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First published on November 23, 2004, doi:10.1177/0363546504263946
This version was published on December 1, 2004
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The American Journal of Sports Medicine 32:1873-1880 (2004)
© 2004 American Orthopaedic Society for Sports Medicine

Biomechanical and Kinematic Influences of a Total Infrapatellar Fat Pad Resection on the Knee

Michael Bohnsack, MD*, Arne Wilharm, Christof Hurschler, PhD, Oliver Rühmann, MD, Christina Stukenborg-Colsman, MD and Carl Joachim Wirth, MD

From the Department of Orthopedic Surgery, Hannover Medical School, Hannover, Germany

* Address correspondence to Michael Bohnsack, MD, Department of Orthopedic Surgery, Hannover Medical School, Anna-Von-Borries-Str 1-7, 30625 Hannover, Germany (e-mail: bohnsack.m{at}addcom.de).

Background: This biomechanical study was performed to evaluate the consequences of total infrapatellar fat pad resection on knee kinematics and patellar contact pressure.

Hypothesis: Resection of the infrapatellar fat pad produces significant changes in knee kinematics and patellar contact pressure.

Study Design: Biomechanical cadaveric study.

Methods: Isokinetic knee extension was simulated on 10 human knee cadaveric specimens (6 men, 4 women; mean age at death, 44 years). Joint kinematics were evaluated by an ultrasound-based 3D motion analysis system, and retro-patellar contact pressure was measured using an electronic pressure-sensitive film. All data were taken before and after resection of the infrapatellar fat pad and statistically analyzed.

Results: A total resection of the infrapatellar fat pad resulted in a significant decrease of the tibial external rotation relative to the femur between 63° of flexion and full knee extension (maximum: 3° rotation difference at 0° knee flexion, P = .011), combined with a significant medial translation of the patella between 29° and 69° of knee flexion (range, 0.9–1.3 mm, P = .017–.028). Retro-patellar contact pressure was significantly reduced (from 20% to 25%, P = .008–.021) at all flexion angles.

Conclusion: A resection of the infrapatellar fat influences patellar biomechanics and knee kinematics.

Clinical Relevance: The infrapatellar fat pad may have a biomechanical function and may play a role in anterior knee pain syndrome.

Key Words: infrapatellar fat pad resection • biomechanical consequences • kinematic analysis • anterior knee pain






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