The Infrapatellar Fat Pad Fibrosis Degree Does Not Influence Postoperative Pain 6 Months Following Patellofemoral Arthroplasty

Domenico Franco; Chilan B. G. Leite; Sebastian Schmidt; Marco T. Di Stefano; Nathan Sherman; Omar Protzuk; Cale Jacobs; Christian Lattermann

doi:10.1055/a-2693-0621

The Journal of Knee Surgery, Table of Contents

J Knee Surg
DOI: 10.1055/a-2693-0621

Original Article

The Infrapatellar Fat Pad Fibrosis Degree Does Not Influence Postoperative Pain 6 Months Following Patellofemoral Arthroplasty

Authors

Domenico Franco

¹Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States

²Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
Chilan B. G. Leite

¹Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
Sebastian Schmidt

¹Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States

³Department of Orthopaedic and Trauma Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
Marco T. Di Stefano

⁴Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
Nathan Sherman

¹Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
Omar Protzuk

¹Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
Cale Jacobs

¹Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
Christian Lattermann

¹Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States

Abstract

This retrospective study investigates whether the degree of infrapatellar fat pad (IFP) fibrosis influences postoperative pain 6 months following patellofemoral arthroplasty (PFA). Furthermore, this study explores whether sex and patellar height are impacted by the degree of IFP fibrosis. A total of 64 patients who underwent PFA from 2010 to 2023 were included, all of whom had a preoperative knee MRI and at least 1 year of follow-up. Patients were categorized into low (grades 0–1) and increased (grades 2–5) IFP fibrosis groups based on defined MRI findings. Pain outcome was assessed via a numeric rating scale. Demographic data, imaging parameters (e.g., preoperative Insall–Salvati index (IS), pre- and postoperative Caton–Deschamps index (CD), and patella morphology), and implant survivorship were analyzed. Contrary to the hypothesis, no significant association was found between IFP fibrosis degree and postoperative pain levels 6 months following PFA. Notably, the low IFP fibrosis group had a significantly higher prevalence of females (p = 0.02) and a higher preoperative IS index (p < 0.05), suggesting a connection among IFP fibrosis status, sex, and patellar height. No differences between groups were observed in age, body mass index, delta CD index, patella type, or implant survivorship. The lack of association between IFP fibrosis and postoperative pain suggests that IFP fibrosis may not be a determinant of PFA outcomes, potentially guiding surgeons to focus on other factors for optimizing postoperative pain management and implant success. Further studies are needed to elucidate the roles of sex and patellar height in the development of IFP fibrosis. The study provides level III evidence.

Keywords

patellofemoral arthroplasty - infrapatellar fat pad - fibrosis - pain - knee osteoarthritis

Full Text

References

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