Comments for HC Chang Orthopaedic Surgery | Singapore http://orthopaedicsports.com Orthopaedic Clinic | Sports Medicine | +65-683 666 36 Wed, 09 May 2012 13:57:47 +0000 hourly 1 http://wordpress.com/ Comment on Hoffa’s Syndrome | Fat Pad Impingement Syndrome – A Cause of Anterior Knee Pain by Dyfan http://orthopaedicsports.com/2011/03/16/hoffas-syndrome-fat-pad-impingement-syndrome-a-cause-of-anterior-knee-pain/#comment-459 Wed, 09 May 2012 13:57:47 +0000 http://orthopaedicsports.com/?p=521#comment-459 Hi Dr Chang,

Thanks for your reply. Things have moved on slightly since l last wrote to you, and l was wondering if you could offer me some advice? I received around 6 weeks of physiotherapy involving ultrasound and taping to relieve the pressure on the fat pad. This seems to work to a degree when the tape is in place, however my skin has had an allergic reaction to the tape, and so for the past week l have been unable to use it. The tape allowed me to get on my bike fairly regularly, however since not using it, the symptoms are beginning to return.

The pain is a dull aching sensation both to the lateral aspect and underneath the patella tendon, with occasional sharp pain. The hoffa’s test is negative, and it is not painful to touch neither does it feel like there is anything lumpy or hard under the skin, so l’m guessing that if there is scarring, there isn’t much of it?

I am contemplating surgery as this has gone on for over 6 months, however l would like to know what you would suggest in this situation? My surgeon has given me a cortisone shot, which definetely helped, but will not give me another.

Many thanks.

]]> Comment on Hoffa’s Syndrome | Fat Pad Impingement Syndrome – A Cause of Anterior Knee Pain by S Bourgeois http://orthopaedicsports.com/2011/03/16/hoffas-syndrome-fat-pad-impingement-syndrome-a-cause-of-anterior-knee-pain/#comment-455 Mon, 07 May 2012 00:52:13 +0000 http://orthopaedicsports.com/?p=521#comment-455 Hi Doc,

I wrote you back in January. I had my surgery on March 7th, so today will mark 2 months out. Doc removed 50% of my fat pad, and GOUT that has crystalized, from what he suspects to be caused by the injury. Anyhow, knee feels fine unless I have it straight out extended. Then the patella tendon hurts like heck! Just had blood drawn and it appears my uric acid levels are in the norm,so I don’t fear any reoccurance of GOUT. PT therapist says my quad muscles are very weak, and I am currently focusing on re-educating the quad muscles and strengthing the quad. PT thinks once the quad is back strong, the patella pain will calm. My question is, can the patella tendon pain be caused by anything else, besides what I explained? Thanks S. Bourgeois

]]> Comment on Hoffa’s Syndrome | Fat Pad Impingement Syndrome – A Cause of Anterior Knee Pain by THilton http://orthopaedicsports.com/2011/03/16/hoffas-syndrome-fat-pad-impingement-syndrome-a-cause-of-anterior-knee-pain/#comment-425 Fri, 06 Apr 2012 16:06:40 +0000 http://orthopaedicsports.com/?p=521#comment-425 DENISE,
I have nearly identical symptoms. When I squat the kneecap gets “hung up” on something and I must push thru the “pop.” Also my kneecap looks like it is indented. The only thing that has helped is strengthening the leg muscles and targeted deep tissue massage to the area that “pops”. Most doctors are not familar with injury to the Hoffa pad.

]]> Comment on Hoffa’s Syndrome | Fat Pad Impingement Syndrome – A Cause of Anterior Knee Pain by Denise http://orthopaedicsports.com/2011/03/16/hoffas-syndrome-fat-pad-impingement-syndrome-a-cause-of-anterior-knee-pain/#comment-424 Fri, 06 Apr 2012 16:01:22 +0000 http://orthopaedicsports.com/?p=521#comment-424 the first part of my message is gone.

Here it is again

I had arthroscopic knee surgery in November of last year. I had an MRI and the radiologist said my meniscus was not torn. My doctor felt otherwise and said I needed surgery. Surgery was about 10 minutes and my meniscus was not torn. I am still having problems to this day. I did fall on my knee about two years ago and just started having symptoms last year. I am not sure if actually related.

I had another MRI in March. My doctors says it does not show anything. Says I have bursitis and may have to remove my bursa. However radiologist suspects a fat pad impingement. My doctor says nothing about that. My symptoms are burning sensation in knee cap and there is an indention in my knee cap. I have trouble squatting and when I do it hurts and it pops. I am seeing another doctor next week for another opinion.

]]> Comment on Hoffa’s Syndrome | Fat Pad Impingement Syndrome – A Cause of Anterior Knee Pain by Denise http://orthopaedicsports.com/2011/03/16/hoffas-syndrome-fat-pad-impingement-syndrome-a-cause-of-anterior-knee-pain/#comment-422 Fri, 06 Apr 2012 15:57:06 +0000 http://orthopaedicsports.com/?p=521#comment-422 Appearance Catches The Eye, Personality Captures The Heart
sure if actually related. I had another MRI in March. My doctors says it does not show anything. Says I have bursitis and may have to remove my bursa. However radiologist suspects a fat pad impingement. My doctor says nothing about that. My symptoms are burning sensation in knee cap and there is an indention in my knee cap. I have trouble squatting and when I do it hurts and it pops. I am seeing another doctor next week for another opinion.

]]> Comment on Hoffa’s Syndrome | Fat Pad Impingement Syndrome – A Cause of Anterior Knee Pain by THilton http://orthopaedicsports.com/2011/03/16/hoffas-syndrome-fat-pad-impingement-syndrome-a-cause-of-anterior-knee-pain/#comment-421 Fri, 06 Apr 2012 15:50:13 +0000 http://orthopaedicsports.com/?p=521#comment-421 Thank you for your response. Unfortunately, based on my experience in the U.S., this condition frequently goes unrecognized and untreated.

]]> Comment on Hoffa’s Syndrome | Fat Pad Impingement Syndrome – A Cause of Anterior Knee Pain by Dr Chang Haw Chong http://orthopaedicsports.com/2011/03/16/hoffas-syndrome-fat-pad-impingement-syndrome-a-cause-of-anterior-knee-pain/#comment-420 Fri, 06 Apr 2012 03:55:09 +0000 http://orthopaedicsports.com/?p=521#comment-420 Dear THilton,

I would try oral anti-inflammatory medications as well as a good course of knee physiotherapy.
As to which form of exercise is good, you need to talk to the therapist.
Do note that when the fat pad is acutely swollen and inflamed, you are unlikely to be able to do much anyway due to the pain.

Regards,

HC Chang

]]> Comment on Hoffa’s Syndrome | Fat Pad Impingement Syndrome – A Cause of Anterior Knee Pain by Dr Chang Haw Chong http://orthopaedicsports.com/2011/03/16/hoffas-syndrome-fat-pad-impingement-syndrome-a-cause-of-anterior-knee-pain/#comment-419 Fri, 06 Apr 2012 03:53:31 +0000 http://orthopaedicsports.com/?p=521#comment-419 Dear Tricia,

It will be painful when the fat pad is inflamed and impinged. The fat pad is very well innervated and hence a rich source of pain.
I tend to agree with your doctor that she should rest, ice the knee and take anti-inflammatory medications. Such simple measures should bring about some results in 1 to 2 weeks’ time.
Try to avoid surgery and see if conservative treatment works.
Surgery should only be done if a trial of non-surgical treatment has been attempted and failed.

Regards,

HC Chang

]]> Comment on Hoffa’s Syndrome | Fat Pad Impingement Syndrome – A Cause of Anterior Knee Pain by Dr Chang Haw Chong http://orthopaedicsports.com/2011/03/16/hoffas-syndrome-fat-pad-impingement-syndrome-a-cause-of-anterior-knee-pain/#comment-418 Fri, 06 Apr 2012 03:50:31 +0000 http://orthopaedicsports.com/?p=521#comment-418 Dear MC,

Yes, I would certainly try to avoid more surgery. The best way to go is to get a good physiotherapist to massage the painful scar tissue and get it more pliable.

All the best!

HC Chang

]]> Comment on Hoffa’s Syndrome | Fat Pad Impingement Syndrome – A Cause of Anterior Knee Pain by Dr Chang Haw Chong http://orthopaedicsports.com/2011/03/16/hoffas-syndrome-fat-pad-impingement-syndrome-a-cause-of-anterior-knee-pain/#comment-417 Fri, 06 Apr 2012 03:49:17 +0000 http://orthopaedicsports.com/?p=521#comment-417 Dear Alyssa,

Thank you for your comment.

As for your sensitive kneecap, it may be related to some scar tissues forming at the areas of the surgery as well as a certain degree of infrapatellar contracture post-surgery. Hence it is better once you are warmed up as scar tissues become more compliant after warming up.

I suggest working with a good physiotherapist to massage the painful areas to loosen up the scar as well as try taping techniques (a bit of trial and error here) to see if it helps.

Good luck!

HC Chang

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