Research progress on the role of the infrapatellar fat pad in the pathogenesis of osteoarthritis_West China Medical Journal

Authors：

ZHANG Hongfeng ¹ , CHENG Jie ¹ ,  WANG Wenji ² , ZHAO Haiyan ²

1. Department of Orthopedics, the First Hospital of Tianshui, Tianshui, Gansu 741000, P. R. China;
2. Department of Orthopedics, the First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P. R. China;

Corresponding?author：

WANG Wenji, Email: ldyygjwwj@163.com

Keywords：

Osteoarthritis; infrapatellar fat pad; imaging; marker; surgery

DOI：

10.7507/1002-0179.202607164

Video：

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Abstract Full text Figures/Tables Video References Cited by

Osteoarthritis (OA) is a common degenerative joint disease. As an important component of the knee joint, the infrapatellar fat pad (IPFP) not only provides mechanical cushioning but also plays an active role in local inflammatory, metabolic, and immune regulation. This review summarizes the anatomical and physiological characteristics of the IPFP and its potential roles in OA pathogenesis, with particular emphasis on inflammation, neural regulation, and mechanical stress. The relationships between IPFP-derived inflammatory cytokines, adipokines, fibrosis, and the development and progression of OA are also discussed. In addition, recent advances in the use of ultrasonography, MRI, and molecular biomarkers for the early diagnosis and prognostic assessment of OA are reviewed. The clinical controversy regarding IPFP preservation versus resection during total knee arthroplasty is further analyzed. Finally, the potential value of the IPFP as a diagnostic biomarker and therapeutic target for OA is discussed, providing a reference for further research and the development of precision diagnosis and treatment strategies for OA.

Citation： ZHANG Hongfeng, CHENG Jie, WANG Wenji, ZHAO Haiyan. Research progress on the role of the infrapatellar fat pad in the pathogenesis of osteoarthritis. West China Medical Journal, 2026, 41(9): 1527-1532. doi: 10.7507/1002-0179.202607164 Copy

1.	Safiri S, Kolahi AA, Smith E, et al. Global, regional and national burden of osteoarthritis 1990-2017: a systematic analysis of the Global Burden of Disease Study 2017[J]. Ann Rheum Dis, 2020, 79(6): 819-828.
2.	Pettenuzzo S, Berardo A, Belluzzi E, et al. Mechanical insights into fat pads: a comparative study of infrapatellar and suprapatellar fat pads in osteoarthritis[J]. Connect Tissue Res, 2025, 66(4): 272-283.
3.	Duong V, Oo WM, Ding C, et al. Evaluation and treatment of knee pain: a review[J]. JAMA, 2023, 330(16): 1568-1580.
4.	Wang MG, Seale P, Furman D. The infrapatellar fat pad in inflammaging, knee joint health, and osteoarthritis[J]. NPJ Aging, 2024, 10(1): 34.
5.	Stephen JM, Sopher R, Tullie S, et al. The infrapatellar fat pad is a dynamic and mobile structure, which deforms during knee motion, and has proximal extensions which wrap around the patella[J]. Knee Surg Sports Traumatol Arthrosc, 2018, 26(11): 3515-3524.
6.	Li J, Gui T, Yao L, et al. Synovium and infrapatellar fat pad share common mesenchymal progenitors and undergo coordinated changes in osteoarthritis[J]. J Bone Miner Res, 2024, 39(2): 161-176.
7.	Tang S, Yao L, Ruan J, et al. Single-cell atlas of human infrapatellar fat pad and synovium implicates APOE signaling in osteoarthritis pathology[J]. Sci Transl Med, 2024, 16(731): eadf4590.
8.	Sanchez-Lopez E, Coras R, Torres A, et al. Synovial inflammation in osteoarthritis progression[J]. Nat Rev Rheumatol, 2022, 18(5): 258-275.
9.	Coryell PR, Diekman BO, Loeser RF. Mechanisms and therapeutic implications of cellular senescence in osteoarthritis[J]. Nat Rev Rheumatol, 2021, 17(1): 47-57.
10.	Emmi A, Stocco E, Boscolo-Berto R, et al. Infrapatellar fat pad-synovial membrane anatomo-fuctional unit: microscopic basis for piezo1/2 mechanosensors involvement in osteoarthritis pain[J]. Front Cell Dev Biol, 2022, 10: 886604.
11.	Fontanella CG, Belluzzi E, Pozzuoli A, et al. Mechanical behavior of infrapatellar fat pad of patients affected by osteoarthritis[J]. J Biomech, 2022, 131: 110931.
12.	Fontanella CG, Belluzzi E, Pozzuoli A, et al. Exploring anatomo-morphometric characteristics of infrapatellar, suprapatellar fat pad, and knee ligaments in osteoarthritis compared to post-traumatic lesions[J]. Biomedicines, 2022, 10(6): 1369.
13.	Edama M, Otsuki T, Yokota H, et al. Morphological characteristics of the infrapatellar fat pad[J]. Sci Rep, 2022, 12(1): 8923.
14.	Peters H, Potla P, Rockel JS, et al. Cell and transcriptomic diversity of infrapatellar fat pad during knee osteoarthritis[J]. Ann Rheum Dis, 2025, 84(2): 351-367.
15.	Mehta B, Goodman S, DiCarlo E, et al. Machine learning identification of thresholds to discriminate osteoarthritis and rheumatoid arthritis synovial inflammation[J]. Arthritis Res Ther, 2023, 25(1): 31.
16.	Chou CH, Jain V, Gibson J, et al. Synovial cell cross-talk with cartilage plays a major role in the pathogenesis of osteoarthritis[J]. Sci Rep, 2020, 10(1): 10868.
17.	Das N, de Almeida LGN, Derakhshani A, et al. Tryptase β regulation of joint lubrication and inflammation via proteoglycan-4 in osteoarthritis[J]. Nat Commun, 2023, 14(1): 1910.
18.	D’Amico E, McNeill TJ, Khay AM, et al. The age-dependent influence of the infrapatellar fat pad on chondrocyte extracellular matrix production[J]. J Gerontol A Biol Sci Med Sci, 2025, 80(7): glaf072.
19.	Wijesinghe SN, MacLeod M, Northall E, et al. From fat to flame: multi-omic insights into how adipose-joint crosstalk stokes the fires of osteoarthritis[J]. Osteoarthritis Cartilage, 2026, 34(3): 395-404.
20.	Wisniewska E, Laue D, Spinnen J, et al. Infrapatellar fat pad modulates osteoarthritis-associated cytokine and MMP expression in human articular chondrocytes[J]. Cells, 2023, 12(24): 2850.
21.	Binvignat M, Sellam J, Berenbaum F, et al. The role of obesity and adipose tissue dysfunction in osteoarthritis pain[J]. Nat Rev Rheumatol, 2024, 20(9): 565-584.
22.	Sellam J, Rat AC, Fellahi S, et al. Pain in women with knee and/or hip osteoarthritis is related to systemic inflammation and to adipose tissue dysfunction: cross-sectional results of the KHOALA cohort[J]. Semin Arthritis Rheum, 2021, 51(1): 129-136.
23.	Li Y, Lu P, Yao H, et al. Observation of the effects of infrapatellar fat pad excision on the inflammatory progression of knee osteoarthritis in mice[J]. J Inflamm Res, 2025, 18: 6653-6672.
24.	Uekusa Y, Mukai M, Tsukada A, et al. Elevated netrin-4 expression and its action in infrapatellar fat pad[J]. Int J Mol Sci, 2024, 25(21): 11369.
25.	Onuma H, Tsuji K, Hoshino T, et al. Fibrotic changes in the infrapatellar fat pad induce new vessel formation and sensory nerve fiber endings that associate prolonged pain[J]. J Orthop Res, 2020, 38(6): 1296-1306.
26.	Bai Z, Bartelo N, Aslam M, et al. Synovial fibroblast gene expression is associated with sensory nerve growth and pain in rheumatoid arthritis[J]. Sci Transl Med, 2024, 16(742): eadk3506.
27.	Tsukada A, Uekusa Y, Ohta E, et al. Association between synovial NTN4 expression and pain scores, and its effects on fibroblasts and sensory neurons in end-stage knee osteoarthritis[J]. Cells, 2025, 14(6): 395.
28.	Braun S, Pollinger P, Sohn R, et al. Expression of thrombospondin-4 in the infrapatellar fat pad and synovial fluid - potential contribution to osteoarthritis pain[J]. Arthritis Res Ther, 2025, 27(1): 170.
29.	Nakanishi S, Tsutsumi M, Kitano M, et al. Effect of isometric quadriceps exercise on local microcirculation of the infrapatellar fat pad in female patients with knee osteoarthritis[J]. Osteoarthritis Cartilage, 2024, 32(10): 1319-1326.
30.	Sun L, Wang Y, Kan T, et al. Elevated expression of piezo1 activates the cGAS-STING pathway in chondrocytes by releasing mitochondrial DNA[J]. Osteoarthritis Cartilage, 2025, 33(5): 601-615.
31.	Satake Y, Izumi M, Aso K, et al. Association between infrapatellar fat pad ultrasound elasticity and anterior knee pain in patients with knee osteoarthritis[J]. Sci Rep, 2023, 13(1): 20103.
32.	Kitagawa T, Nakase J, Takata Y, et al. Flexibility of infrapatellar fat pad affecting anterior knee pain 6 months after anterior cruciate ligament reconstruction with hamstring autograft[J]. Sci Rep, 2020, 10(1): 21347.
33.	Li J, Fu S, Gong Z, et al. MRI-based texture analysis of infrapatellar fat pad to predict knee osteoarthritis incidence[J]. Radiology, 2022, 304(3): 611-621.
34.	Pelletier JP, Paiement P, Abram F, et al. Comprehensive comparative analysis of infrapatellar fat pad morphologies in a longitudinal knee osteoarthritis exploratory study: new insights into its role as an independent prognostic marker[J]. Arthritis Res Ther, 2025, 27(1): 98.
35.	Yang Z, Lu H, Lin Z, et al. MRI-based patient-specific nomogram for diagnostic risk stratification of patients with early knee OA[J]. Rheumatology (Oxford), 2025, 64(10): 5428-5438.
36.	Lv W, Peng J, Hu J, et al. LMSST-GCN: longitudinal MRI sub-structural texture guided graph convolution network for improved progression prediction of knee osteoarthritis[J]. Comput Methods Programs Biomed, 2025, 261: 108600.
37.	Liu Y, Gao Q. Partial excision of infrapatellar fat pad for the treatment of knee osteoarthritis[J]. J Orthop Surg Res, 2024, 19(1): 631.
38.	Lee K, Banuls-Mirete M, Lombardi AF, et al. Infrapatellar fat pad size and subcutaneous fat in knee osteoarthritis radiographic progression: data from the osteoarthritis initiative[J]. Arthritis Res Ther, 2024, 26(1): 145.
39.	Wang Q, Zhao W, Ji X, et al. Broken-fat pad sign: a characteristic radiographic finding to distinguish between knee rheumatoid arthritis and osteoarthritis[J]. Insights Imaging, 2024, 15(1): 33.
40.	Wang Z, Lu J, Li Z, et al. Qualitative and quantitative measures in the infrapatellar fat pad in older adults: associations with knee pain, radiographic osteoarthritis, kinematics, and kinetics of the knee[J]. Acad Radiol, 2024, 31(8): 3315-3326.
41.	Haartmans MJJ, Claes BSR, Eijkel GB, et al. Matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI-MSI) reveals potential lipid markers between infrapatellar fat pad biopsies of osteoarthritis and cartilage defect patients[J]. Anal Bioanal Chem, 2023, 415(24): 5997-6007.
42.	Chen HH, Chen YC, Yu SN, et al. Infrapatellar fat pad-derived mesenchymal stromal cell product for treatment of knee osteoarthritis: a first-in-human study with evaluation of the potency marker[J]. Cytotherapy, 2022, 24(1): 72-85.
43.	Pereira Herrera B, Emanuel K, Emans PJ, et al. Infrapatellar fat pad as a source of biomarkers and therapeutic target for knee osteoarthritis[J]. Arthritis Res Ther, 2025, 27(1): 81.
44.	Yao B, Samuel LT, Acu?a AJ, et al. Infrapatellar fat pad resection or preservation during total knee arthroplasty: a systematic review[J]. J Knee Surg, 2021, 34(4): 415-421.
45.	van Duren BH, Lamb JN, Nisar S, et al. Preservation vs. resection of the infrapatellar fat pad during total knee arthroplasty part I: a survey of current practice in the UK[J]. Knee, 2019, 26(2): 416-421.
46.	Afzali MF, Radakovich LB, Sykes MM, et al. Early removal of the infrapatellar fat pad/synovium complex beneficially alters the pathogenesis of moderate stage idiopathic knee osteoarthritis in male Dunkin Hartley guinea pigs[J]. Arthritis Res Ther, 2022, 24(1): 282.
47.	Zhang C, Zhang Z, Lin Y, et al. A novel infrapatellar fat pad preservation technique in total knee arthroplasty reduced postoperative pain and wound complications[J]. Orthop Surg, 2024, 16(8): 1946-1954.
48.	Xu X, Wang S, Zhu Z, et al. Resection of pathologically altered infrapatellar fat pads during total knee arthroplasty has a positive impact on postoperative knee function[J]. Knee, 2025, 54: 58-70.
49.	Chaiyakit P, Petcharat B, Onklin I. Preservation of the infrapatellar fat pad during total knee arthroplasty reduces subacute postoperative anterior knee pain: a randomized controlled trial[J]. BMC Musculoskelet Disord, 2025, 26(1): 734.
50.	Skaik K, Oulousian S, Lameire DL, et al. Excision versus preservation of the infrapatellar fat pad during total knee arthroplasty: a systematic review and meta-analysis[J]. J Arthroplasty, 2026, 41(9): 2870-2878.e4.
51.	Michalak S, ?apaj ?, Witkowska-?uczak A, et al. Resection of infrapatellar fat pad during total knee arthroplasty has no impact on postoperative function, pain and sonographic appearance of patellar tendon[J]. J Clin Med, 2022, 11(24): 7339.
52.	Sch?fer L, Maffulli N, Memminger MK, et al. Retention of the infrapatellar fat pad does not influence the outcome of total knee arthroplasty: a systematic review[J]. Br Med Bull, 2025, 155(1): ldaf010.
53.	Benner JL, Boerma-Argelo KDS, Simon-Konijnenburg MD, et al. Hoffa’s fat pad resection during total knee arthroplasty does not affect functioning and gait: a double-blind randomized clinical trial[J]. Arch Orthop Trauma Surg, 2024, 144(8): 3657-3668.

1. Safiri S, Kolahi AA, Smith E, et al. Global, regional and national burden of osteoarthritis 1990-2017: a systematic analysis of the Global Burden of Disease Study 2017[J]. Ann Rheum Dis, 2020, 79(6): 819-828.
2. Pettenuzzo S, Berardo A, Belluzzi E, et al. Mechanical insights into fat pads: a comparative study of infrapatellar and suprapatellar fat pads in osteoarthritis[J]. Connect Tissue Res, 2025, 66(4): 272-283.
3. Duong V, Oo WM, Ding C, et al. Evaluation and treatment of knee pain: a review[J]. JAMA, 2023, 330(16): 1568-1580.
4. Wang MG, Seale P, Furman D. The infrapatellar fat pad in inflammaging, knee joint health, and osteoarthritis[J]. NPJ Aging, 2024, 10(1): 34.
5. Stephen JM, Sopher R, Tullie S, et al. The infrapatellar fat pad is a dynamic and mobile structure, which deforms during knee motion, and has proximal extensions which wrap around the patella[J]. Knee Surg Sports Traumatol Arthrosc, 2018, 26(11): 3515-3524.
6. Li J, Gui T, Yao L, et al. Synovium and infrapatellar fat pad share common mesenchymal progenitors and undergo coordinated changes in osteoarthritis[J]. J Bone Miner Res, 2024, 39(2): 161-176.
7. Tang S, Yao L, Ruan J, et al. Single-cell atlas of human infrapatellar fat pad and synovium implicates APOE signaling in osteoarthritis pathology[J]. Sci Transl Med, 2024, 16(731): eadf4590.
8. Sanchez-Lopez E, Coras R, Torres A, et al. Synovial inflammation in osteoarthritis progression[J]. Nat Rev Rheumatol, 2022, 18(5): 258-275.
9. Coryell PR, Diekman BO, Loeser RF. Mechanisms and therapeutic implications of cellular senescence in osteoarthritis[J]. Nat Rev Rheumatol, 2021, 17(1): 47-57.
10. Emmi A, Stocco E, Boscolo-Berto R, et al. Infrapatellar fat pad-synovial membrane anatomo-fuctional unit: microscopic basis for piezo1/2 mechanosensors involvement in osteoarthritis pain[J]. Front Cell Dev Biol, 2022, 10: 886604.
11. Fontanella CG, Belluzzi E, Pozzuoli A, et al. Mechanical behavior of infrapatellar fat pad of patients affected by osteoarthritis[J]. J Biomech, 2022, 131: 110931.
12. Fontanella CG, Belluzzi E, Pozzuoli A, et al. Exploring anatomo-morphometric characteristics of infrapatellar, suprapatellar fat pad, and knee ligaments in osteoarthritis compared to post-traumatic lesions[J]. Biomedicines, 2022, 10(6): 1369.
13. Edama M, Otsuki T, Yokota H, et al. Morphological characteristics of the infrapatellar fat pad[J]. Sci Rep, 2022, 12(1): 8923.
14. Peters H, Potla P, Rockel JS, et al. Cell and transcriptomic diversity of infrapatellar fat pad during knee osteoarthritis[J]. Ann Rheum Dis, 2025, 84(2): 351-367.
15. Mehta B, Goodman S, DiCarlo E, et al. Machine learning identification of thresholds to discriminate osteoarthritis and rheumatoid arthritis synovial inflammation[J]. Arthritis Res Ther, 2023, 25(1): 31.
16. Chou CH, Jain V, Gibson J, et al. Synovial cell cross-talk with cartilage plays a major role in the pathogenesis of osteoarthritis[J]. Sci Rep, 2020, 10(1): 10868.
17. Das N, de Almeida LGN, Derakhshani A, et al. Tryptase β regulation of joint lubrication and inflammation via proteoglycan-4 in osteoarthritis[J]. Nat Commun, 2023, 14(1): 1910.
18. D’Amico E, McNeill TJ, Khay AM, et al. The age-dependent influence of the infrapatellar fat pad on chondrocyte extracellular matrix production[J]. J Gerontol A Biol Sci Med Sci, 2025, 80(7): glaf072.
19. Wijesinghe SN, MacLeod M, Northall E, et al. From fat to flame: multi-omic insights into how adipose-joint crosstalk stokes the fires of osteoarthritis[J]. Osteoarthritis Cartilage, 2026, 34(3): 395-404.
20. Wisniewska E, Laue D, Spinnen J, et al. Infrapatellar fat pad modulates osteoarthritis-associated cytokine and MMP expression in human articular chondrocytes[J]. Cells, 2023, 12(24): 2850.
21. Binvignat M, Sellam J, Berenbaum F, et al. The role of obesity and adipose tissue dysfunction in osteoarthritis pain[J]. Nat Rev Rheumatol, 2024, 20(9): 565-584.
22. Sellam J, Rat AC, Fellahi S, et al. Pain in women with knee and/or hip osteoarthritis is related to systemic inflammation and to adipose tissue dysfunction: cross-sectional results of the KHOALA cohort[J]. Semin Arthritis Rheum, 2021, 51(1): 129-136.
23. Li Y, Lu P, Yao H, et al. Observation of the effects of infrapatellar fat pad excision on the inflammatory progression of knee osteoarthritis in mice[J]. J Inflamm Res, 2025, 18: 6653-6672.
24. Uekusa Y, Mukai M, Tsukada A, et al. Elevated netrin-4 expression and its action in infrapatellar fat pad[J]. Int J Mol Sci, 2024, 25(21): 11369.
25. Onuma H, Tsuji K, Hoshino T, et al. Fibrotic changes in the infrapatellar fat pad induce new vessel formation and sensory nerve fiber endings that associate prolonged pain[J]. J Orthop Res, 2020, 38(6): 1296-1306.
26. Bai Z, Bartelo N, Aslam M, et al. Synovial fibroblast gene expression is associated with sensory nerve growth and pain in rheumatoid arthritis[J]. Sci Transl Med, 2024, 16(742): eadk3506.
27. Tsukada A, Uekusa Y, Ohta E, et al. Association between synovial NTN4 expression and pain scores, and its effects on fibroblasts and sensory neurons in end-stage knee osteoarthritis[J]. Cells, 2025, 14(6): 395.
28. Braun S, Pollinger P, Sohn R, et al. Expression of thrombospondin-4 in the infrapatellar fat pad and synovial fluid - potential contribution to osteoarthritis pain[J]. Arthritis Res Ther, 2025, 27(1): 170.
29. Nakanishi S, Tsutsumi M, Kitano M, et al. Effect of isometric quadriceps exercise on local microcirculation of the infrapatellar fat pad in female patients with knee osteoarthritis[J]. Osteoarthritis Cartilage, 2024, 32(10): 1319-1326.
30. Sun L, Wang Y, Kan T, et al. Elevated expression of piezo1 activates the cGAS-STING pathway in chondrocytes by releasing mitochondrial DNA[J]. Osteoarthritis Cartilage, 2025, 33(5): 601-615.
31. Satake Y, Izumi M, Aso K, et al. Association between infrapatellar fat pad ultrasound elasticity and anterior knee pain in patients with knee osteoarthritis[J]. Sci Rep, 2023, 13(1): 20103.
32. Kitagawa T, Nakase J, Takata Y, et al. Flexibility of infrapatellar fat pad affecting anterior knee pain 6 months after anterior cruciate ligament reconstruction with hamstring autograft[J]. Sci Rep, 2020, 10(1): 21347.
33. Li J, Fu S, Gong Z, et al. MRI-based texture analysis of infrapatellar fat pad to predict knee osteoarthritis incidence[J]. Radiology, 2022, 304(3): 611-621.
34. Pelletier JP, Paiement P, Abram F, et al. Comprehensive comparative analysis of infrapatellar fat pad morphologies in a longitudinal knee osteoarthritis exploratory study: new insights into its role as an independent prognostic marker[J]. Arthritis Res Ther, 2025, 27(1): 98.
35. Yang Z, Lu H, Lin Z, et al. MRI-based patient-specific nomogram for diagnostic risk stratification of patients with early knee OA[J]. Rheumatology (Oxford), 2025, 64(10): 5428-5438.
36. Lv W, Peng J, Hu J, et al. LMSST-GCN: longitudinal MRI sub-structural texture guided graph convolution network for improved progression prediction of knee osteoarthritis[J]. Comput Methods Programs Biomed, 2025, 261: 108600.
37. Liu Y, Gao Q. Partial excision of infrapatellar fat pad for the treatment of knee osteoarthritis[J]. J Orthop Surg Res, 2024, 19(1): 631.
38. Lee K, Banuls-Mirete M, Lombardi AF, et al. Infrapatellar fat pad size and subcutaneous fat in knee osteoarthritis radiographic progression: data from the osteoarthritis initiative[J]. Arthritis Res Ther, 2024, 26(1): 145.
39. Wang Q, Zhao W, Ji X, et al. Broken-fat pad sign: a characteristic radiographic finding to distinguish between knee rheumatoid arthritis and osteoarthritis[J]. Insights Imaging, 2024, 15(1): 33.
40. Wang Z, Lu J, Li Z, et al. Qualitative and quantitative measures in the infrapatellar fat pad in older adults: associations with knee pain, radiographic osteoarthritis, kinematics, and kinetics of the knee[J]. Acad Radiol, 2024, 31(8): 3315-3326.
41. Haartmans MJJ, Claes BSR, Eijkel GB, et al. Matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI-MSI) reveals potential lipid markers between infrapatellar fat pad biopsies of osteoarthritis and cartilage defect patients[J]. Anal Bioanal Chem, 2023, 415(24): 5997-6007.
42. Chen HH, Chen YC, Yu SN, et al. Infrapatellar fat pad-derived mesenchymal stromal cell product for treatment of knee osteoarthritis: a first-in-human study with evaluation of the potency marker[J]. Cytotherapy, 2022, 24(1): 72-85.
43. Pereira Herrera B, Emanuel K, Emans PJ, et al. Infrapatellar fat pad as a source of biomarkers and therapeutic target for knee osteoarthritis[J]. Arthritis Res Ther, 2025, 27(1): 81.
44. Yao B, Samuel LT, Acu?a AJ, et al. Infrapatellar fat pad resection or preservation during total knee arthroplasty: a systematic review[J]. J Knee Surg, 2021, 34(4): 415-421.
45. van Duren BH, Lamb JN, Nisar S, et al. Preservation vs. resection of the infrapatellar fat pad during total knee arthroplasty part I: a survey of current practice in the UK[J]. Knee, 2019, 26(2): 416-421.
46. Afzali MF, Radakovich LB, Sykes MM, et al. Early removal of the infrapatellar fat pad/synovium complex beneficially alters the pathogenesis of moderate stage idiopathic knee osteoarthritis in male Dunkin Hartley guinea pigs[J]. Arthritis Res Ther, 2022, 24(1): 282.
47. Zhang C, Zhang Z, Lin Y, et al. A novel infrapatellar fat pad preservation technique in total knee arthroplasty reduced postoperative pain and wound complications[J]. Orthop Surg, 2024, 16(8): 1946-1954.
48. Xu X, Wang S, Zhu Z, et al. Resection of pathologically altered infrapatellar fat pads during total knee arthroplasty has a positive impact on postoperative knee function[J]. Knee, 2025, 54: 58-70.
49. Chaiyakit P, Petcharat B, Onklin I. Preservation of the infrapatellar fat pad during total knee arthroplasty reduces subacute postoperative anterior knee pain: a randomized controlled trial[J]. BMC Musculoskelet Disord, 2025, 26(1): 734.
50. Skaik K, Oulousian S, Lameire DL, et al. Excision versus preservation of the infrapatellar fat pad during total knee arthroplasty: a systematic review and meta-analysis[J]. J Arthroplasty, 2026, 41(9): 2870-2878.e4.
51. Michalak S, ?apaj ?, Witkowska-?uczak A, et al. Resection of infrapatellar fat pad during total knee arthroplasty has no impact on postoperative function, pain and sonographic appearance of patellar tendon[J]. J Clin Med, 2022, 11(24): 7339.
52. Sch?fer L, Maffulli N, Memminger MK, et al. Retention of the infrapatellar fat pad does not influence the outcome of total knee arthroplasty: a systematic review[J]. Br Med Bull, 2025, 155(1): ldaf010.
53. Benner JL, Boerma-Argelo KDS, Simon-Konijnenburg MD, et al. Hoffa’s fat pad resection during total knee arthroplasty does not affect functioning and gait: a double-blind randomized clinical trial[J]. Arch Orthop Trauma Surg, 2024, 144(8): 3657-3668.

West China Medical Journal

Research progress on the role of the infrapatellar fat pad in the pathogenesis of osteoarthritis

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