Chiang, Chih-YungChih-YungChiangWu, Chang-ChinChang-ChinWuLin, Feng-HueiFeng-HueiLinYang, Kai-ChiangKai-ChiangYang2025-07-312025-07-312025-0703069877https://www.scopus.com/record/display.uri?eid=2-s2.0-105008528795&origin=resultslisthttps://scholars.lib.ntu.edu.tw/handle/123456789/730842Infrapatellar 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.falseArthroscopyInflammationInfrapatellar fat padKnee osteoarthritisMesenchymal stem cells[SDGs]SDG3journal article10.1016/j.mehy.2025.1116892-s2.0-105008528795