%0 Journal Article
%T The Patellar Arterial Supply via the Infrapatellar Fat Pad (of Hoffa): A Combined Anatomical and Angiographical Analysis
%A Gregor Nemschak
%A Michael L. Pretterklieber
%J Anatomy Research International
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/713838
%X Even though the vascular supply of the human patella has been object of numerous studies until now, none of them has described in detail the rich arterial supply provided via the infrapatellar fat pad (of Hoffa). Therefore, we aimed to complete the knowledge about this interesting and clinically relevant topic. Five human patellae taken from voluntary body donators were studied at the Department of Applied Anatomy of the Medical University of Vienna. One was dissected under the operation microscope, a second was made translucent by Sihlers-solution, and three underwent angiography using a 3D X-ray unit. The results revealed that the patella to a considerable amount is supplied by arteries coursing through the surrounding parts of the infrapatellar fat pad. The latter were found to branch off from the medial and lateral superior and inferior genicular arteries. Within the infrapatellar fat pad, these arteries formed a dense network of anastomoses which are all contributing to the viability of the patellar bone. Due to the rich arterial supply reaching the patella via the infrapatellar fat pad, it seems advisable to preserve the fat pad during surgery of the knee in order to reduce the risk of vascular impairment of the patella. 1. Introduction The infrapatellar fat pad (of Hoffa) is located in the anterior compartment of the knee joint and is bordered by the inferior pole of the patella, the patellar retinacula, the patellar tendon, the anterior part of the tibia, the anterior horns of the menisci, and the femoral condyles. Further, it is attached to the intercondylar notch of the femur by the infrapatellar synovial plica also referred to as ligamentum mucosum [1]. Because of its high amount of nerve endings, the infrapatellar fat pad may become source of anterior knee pain. As reported by Bennell et al., the application of hypertonic saline into the fat pad led to pain experience in healthy volunteers [2]. In rare cases, tumour-like lesions of the infrapatellar fat pad such as osteochondroma, pigmented villonodular synovitis, synovial cysts [3], and vascular malformation [4] may lead to anterior knee pain. Furthermore, the infrapatellar fat pad may be affected by postarthroscopic alterations, postsurgery fibrosis, and shear injuries [5]. As reported by Bohnsack et al., the fat pad plays a role in stabilizing the knee joint in the extremes of motion, especially during flexion angles of less than 20กใ and greater than 100กใ [6]. Due to surgical demand, it is often removed or at least partially resected during surgery in order to improve visibility to the
%U http://www.hindawi.com/journals/ari/2012/713838/