Abstract

Objective: To determine the effect of infrapatellar fat pad (IPFP) excision or preservation on outcomes following primary total knee arthroplasty (TKA).
Methodology: This randomized controlled trial was conducted at The Department of Orthopedic Surgery, Lahore General Hospital, Lahore, Pakistan from September 2020 to June 2021. A total of 60 cases (30 in each group) aged between 20 to 75 years who underwent primary TKA were enrolled. There were 30 patients who were placed in IPFP removed (IPFPR) groups and 30 others were to be in IPFP not removed (IPFPNR) group. Knee range of motion (ROM), anterior knee pain and total “Knee Society Score” were measured as outcomes in both groups.
Results: Out of 60 patients, 44 (73.3%) were female. Mean age was 65.7+6.5 years. Majority, 31 (51.7%) belonged to urban areas. There were 55 (91.7%) patients who had osteoarthritis. Comparison of knee flexion and knee society scores at different intervals during the study period showed no significant differences (p>0.05). At 6-months follow up, there were 4 (14.3%) patients who had anterior knee pain in IPFPR group in comparison to 0 in IPFPNR group and the difference in terms of anterior knee pain was statistically significant (p=0.041). None of the patients had avascular necrosis or patellar fractures during follow ups.
Conclusion: Increased rates of anterior knee pain were observed among patients who had removal of infrapatellar fat pad. No significant differences in knee flexion and knee society scores were observed among patient who had removal or preservation of infrapatellar fat pad.

Key words: Infrapatellar fat pad, total knee arthroplasty, knee flexion, anterior knee pain.