Infrapatellar fat pad resection: A potential approach for slowing knee osteoarthritis progression
Journal
Medical Hypotheses
Journal Volume
200
Start Page
111689
ISSN
0306-9877
Date Issued
2025-07
Author(s)
Abstract
Infrapatellar fat pad (IFP) is known as a major source of inflammatory mediators that can initiate and aggravate knee osteoarthritis (OA). Despite obesity being recognized as a risk factor for knee OA, non-weight-bearing joints also suffer from OA. IFP, but not the subcutaneous adipose tissue, has an inflammatory phenotype and secretes high levels of catabolic cytokines and adipokines. They can also directly stimulate the production of pro-inflammatory mediators and matrix metalloproteinases in the synovium, accelerating cartilage degradation and joint deterioration. In addition, nociceptive nerve fibers and the released substance P in IFP contribute to the sensitization of anterior pain in the knee joint. Notably, an animal study demonstrated that removal of the IFP/synovium complex improved OA pathology, suggesting that surgical intervention targeting IFP may have therapeutic benefits. However, given that synoviocytes are essential for hyaluronic acid production, which is critical for joint lubrication, a refined surgical approach is warranted. We propose arthroscopic resection of the IFP while preserving the synovium to achieve pain relief and slow disease progression without compromising joint lubrication. This targeted intervention may offer a viable strategy for improving clinical outcomes in knee OA patients by reducing the inflammatory burden and nociceptive sensitization while maintaining synovial function.
Subjects
Arthroscopy
Inflammation
Infrapatellar fat pad
Knee osteoarthritis
Mesenchymal stem cells
Publisher
Elsevier BV
Type
journal article