Evaluation of the relationship between Hoffa volume and radiological and clinical scoring in the diagnosis and treatment of anterior knee pain: A retrospective observational study

This study aimed to evaluate the relationship between clinical outcomes and Hoffa fat pad (HFP) volume with respect to treatment type: conventional therapy (NSAIDs and topical cold) and intra-articular platelet-rich plasma (PRP). This retrospective study included patients aged 18 to 40 years with anterior knee pain (AKP), positive Hoffa squeeze and extension impingement tests, and no radiological pathology. After applying the inclusion and exclusion criteria, the patients were divided into conventional treatment (n = 28) and PRP (n = 27) groups, with a control group (n = 25) to compare the baseline HFP volume. HFP volume was measured pre- and posttreatment using 3D Slicer software, while clinical outcomes were assessed using Lysholm, Oxford Knee, and visual analog scale (VAS) scores. Baseline HFP volumes did not differ significantly between the groups (P = .236). The conventional group showed a significant reduction in HFP volume, from 30.8 ± 5.9 cm3 to 29.5 ± 5.7 cm3 (P = .002), while the PRP group saw an increase from 28.0 ± 5.3 cm3 to 29.9 ± 6.3 cm3 (P = .001). Baseline VAS scores were higher in the PRP group (7.1 ± 0.9 vs 6.0 ± 1.0, P < .001), with posttreatment VAS scores improving in both groups (PRP: 3.0, P < .001; Conventional: 1.5, P < .001). Lysholm and Oxford scores increased significantly posttreatment (P < .001), although no correlation was found between HFP volume and these scores. These findings suggest Hoffa volume may influence AKP, although volume changes do not directly correlate with functional improvement, indicating that other pathophysiological factors may play a role. These findings highlight the need for further studies to understand HFP's role of HFP in AKP and inform targeted treatments.