Resection of pathologically altered infrapatellar fat pads during total knee arthroplasty has a positive impact on postoperative knee function

作者：Xun Xu, Shijie Wang, Zheng Zhu, Shuo Yang, Zhengming Zhu, Lingchao Kong, Rende Ning · 发表于：The Knee · 年份：2025 · DOI：10.1016/j.knee.2025.02.012 · 被引用次数：6 · 研究领域：Total Knee Arthroplasty Outcomes、Lower Extremity Biomechanics and Pathologies、Musculoskeletal synovial abnormalities and treatments

BACKGROUND: The ongoing debate regarding the excision of the infrapatellar fat pad (IPFP) during total knee arthroplasty (TKA) remains a contentious issue, with established parameters for IPFP management still lacking. Excessive resection of IPFP tissue may lead to patellar tendon (PT) shortening and reduced mobility of the knee joint. This study aims to evaluate whether the resection of pathologically altered IPFP tissue during TKA affects knee joint function and PT dimensions. METHODS: A total of 100 patients with end-stage knee osteoarthritis (KOA) who successfully underwent their first TKA were randomly assigned to two groups: one group received resection of the pathologically altered IPFP tissue, while the other group underwent complete resection of all IPFP tissue. The excised IPFP specimens were subjected to pathological and immunohistochemical analysis. Patients underwent X-ray and MRI assessments prior to surgery, as well as at 6 weeks and 6 months postoperatively; additionally, the Numeric Rating Scale (NRS), Knee Injury and Osteoarthritis Outcome Scale (KOOS), and Oxford Knee Score (OKS) were utilized for evaluation. Furthermore, patellar tendon length and thickness were assessed. RESULTS: Histological examination of the IPFP tissue from patients with KOA revealed that not all IPFP specimens exhibited lesions under hematoxylin and eosin (HE) staining and immunohistochemical analysis, with lesion areas predominantly localized near the synovium. There was no signific...