Arthroscopic Versus Open Resection of Infrapatellar Fat Pad Tumour

Background: While few comparative studies exist, it has been suggested that open resection of Hoffa’s fat pad tumour provides inferior results when compared with the all-arthroscopic technique.
Purpose: The purpose of this study was to compare the intermediate-term results of patients undergoing arthroscopic versus open resection for the treatment of Hoffa’s fat pad tumours.
Methods: We report prospective study of 15 patients with symptomatic Hoffa’s fat pad impingement. Patients were divided into two groups (9 arthroscopic, 6 open). The mean follow-up for group I (open) and group II (arthroscopic) was 2.3 years and 1.2 years, respectively. The diagnosis was made by clinical exam, MRI imaging and verified by anatomopathology. Lysholm score and American knee score were obtained pre and post operative and at final follow up. Each patient completed a questionnaire assessing their scar satisfaction, percentage of normal knee function and willingness to have the surgery again. Risk factors for poor outcomes were analyzed.
Results: There was a significant improvement in their symptoms and function after the surgery at an average follow-up of 14 months. Arthroscopic patients had significantly less pain (P = .035) by Visual analog scale (0.61±1.02) compared to open excision group (1.59±2.15) and better knee function (92.9%±8.6 in arthroscopic group vs 89.7%±12.5 in open excision group) at final follow-up. The average operative time was (53.1 minutes using arthroscopic technique vs 41 minutes by open technique).The one poor result was because of paresthesia over the distribution of the infrapatellar branch of the saphenous nerve after open resection.
Conclusion: Open and arthroscopic resection of infrapatellar fat pad are both effective surgeries. Hoffa’s fat pad tumours should be treated by arthroscopic resection because of less residual pain and less complication using this technique. In case of high volume of tumours only open excision can provide complete excision to avoid reccurence.