Should We Resect Hoffa's Fat Pad during Total Knee Replacement?

2.50
Hdl Handle:
http://hdl.handle.net/11287/620250
Title:
Should We Resect Hoffa's Fat Pad during Total Knee Replacement?
Authors:
Sellars, Hannah; Yewlett, A.; Trickett, R.; Forster, M.; Ghandour, A.
Abstract:
Resection of Hoffa's fat pad during total knee arthroplasty is sometimes performed to improve access and view. Opponents of this technique argue that sacrificing the fat pad potentially compromises blood supply to the patellar tendon and it can subsequently shorten. Our objective was to identify any difference in the Insall-Salvati ratio of knees undergoing total knee arthroplasty between a cohort that had Hoffa's fat pad preserved and the one that had Hoffa's fat pad completely excised. The total knee arthroplasties by two surgeons at our institution were reviewed over a 3-year period. Surgeon A routinely preserves the fat pad and surgeon B routinely excises the fat pad. Radiographs preoperatively, immediately postoperatively, and at a minimum of 1-year follow up were analyzed for the Insall-Salvati ratio. A total of 161 knees were reviewed, 65 in the preserved group and 96 in the excised group with a mean age of 67 and 70 years, respectively. The mean preoperative Insall-Salvati ratio for the preserved group was 1.12 (±0.145) and excised group 1.16 (±0.168) (p = 0.094). The mean immediate postoperative Insall-Salvati ratio for the preserved group was 1.10 (±0.154) and for excised group 1.18 (±0.194). The difference in Insall-Salvati ratio from preoperative to the immediate postoperative period in the preserved group compared with the excised group demonstrated a significant difference (p = 0.010). However, the change of Insall-Salvati ratio at 1 year did not significantly differ between the groups (p = 0.059). There does not appear to be any difference in the Insall-Salvati ratios of both groups at 1 year's follow up; therefore, this study radiologically at least supports the use of either technique.
Citation:
Should We Resect Hoffa's Fat Pad during Total Knee Replacement? 2017 J Knee Surg
Publisher:
Thieme
Journal:
The Journal of Knee Surgery
Issue Date:
24-Feb-2017
URI:
http://hdl.handle.net/11287/620250
DOI:
10.1055/s-0037-1598039
PubMed ID:
28235234
Additional Links:
http://www.thieme-connect.com/DOI/DOI?10.1055/s-0037-1598039
Type:
Journal Article
Language:
en
ISSN:
1938-2480
Appears in Collections:
General Trauma & Orthopaedics; 2017 RD&E publications

Full metadata record

DC FieldValue Language
dc.contributor.authorSellars, Hannahen
dc.contributor.authorYewlett, A.en
dc.contributor.authorTrickett, R.en
dc.contributor.authorForster, M.en
dc.contributor.authorGhandour, A.en
dc.date.accessioned2017-03-09T13:22:28Z-
dc.date.available2017-03-09T13:22:28Z-
dc.date.issued2017-02-24-
dc.identifier.citationShould We Resect Hoffa's Fat Pad during Total Knee Replacement? 2017 J Knee Surgen
dc.identifier.issn1938-2480-
dc.identifier.pmid28235234-
dc.identifier.doi10.1055/s-0037-1598039-
dc.identifier.urihttp://hdl.handle.net/11287/620250-
dc.description.abstractResection of Hoffa's fat pad during total knee arthroplasty is sometimes performed to improve access and view. Opponents of this technique argue that sacrificing the fat pad potentially compromises blood supply to the patellar tendon and it can subsequently shorten. Our objective was to identify any difference in the Insall-Salvati ratio of knees undergoing total knee arthroplasty between a cohort that had Hoffa's fat pad preserved and the one that had Hoffa's fat pad completely excised. The total knee arthroplasties by two surgeons at our institution were reviewed over a 3-year period. Surgeon A routinely preserves the fat pad and surgeon B routinely excises the fat pad. Radiographs preoperatively, immediately postoperatively, and at a minimum of 1-year follow up were analyzed for the Insall-Salvati ratio. A total of 161 knees were reviewed, 65 in the preserved group and 96 in the excised group with a mean age of 67 and 70 years, respectively. The mean preoperative Insall-Salvati ratio for the preserved group was 1.12 (±0.145) and excised group 1.16 (±0.168) (p = 0.094). The mean immediate postoperative Insall-Salvati ratio for the preserved group was 1.10 (±0.154) and for excised group 1.18 (±0.194). The difference in Insall-Salvati ratio from preoperative to the immediate postoperative period in the preserved group compared with the excised group demonstrated a significant difference (p = 0.010). However, the change of Insall-Salvati ratio at 1 year did not significantly differ between the groups (p = 0.059). There does not appear to be any difference in the Insall-Salvati ratios of both groups at 1 year's follow up; therefore, this study radiologically at least supports the use of either technique.en
dc.language.isoenen
dc.publisherThiemeen
dc.relation.urlhttp://www.thieme-connect.com/DOI/DOI?10.1055/s-0037-1598039en
dc.rightsArchived with thanks to The Journal of Knee Surgeryen
dc.subjectWessex Classification Subject Headings::Orthopaedicsen
dc.titleShould We Resect Hoffa's Fat Pad during Total Knee Replacement?en
dc.typeJournal Articleen
dc.identifier.journalThe Journal of Knee Surgeryen
dc.type.versionIn press (epub ahead of print)en

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