A large infrapatellar fat pad protects against knee pain and lateral tibial cartilage volume loss

A Teichtahl,E Wulidasari,S Brady,Y Wang,A Wluka,C Ding,G Giles,F Cicuttini

doi:10.1016/j.joca.2015.02.517

A Teichtahl, E Wulidasari + Show 6 more

Open Access

https://doi.org/10.1016/j.joca.2015.02.517

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Abstract

Purpose: The infrapatellar fat pad (IPFP) is commonly resected during knee joint arthroplasty. This longitudinal study examined the associations between the maximum cross-sectional area (CSA) of the IPFP and knee cartilage volume and pain in adults without knee osteoarthritis (OA). Methods: 297 adults without baseline knee pain or a diagnosis of knee OA had MRI performed at baseline and follow-up (n = 271). IPFP maximal CSA and tibial cartilage volume were measured from MRI. Body composition was performed at baseline using bio-impedance. Knee pain was assessed at follow-up using the Western Ontario and McMaster University Osteoarthritis Index (WOMAC). Results: A larger IPFP at baseline was associated with reduced knee pain at follow-up (OR 0.5, 95% CI: 0.3 to 0.9, p = 0.02) and lateral tibial cartilage volume loss (β: -0.9% (95% CI: -1.6, -0.1%) per annum, p = 0.03). The maximal CSA of the IPFP was predominantly located in the lateral (54.2%), rather than the medial tibiofemoral compartment (1.7%). Male gender (OR 12.0, 95% CI: 6.5 to 22.0, p < 0.001) and fat free mass (OR 1.15, 95% CI 1.04 to 1.28, p = 0.007) were both associated with a large IPFP. Conclusions: A larger IPFP predicts reduced lateral tibial cartilage volume loss and knee pain and mechanistically might function as a local shock-absorber. The lack of association between measures of adiposity and the size of the IPFP might suggest that the IPFP size is not simply a marker of systemic obesity. OA: Cartilage and Bone

Highlights

This study examines whether obesity and body composition are associated with hip cartilage changes using magnetic resonance imaging (MRI) in community-based adults
141 community-based participants with no clinical hip disease, including OA, had BMI and body composition measured at baseline (1990 to 1994), and BMI measured and 3.0T MRI performed at follow-up (2009-2010)
While increased baseline fat mass was associated with an increased risk of cartilage defects in the central superolateral region of the femoral head (OR1⁄4 1.08, 95% CI 1.00-1.15, p1⁄40.04), increased baseline fat free mass was associated with a reduced risk of cartilage defects in this region (OR1⁄40.82, 95% CI 0.67-0.99; p1⁄40.04)

Summary

Introduction

This study examines whether obesity and body composition are associated with hip cartilage changes using magnetic resonance imaging (MRI) in community-based adults. Conclusions: This community-based study of healthy adults has shown that VM fat infiltration can be modified by lifestyle factors including weight loss and exercise, and reducing fat infiltration in VM has beneficial effect on knee cartilage preservation.

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