Hoffa Syndrome: Impingement of the Fat Pad of the Knee

Here is a great illustration of the amount of pressure tennis pro Rafael Nadal places on his knee during play.  Impingement of the fatpad behind the kneecap is known as Hoffa Syndrome.

Symptoms & findings include:

• Pain and/or swelling behind or below the kneecap
• Possible history of knee hyper-extension (called genu recurvatum)
• Positive finding on "Hoffa’s test" physical exam manuever by a sports medicine physician

Treatment should start with non-surgical:

• Rest and avoiding aggravating activities
• Ice or cryotherapy
• Anti-inflammatory (pills or injection)
• Physiotherapy modalities such as ultrasound or TENS.
• Muscle strengthening
• Kinesio-Taping

If conservative treatment does not work then surgery may be advised. This may involve the complete or partial removal of the fat pad itself.  See a sports medicine specialist if you think you have Hoffa Syndrome.