Abstract
IntroductionRecent studies regarding the infrapatellar fat pad (IPFP) mainly focus on the roles of the cells derived from the IPFP. There have been few clinical or epidemiological studies reporting on the association between the IPFP and knee osteoarthritis (OA). Our objective is to generate hypotheses regarding the associations between IPFP maximum area and knee OA measures in older adults.MethodsA total of 977 subjects between 50 and 80 years of age (mean, 62.4 years) participated in the study. Radiographic knee osteophyte and joint space narrowing (JSN) were assessed using the Osteoarthritis Research Society International atlas. T1- or T2-weighted fat suppressed magnetic resonance imaging (MRI) was utilized to assess IPFP maximum area, cartilage volume, cartilage defects, and bone marrow lesions (BMLs). Knee pain was assessed by self-administered Western Ontario McMaster Osteoarthritis Index (WOMAC) questionnaire.ResultsAfter adjustment for potential confounders, IPFP maximum area was significantly associated with joint space narrowing (odds ratio (OR): 0.75, 95% confidence interval (CI): 0.62 to 0.91 (medial), 0.77, 95% CI: 0.62 to 0.96 (lateral)) and medial osteophytes (OR: 0.52, 95% CI: 0.35 to 0.76), knee tibial and patellar cartilage volume (β: 56.9 to 164.9 mm3/cm2, all P <0.001), tibial cartilage defects (OR: 0.58, 95% CI: 0.41 to 0.81 (medial), 0.53, 95% CI: 0.40-0.71 (lateral)), any BMLs (OR: 0.77, 95% CI: 0.63 to 0.94), and knee pain on a flat surface (OR: 0.79, 95% CI: 0.63 to 0.98). IPFP maximum area was negatively, but not significantly, associated with femoral cartilage defects, lateral tibiofemoral BMLs, and total knee pain or other knee pain subscales.ConclusionIPFP maximum area is beneficially associated with radiographic OA, MRI structural pathology and knee pain on a flat surface suggesting a protective role for IPFP possibly through shock absorption. Consequently, we must pay special attention to IPFP in the clinical settings, avoiding resection of normal IPFP in knee surgery.
Highlights
Recent studies regarding the infrapatellar fat pad (IPFP) mainly focus on the roles of the cells derived from the IPFP
Subjects This study was conducted as part of the Tasmanian Older Adult Cohort (TASOAC) study, an ongoing prospective, population-based study aimed at identifying the environmental, genetic, and biochemical factors associated with the development and progression of OA (assessed by both radiography and magnetic resonance imaging (MRI))
Our findings on age and body mass index (BMI) were consistent with this study, but we found that weight and height, measures of body size rather than obesity status, were significantly and positively associated with IPFP area
Summary
Recent studies regarding the infrapatellar fat pad (IPFP) mainly focus on the roles of the cells derived from the IPFP. Osteoarthritis (OA), the most prevalent form of arthritis, is a common cause of chronic disability in older adults [1]. It can affect one or more joints of the body but is most common in the knees [2]. Recent studies [10,11] mainly focus on the roles of the cells derived from IPFP, such as inflammatory cells and substance P nerve cells in OA, and consider IPFP as an active joint tissue in the initiation and progression of knee OA [8], as inflammatory cells from IPFP can produce inflammatory mediators, which are able to influence the cartilage and synovium metabolism, and substance P nerve could be an important source of pain in knee OA. There have been few clinical or epidemiological studies [12] reporting the association between IPFP and knee OA measures, so the role of IPFP in knee OA is largely unknown
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