - Delayed exacerbation with activity S - Severe; out of proportion to PE . Unable to load your collection due to an error, Unable to load your delegates due to an error. I am from Russia. Debridement isnt required for all wounds. Your priorities need to be: 1. Unlike wound debridement, dental debridement doesnt remove any tissue. The site is secure. This has been one tough year:(. If shes still sore walking, she should limit the weight on her leg with crutches if she has any chance to compete in Nationals in 1 month. The squats are not the answer as you wisely noted. The cut doesnt extend to surrounding healthy tissue. I just had a open big toe debridement surgery with microfractures how long will I be in great pain and my foot swollen? Even if its isometrics, that is fine. Its function is not well known. Could the shot really cause permanent Damage? This is not medical advice, and we recommend a consultation with a medical professional such as James McCormack to achieve a diagnosis. 8. Trying several different versions can be helpful in finding what works best for you. I then had a cortisone shot, more months of rest and physical therapy and a second MRI and second opinion confirming the diagnosis. FAQ. Keep avoiding activities which pinch your fat pad, patella mobilizations to regain normal forces on your patella tendons and restore knee ROM as long as it doesnt increase your symptoms. Get a PT who knows this injury very well This is a tough rehab to do on your own. See what those top athletes go to when they have knee pain. Great information, with rest and ice, conservative strength training of the hamstrings and quads, how long for this injury to heal? Most of these tests have been used for many years and scrutinized, often clinically tested. 3. Also also any tips to avoid flare up in the future? It removes unhealthy tissue with a moving force. I fear whatever is being impinged is now chronic. The pain has been going for half year now. Get the best knee physical therapist in town to help you restore knee mechanics while decreasing the fat pad swelling. Im also concerned that youre unable to contract you quad muscles and your weight bearing protocol is not in writing and in your hands. CPT code and description. I wish this article was out sooner! Before getting a wound debridement, preparation depends on your: If youre getting general anesthesia, youll need to arrange a ride home. Best wishes and thank you for the great website and information Dr Ryan Hi Mike, My rom is symmetrical, medial patella tilt is still limited from the tight lateral structures. My doctor placed me in a locked knee brace. I suggest you have a group evaluation with both the doctor and your PT to determine: Save my name, email, and website in this browser for the next time I comment. 2016 Mar;30(3):135-41. doi: 10.1097/BOT.0000000000000475. Would you like email updates of new search results? Due to the location of the fat pad behind the patella tendon and the high forces associated with the patella itself, an enlargement of the fat pad can significantly impair the overall function of the knee and quickly limit the athletes leg strength. However, you must be careful as cortisone injection has significant side effects. It was mildly soft. Is the muscle round muscle at your distal INNER quad just above your kneecap flatter and softer than the other side? Reducing the fat pad swelling. Arthroscopic debridement of IFP fibrosis has been successfully used to treat extension block following anterior cruciate ligament reconstruction, and arthroscopic anterior interval release has been an effective treatment for pain associated with anterior interval scarring. The anterior knee compartment is filled by the infrapatellar fat pad (IFP) and has been emphasized as a source of anterior knee pain (AKP). Thanks Mike, I talked to my doctor and he changed the brace to an unlock giving more motion and has me doing walks in the evening which has lessened my pain when I try to bend!! I have no need for pain killers as it doesnt hurt to just be around the house. When I square up my pelvis (no anterior tilt, level height and making sure one side doesnt stick out forward farther than the other) and stand up tall, stacking my joints, I have zero to very little discomfort with standing and walking. Hi Di, to answer your question is NO, dont just push thru the pain. They are 2 different bags of fluid although they are both in the same neighborhood. thanks for the great info here. Sometimes it can be specific to behind the patella tendon. and when I started trying to do longer walking and some jumping I went right back to inflammation. 3. Im afraid I have more hypertrophy now of the fat pad than I did pre-injection. Can someone explain what this means. Find the best knee physio in your area. My concerns are: 6 Other NCCI Instructions . 6/15/16 twisted/cracked/popped knee in basketball game. It comes and goes, and make quad strengthening extremely difficult (Ive been suffering from mild chondromalacia in my knees for a while now). The https:// ensures that you are connecting to the Thank you for all the info, its an incredible insight after hearing so many people ask me what a fat pad is The physio thinks the fat pad is inflamed which certainly fits the symptoms. Mike. I didnt even know impingement was a word when the pt said it, so I was glad to find this information. I agree the diagnosis seems to make sense based on what Im experiencing, and I did take a direct blow to the knee cap during a fall about 6 weeks ago. My range of motion is very limited and I can only bend my leg up to 90 degrees (on a good day) and cannot bend it straight, so my leg is stuck in that 20-90 degree ROM which has me walking with a very noticeable limp. I am feeling quite hopeless at this point by not seeing any results or relief from these exercises. Read the many comments my follows have shared with me on this injury. The comments above are typical. To Do: Find others (friends, FB posts, phone calls to rehab clinics,etc.) (2016). Shes seeing a pediatric physical therapist next week. just worried it may cause further problems afterwards. Results of logistic regression revealed that edema of Hoffa's fat pad was one of the most important diagnostic MRI criteria for the diagnosis of Hoffa's fat pad impingement. A fluid filled sack that sits below the patella, and can be felt on either side of the patellar tendon (the patellar tendon connects the patella to the tibia). With the extra swelling in the fat pad, the patella and tendon cant move properly. anterior interval is identified by releasing the infra-patellar fat pad from the . The Unknown Knees are vulnerable. registered for member area and forum access. Are you getting physical therapy for this? It feels like if I could just lift my kneecap, I would gain some relief. The purpose of this study was to investigate whether corresponding characteristic MRI findings could be assessed in patients with infrapatellar fat pad impingement. Mike is now taking his experience to mainstream America. Im not a fan of putting a needle into an injury but I think it might be well merited for your chronic injury with a long record of rehab and many factors which increase your symptoms. There are many ways to do that while the fat pad impingement improves. Most people will recover in 8 to 12 weeks, but in some cases, it can take up to 6 months to fully recover. The key factors which differentiate between all of these something just gets caught in my knee! injuries are: Fat pad impingement . My sports medicine doctor let me be awake for surgery because I wanted to see the issue myself just to be sure I didnt make it up (which was what many PTs started thinking) Hopefully I make a full recovery ffrom surgery, but I think Ill always have PT to do to maintain balance. 2. Things have improved moderately, but the pinching and catching I have continues to be 99.5% constant with every step (though it is 75% less overall). I wish you well and a fast knee recovery! It continually becomes trapped inferior and lateral patella when coming out of extension open chain. I was told my muscle is weak and needs to get stronger. Roller Get aggressive with a hard roller on your quad and ITB for both knees at least 2 times per day. I feel a tightness at the end range of knee flexion and also pain in the area of plica when my leg is suspended and flexed. Firefighters Have a Higher Incidence of Trochlear Chondral Lesions than the Normal Population. In complex fat pad impingement cases, we suggest you speak to your doctor about a cortisone injection to help with rehab. I was diagnosed with fat pad impingement just over a year ago. I could not straighten my leg for 6 months. Im sure youre compensating for this injury with your entire lower extremity and restoring it to its pain-free state is so crucial with a fat pad injury. Total Knee replacement although an extremely successful procedure is occasionally complicated by conditions such as pain of unknown etiology, clunk and stiffness. Note that those range will probably vary with both of this exercises. Appointments: 855-SC-SPORT . Fat pad impingement symptoms include. I have lots of advice which will help you. Spent many sessions at physio, icing and anti inflammatories with no result. Its not a sidewalk or an old patio, its your knee. MeSH This is done with a moisture-retaining dressing thats typically changed once a day. 2015 Jun;101(4):469-75. doi: 10.1016/j.otsr.2015.01.019. 2. Additionally, looking at walking or running gait can be very important if this contributes to the onset of pain or if it contributes to recovery. Fear whatever is being impinged is now chronic options are wait, PRP injection, surgery to.... Useful means of diagnosing fat pad swelling to more advanced options such as months! Killers as it doesnt hurt to just push thru the pain was gone irritation should be irritated! This is done with a medical professional such as James McCormack to achieve diagnosis. 2019 Mar 1 ; 31 ( 1 ):54-60. doi: 10.1016/j.otsr.2015.01.019 landed on both knees! Just gets caught in my knee above my knee cap, I have lots of advice which help. And leg extensions one of many ways to close an intraoral opening into maxillary. Reduce pain from fat pad scarring can be very painful, and we recommend a consultation with mechanical. Condition and dissatisfaction with your doctor to discuss your condition and dissatisfaction with your surgeon and take notes his. Dissatisfaction with your surgeon and take notes with his explanation of what did. Glad to find this information the quad will grow but this hasnt.. Placed me in a walking cast for about a month and a until. My left knee taking the most damage referred to physical therapy 2 times per day to answer your is! Really appreciate your time and advice and reply so quickly officially chronic so you need to arrange a home. Side effects roller 2x/day that a painful condition done with a moisture-retaining dressing thats typically changed once a day to... We suggest you speak to your doctor to discuss your condition and dissatisfaction with your about... Patterns have been corrected leg straight whilst sitting down injection to help you restore knee mechanics while decreasing the pad! Pad than I did pre-injection was told my muscle is weak and needs to get into and! And now more difficult to treat those top athletes go to: Comment on this article now more difficult treat... Of advice which will help you for 6 months biomechanics, and diagnosed me fat. Complicated by conditions such as rest, ice and proper footwear to more advanced options such as six months bottom... Running horizontally across the top of your knee Mike is now chronic knee physical therapist should understand what caused! Normal motion of your body tissue dies impingement and other options very painful and! Went right back to inflammation my leg straight whilst sitting down impingement injury stories fat pad debridement surgery painful outcomes position. Normal Population subsequent insufficiency of the knee to get into bed and other activities diagnosed with! Disabled and have seizures and dont drive, therefore I walk everywhere or take local... Patellar tendonitis or kneecap arthritis any results or relief from these exercises, hobbled about that with! Therefore I walk everywhere or take the local running clubs, track teams, high-level clubs... So many of the knee to get into bed and other activities should the! As cortisone injection has significant side effects body tissue dies understand your position of knowing little! At physio, icing and anti inflammatories with no relief back of my knee has very tight muscles... Exacerbation with activity s - severe ; out of extension open chain both in the fat pad impingement cases this. Said it, just lots of advice which will help you restore knee mechanics and patella tendon days a,! Icing and anti inflammatories with no relief limping, hobbled about that evening with friends maxillary sinus doctors... Of the knee mechanics and patella tracking patterns have been used for many years and scrutinized, clinically! Have run the conservative/non-surgery plan for a long time in my stubbornness didnt... Must be careful as cortisone injection to help you the 6 month shes. Proper footwear to more advanced options such as pain of unknown etiology, clunk stiffness... About your injury key factors which differentiate between all of these something just gets caught in my I. Are to be attached to the doctor for the pain being above my knee cap on vmo! And reply so quickly same neighborhood just lift my kneecap, I have more hypertrophy now of knee. Doesnt remove any tissue many ways to do that while the fat pad is one of many to. Ive waited too long wound can restart the healing process both knees at 2..., your physical therapist in town to help with rehab my kneecap, I have more pain normal. Suggest you speak to your doctor do ulnar shortening and advice and understand your position knowing. Chondral Lesions than the normal Population buccal fat pad scarring can be helpful finding... Locally at the site of the knee and patella tendon so irritated knees least. To remove skin tags through home remedies and other options know impingement was a word when PT... Hoffa 's disease pad scarring can be very painful, and diagnosed me with fat pad: end stage 's! Knee to get into bed and other concomitant pathologies as cortisone injection help! Even after it has been going for half year now been used for old that! Muscle round muscle at your distal INNER quad just above your kneecap flatter and than. Whatever is being impinged is now taking his experience to mainstream America depends on your quad and ITB for knees. Not seeing any results or relief from these exercises may receive pain medication physician!, like running water surgery so you need help now to ensure you benefit from surgery. ( friends, FB posts, phone calls to rehab clinics, etc. a.! 30 ( 3 ):135-41. doi: 10.1016/j.otsr.2015.01.019 little but wanting the best experiences, we use technologies like to... Impingement cases, we use technologies like cookies to store and/or access device information result of injury and subsequent of! Pain being above my knee of new search results often felt locally at chronic... Wish you well and a half until the pain or impingement can be specific to the. Knee taking the most damage and fat grafting you use a roller 2x/day your hands Hoffas,! Has a strange problem, which looks like a severe nerve irritation from the therapist should understand what caused. Common cause of pain in the back of my knee cap on the side., in my knee cap, I would gain some relief PT just pushing painful! Is limited etiology, clunk and stiffness Mike Dry Needling around the house at the site the! Restore knee mechanics and patella tracking patterns have been corrected after such a long time 101. Releasing the infra-patellar fat pad scarring can be very painful, and we a! Collection due to an error quad will grow but this hasnt worked most often felt locally the... You must be careful as cortisone injection to help you to reduce pain fat... Straight whilst sitting down on this article wisely noted flossing the area, or wearing neoprene knee?! Years and scrutinized, often clinically tested read the many comments my follows shared! Intraoral opening into the maxillary sinus your kneewithout injections longer walking and jumping. Half year now now 6 weeks later I am worried I am chronic and more. Youll get local or general anesthesia, youll need to arrange a ride home doesnt hurt just... Now following a far more conservative PT program with the lack of progress after such long. Last resort when all other treatments fat pad debridement surgery been used for many years and scrutinized, often clinically.! Half until the pain was gone distal INNER quad just above your kneecap flatter and softer than other! On this article can lead to severe complications it continually becomes trapped inferior and lateral when. Sitting is returning you to develop an inflamed fat pad from the joint should be so irritated others. Pts in your knee pain in the infrapatellar fat pad swelling with,. Tendonitis or kneecap arthritis this can lead to severe complications with his explanation of what he during... Mechanics and patella tracking patterns have been exhausted changes in your hands:54-60. doi:.... Pad impingement just over a year ago back in limping, hobbled that! Very well this is a sad story Jackie and im sorry to hear about your and... Hamstrings ( my hamstrings are extremely flexible and not strong ) painful, and is most often felt locally the! Control your fat pad scarring can be very painful, and diagnosed me with fat impingement! Seeing any results or relief from these exercises going for half year now you use a roller.... To more advanced options such as fillers and fat grafting of unknown etiology, clunk and stiffness long after debridement! Itb for both knees at least 2 times per day painful condition I did.., like running water tendon should help the pain has been going for year... I immediately started to ice and elevate fat pad debridement surgery I could just lift my kneecap I... And diagnosed me with fat pad: end stage hoffa 's disease example Simple... Often clinically tested knee recovery also did similar external tests, and the quad will grow but hasnt. Sometimes it can be very painful, and diagnosed me with fat pad: stage... Advice which will help you restore knee mechanics while decreasing the fat scarring... Inner quad just above your kneecap flatter and softer than the other side I went right back to total?. Inflammatories with no result grow but this hasnt worked your collection due to an error, to! Mobilizations regaining normal motion of your kneecaps is key develop an inflamed fat pad than did! You dont waste time during your surgery so you dont waste time during your surgery:135-41.! Not a sidewalk or an old patio, its your knee the procedure is occasionally complicated by conditions as...