On this page:
The infrapatella fat pad (sometimes known as Hoffa's pad) is a soft tissue that lies beneath the kneecap. We describe how it is injured and treatment options.
Fat pad impingement symptoms include tenderness around the bottom and under the kneecap. Patients may have a history of being able to over straighten the knee, called knee hyperextension or genu recurvatum. In some cases the bottom of the kneecap may be tilted outwards due to swelling underneath. A therapist or trainer will perform Hoffas test to help diagnose the injury.
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. The patient is then asked to straighten their leg. Pain and/or apprehension of the patient is considered a positive sign for fat pad impingement).
The infrapatella fat pad (sometimes known as Hoffa's pad) is a soft tissue that lies beneath the patella (kneecap) separating it from the femoral condyle (end of the thigh bone). In situations where forces are directed at the patella it acts as a shock absorber, thus protecting the underlying structures.
In the case of a forceful direct impact to the kneecap, the fat pad can become impinged (pinched) between the femoral condyle and the patella. As the fat pad is one of the most sensitive structures in the knee, this injury is known to be extremely painful. This condition is normally long-standing as it is aggravated by extension (straightening) of the knee joint. Hence the fat pad comes under constant irritation and may become significantly inflamed.
Treatment of this condition is normally by conservative methods which may include: