Hoffa's syndrome
- impingement of the fat pad with knee ROM
Rare
Diagnosis of exclusion
May be more prevalent in patients with intact ligamentum mucosum
Hoffa's sign
- apply pressure to fat pad each side of patella tendon with knee in flexion
- extend knee
Repeated dislocation of patella with minimal trauma
- 15-20% of paediatric acute patella dislocations
- more common girls
- often bilateral
Dislocation occurs unexpectedly when quadriceps contracted with knee in flexion
90% respond
- very important
- 6 - 12 months minimum before offering surgery
1. Stretches
- quads stretches
- ITB
- lateral retinaculum
Quantify Valgus Malalignment
30o flexion
Softening and fibrillation of articular cartilage of patella
Problem
- softening and fibrillation often seen in asymptomatic population
- can have typical anterior knee pain without retro-patellar changes
Female adolescent
- recent increase in activity
1 in 10 patients with symptomatic knees have isolated PFJ OA
Obesity
Repetitive deep flexion
Malalignment
Lateral patella tightness
Blunt trauma
Anterior knee pain
- rising from chair