{"id":4324,"date":"2022-12-16T22:52:58","date_gmt":"2022-12-16T22:52:58","guid":{"rendered":"https:\/\/langs.physio-pedia.com\/fat-pad-syndrome-fr\/"},"modified":"2022-12-18T17:13:06","modified_gmt":"2022-12-18T17:13:06","slug":"fat-pad-syndrome-fr","status":"publish","type":"page","link":"https:\/\/langs.physio-pedia.com\/fr\/fat-pad-syndrome-fr\/","title":{"rendered":"Syndrome du pad graisseux (la maladie de Hoffa)"},"content":{"rendered":"<div class=\"mw-parser-output\">\n<div class=\"editorbox\">\n<p><b>\u00c9diteur original <\/b>&#8211; <a href=\"\/User:Mariam_Hashem\" title=\"User:Mariam Hashem\">Mariam Hashem<\/a><\/p>\n<p><b>Principaux contributeurs<\/b> &#8211; <a href=\"\/User:Mariam_Hashem\" class=\"mw-userlink\" title=\"User:Mariam Hashem\"><bdi>Mariam Hashem<\/bdi><\/a>, <a href=\"\/User:Tarina_van_der_Stockt\" class=\"mw-userlink\" title=\"User:Tarina van der Stockt\"><bdi>Tarina van der Stockt<\/bdi><\/a>, <a href=\"\/User:Kim_Jackson\" class=\"mw-userlink\" title=\"User:Kim Jackson\"><bdi>Kim Jackson<\/bdi><\/a>, <a href=\"\/User:Tony_Lowe\" class=\"mw-userlink\" title=\"User:Tony Lowe\"><bdi>Tony Lowe<\/bdi><\/a>, <a href=\"\/User:Simisola_Ajeyalemi\" class=\"mw-userlink\" title=\"User:Simisola Ajeyalemi\"><bdi>Simisola Ajeyalemi<\/bdi><\/a> , <a href=\"\/User:Uchechukwu_Chukwuemeka\" class=\"mw-userlink\" title=\"Utilisateur:Uchechukwu Chukwuemeka\"><bdi>Uchechukwu Chukwuemeka<\/bdi><\/a>, <a href=\"\/User:Wanda_van_Niekerk\" class=\"mw-userlink\" title=\"User:Wanda van Niekerk\"><bdi>Wanda van Niekerk<\/bdi><\/a>, <a href=\"\/User:Jess_Bell\" class=\"mw-userlink\" title=\"User:Jess Bell\"><bdi>Jess Bell<\/bdi><\/a>, <a href=\"\/User:Marleen_Moll\" class=\"mw-userlink\" title=\"User:Marleen Moll\"><bdi>Marleen Moll<\/bdi><\/a> et <a href=\"\/User:Robin_Tacchetti\" class=\"mw-userlink\" title=\"User:Robin Tacchetti\"><bdi>Robin Tacchetti<\/bdi><\/a><br \/>\n<b>Propri\u00e9taire d&rsquo;une page<\/b> &#8211; <a href=\"\/User:Marleen_Moll\" title=\"User:Marleen Moll\">Marleen Moll<\/a> dans le cadre du projet One Page<\/p>\n<\/div>\n<div id=\"toc\" class=\"toc\" role=\"navigation\" aria-labelledby=\"mw-toc-heading\"><input type=\"checkbox\" role=\"button\" id=\"toctogglecheckbox\" class=\"toctogglecheckbox\" style=\"display:none\"><\/p>\n<div class=\"toctitle\" lang=\"en\" dir=\"ltr\">\n<h2 id=\"mw-toc-heading\">Contenu<\/h2>\n<p><span class=\"toctogglespan\"><label class=\"toctogglelabel\" for=\"toctogglecheckbox\"><\/label><\/span><\/p>\n<\/div>\n<ul>\n<li class=\"toclevel-1 tocsection-1\"><a href=\"#Introduction\"><span class=\"tocnumber\">1<\/span> <span class=\"toctext\">Introduction<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-2\"><a href=\"#Anatomy.2FBiomechanics\"><span class=\"tocnumber\">2<\/span> <span class=\"toctext\">Anatomie \/ Biom\u00e9canique<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-3\"><a href=\"#Metabolic_influence_of_the_Infrapatellar_fat_pad\"><span class=\"tocnumber\">3<\/span> <span class=\"toctext\">Influence m\u00e9tabolique du pad graisseux infrapatellaire<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-4\"><a href=\"#Pathophysiology.2FClinical_Picture\"><span class=\"tocnumber\">4<\/span> <span class=\"toctext\">Physiopathologie \/ Tableau clinique<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-5\"><a href=\"#Diagnosis.2FPhysical_Examination\"><span class=\"tocnumber\">5<\/span> <span class=\"toctext\">Diagnostic \/ examen physique<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-6\"><a href=\"#Differentiation\"><span class=\"tocnumber\">5.1<\/span> <span class=\"toctext\">Diff\u00e9renciation<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-7\"><a href=\"#Imaging\"><span class=\"tocnumber\">5.2<\/span> <span class=\"toctext\">Imagerie<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-8\"><a href=\"#Management\"><span class=\"tocnumber\">6<\/span> <span class=\"toctext\">Traitement<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-9\"><a href=\"#Management_of_Acute_Fat_Pad_Syndrome\"><span class=\"tocnumber\">6.1<\/span> <span class=\"toctext\">Traitement du syndrome du pad graisseux aigu <\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-10\"><a href=\"#Management_of_Chronic_Fat_Pad_Syndrome\"><span class=\"tocnumber\">6.2<\/span> <span class=\"toctext\">Traitement du syndrome du pad graisseux chronique <\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-11\"><a href=\"#References\"><span class=\"tocnumber\">7<\/span> <span class=\"toctext\">R\u00e9f\u00e9rences<\/span><\/a><\/li>\n<\/ul>\n<\/div>\n<h2><span class=\"mw-headline\" id=\"Introduction\">Introduction<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;veaction=edit&amp;section=1\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Introduction\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;action=edit&amp;section=1\" title=\"Edit section: Introduction\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>L&rsquo;inflammation aigu\u00eb ou chronique du pad graisseux infrapatellaire est une source courante de <a href=\"\/Anterior_Knee_Pain\" title=\"Anterior Knee Pain\">douleur ant\u00e9rieure du genou<\/a>, \u00e9galement appel\u00e9e maladie de Hoffa, syndrome du pad graisseux ou hoffite. Le syndrome du pad graisseux a \u00e9t\u00e9 signal\u00e9 pour la premi\u00e8re fois par Albert Hoffa en 1904 <sup id=\"cite_ref-:5_1-0\" class=\"reference\"><a href=\"#cite_note-:5-1\">(1)<\/a><\/sup>.<\/p>\n<h2><span id=\"Anatomy\/Biomechanics\"><\/span><span class=\"mw-headline\" id=\"Anatomy.2FBiomechanics\">Anatomie \/ Biom\u00e9canique<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;veaction=edit&amp;section=2\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Anatomy\/Biomechanics\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;action=edit&amp;section=2\" title=\"Edit section: Anatomy\/Biomechanics\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Le pad graisseux infrapatellaire r\u00e9partit la pression sur l&rsquo;articulation f\u00e9moro-patellaire, facilite la d\u00e9formation flexible de l&rsquo;articulation du genou et soutient la stabilit\u00e9 de la rotule. se trouve dans le compartiment ant\u00e9rieur du <a href=\"\/Knee\" title=\"Genou\">genou<\/a> sous la forme d&rsquo;une masse de tissu adipeux qui est <b>intracapsulaire mais extra synovial (extra-articulaire) <\/b><sup id=\"cite_ref-:5_1-1\" class=\"reference\"><a href=\"#cite_note-:5-1\">(1)<\/a><\/sup><b>.<\/b> Le pad graisseux infrapatellaire r\u00e9partit la pression sur l&rsquo;articulation f\u00e9moro-patellaire, facilite la d\u00e9formation flexible de l&rsquo;articulation du genou et soutient la stabilit\u00e9 de la rotule <sup id=\"cite_ref-2\" class=\"reference\"><a href=\"#cite_note-2\">(2)<\/a><\/sup>. De plus, le pad graisseux infrapatellaire peut jouer un r\u00f4le de m\u00e9chor\u00e9cepteur \/ proprior\u00e9cepteur en raison de la densit\u00e9 relativement \u00e9lev\u00e9e de nerfs qu&rsquo;il contient <sup id=\"cite_ref-3\" class=\"reference\"><a href=\"#cite_note-3\">(3)<\/a><\/sup><sup id=\"cite_ref-4\" class=\"reference\"><a href=\"#cite_note-4\">(4)<\/a><\/sup>.<\/p>\n<p><u><b>Ses d\u00e9limitations :<\/b><\/u><\/p>\n<ul>\n<li>En son bord sup\u00e9rieur il est d\u00e9limit\u00e9 par le p\u00f4le inf\u00e9rieur de la rotule et les plis alaires <sup id=\"cite_ref-:5_1-2\" class=\"reference\"><a href=\"#cite_note-:5-1\">(1)<\/a><\/sup><\/li>\n<li>En son bord inf\u00e9rieur, par le tibia ant\u00e9rieur, le ligament interm\u00e9niscal, les cornes m\u00e9niscales et la bourse infrapatellaire <sup id=\"cite_ref-:0_5-0\" class=\"reference\"><a href=\"#cite_note-:0-5\">(5)<\/a><\/sup><\/li>\n<li>En ant\u00e9rieur par le tendon rotulien <sup id=\"cite_ref-:0_5-1\" class=\"reference\"><a href=\"#cite_note-:0-5\">(5) <\/a><\/sup>le ligament rotulien et la capsule articulaire <sup id=\"cite_ref-:5_1-3\" class=\"reference\"><a href=\"#cite_note-:5-1\">(1)<\/a><\/sup><\/li>\n<li>En post\u00e9rieur, par les condyles f\u00e9moraux, l&rsquo;\u00e9chancrure intercondylienne <sup id=\"cite_ref-:0_5-2\" class=\"reference\"><a href=\"#cite_note-:0-5\">(5)<\/a><\/sup> et la membrane synoviale <sup id=\"cite_ref-:5_1-4\" class=\"reference\"><a href=\"#cite_note-:5-1\">(1)<\/a><\/sup>.<\/li>\n<\/ul>\n<p><b><u>Ses attaches :<\/u><\/b><\/p>\n<ul>\n<li>L&rsquo;\u00e9chancrure intercondylienne via le ligamentum mucosum,<\/li>\n<li>Les cornes ant\u00e9rieures des m\u00e9nisques<\/li>\n<li>L&rsquo;extr\u00e9mit\u00e9 proximale du tendon de la rotule<\/li>\n<li>Le p\u00f4le inf\u00e9rieur de la rotule <sup id=\"cite_ref-:0_5-3\" class=\"reference\"><a href=\"#cite_note-:0-5\">(5)<\/a><\/sup><\/li>\n<\/ul>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width:302px;\"><a href=\"\/File:Infrapatellar_Fat_Pad_Biomechanics.jpg\" class=\"image\"><img loading=\"lazy\" alt=\"Infrapatellar Fat Pad Biomechanics.jpg\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/9\/99\/Infrapatellar_Fat_Pad_Biomechanics.jpg\/300px-Infrapatellar_Fat_Pad_Biomechanics.jpg\" decoding=\"async\" width=\"300\" height=\"366\" class=\"thumbimage\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/9\/99\/Infrapatellar_Fat_Pad_Biomechanics.jpg\/450px-Infrapatellar_Fat_Pad_Biomechanics.jpg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/9\/99\/Infrapatellar_Fat_Pad_Biomechanics.jpg\/600px-Infrapatellar_Fat_Pad_Biomechanics.jpg 2x\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><a href=\"\/File:Infrapatellar_Fat_Pad_Biomechanics.jpg\" class=\"internal\" title=\"Enlarge\"><\/a><\/div>\n<\/div>\n<\/div>\n<\/div>\n<p>Innerv\u00e9e principalement par le nerf tibial post\u00e9rieur <sup id=\"cite_ref-6\" class=\"reference\"><a href=\"#cite_note-6\">(6),<\/a><\/sup> le pad graisseux infrapatellaire peut \u00eatre une source de <a href=\"\/Pain_Behaviours\" title=\"Pain Behaviours\">douleur<\/a> localis\u00e9e et s\u00e9v\u00e8re au genou. Cela pourrait \u00eatre attribu\u00e9 \u00e0 la pr\u00e9sence de terminaisons nerveuses de type VIa <sup id=\"cite_ref-7\" class=\"reference\"><a href=\"#cite_note-7\">(7)<\/a><\/sup> qui pourraient \u00eatre activ\u00e9es par une d\u00e9formation m\u00e9canique ou des m\u00e9diateurs chimiques de la douleur. Des fibres nerveuses de substance P sont \u00e9galement pr\u00e9sentes chez les personnes souffrant de douleurs ant\u00e9rieures du genou, en particulier lorsque le pad graisseux infrapatellaire est enflamm\u00e9 <sup id=\"cite_ref-8\" class=\"reference\"><a href=\"#cite_note-8\">(8)<\/a><\/sup>. En tant que source potentielle d&rsquo;inflammation et de douleur, certains auteurs ont consid\u00e9r\u00e9 le pad graisseux comme une structure cl\u00e9 dans la <a href=\"\/Patellar_Tendinopathy\" title=\"Tendinopathie rotulienne\">tendinopathie rotulienne <\/a><sup id=\"cite_ref-9\" class=\"reference\"><a href=\"#cite_note-9\">(9)<\/a><\/sup> et l&rsquo;<a href=\"\/Knee_Osteoarthritis\" title=\"Knee Osteoarthritis\">ost\u00e9oarthrite <\/a><sup id=\"cite_ref-10\" class=\"reference\"><a href=\"#cite_note-10\">(10)<\/a><\/sup><a href=\"\/Knee_Osteoarthritis\" title=\"Knee Osteoarthritis\">.<\/a><\/p>\n<p>Le pad graisseux infrapatellaire est une structure dynamique. Il modifie la position, la pression et le volume tout au long du mouvement du genou <sup id=\"cite_ref-:3_11-0\" class=\"reference\"><a href=\"#cite_note-:3-11\">(11)<\/a><\/sup>. Lorsque le <a href=\"\/Knee\" title=\"Genou\">genou<\/a> se d\u00e9place en flexion, la partie sup\u00e9ro-externe du pad graisseux infrapatellaire se d\u00e9tend, s&rsquo;expanse librement et se d\u00e9place vers l&rsquo;arri\u00e8re. En extension, le pad graisseux infrapatellaire se situe entre la facette externe de la rotule et le tendon du quadriceps. Par cons\u00e9quent, les sympt\u00f4mes les plus couramment observ\u00e9s sont associ\u00e9s \u00e0 l&rsquo;extension. Cependant, ils peuvent \u00e9galement \u00eatre observ\u00e9s en flexion, o\u00f9 la douleur est provoqu\u00e9e par le coincement du pad graisseux infrapatellaire entre le tendon de la rotule et la partie ant\u00e9rieure du f\u00e9mur <sup id=\"cite_ref-:0_5-4\" class=\"reference\"><a href=\"#cite_note-:0-5\">(5)<\/a><\/sup>.<\/p>\n<p>Le pad graisseux infrapatellaire facilite le glissement entre les condyles f\u00e9moraux et la capsule articulaire. La m\u00e9canique du genou peut \u00eatre alt\u00e9r\u00e9e lorsqu&rsquo;il existe une adh\u00e9rence dans le pad graisseux infrapatellaire qui modifie la position de la rotule et du tendon rotulien. Par cons\u00e9quent, l&rsquo;efficacit\u00e9 du m\u00e9canisme extenseur est compromise, ce qui diminue le bras du moment effectif et sollicite davantage le quadriceps pour produire la m\u00eame force d&rsquo;extension du genou. Une longueur de tendon rotulien plus courte affecte la mobilit\u00e9 rotulienne et cr\u00e9e une r\u00e9sistance \u00e0 la translation lat\u00e9rale en pleine extension <sup id=\"cite_ref-:3_11-1\" class=\"reference\"><a href=\"#cite_note-:3-11\">(11)<\/a><\/sup>.<\/p>\n<p>Une \u00e9tude a montr\u00e9 une coordination r\u00e9duite entre les unit\u00e9s motrices des <a href=\"\/Vastus_Lateralis\" title=\"Vastus Lateralis\">muscles vastes externe<\/a> et interne dans les douleurs ant\u00e9rieures du genou <sup id=\"cite_ref-12\" class=\"reference\"><a href=\"#cite_note-12\">(12)<\/a><\/sup>. Une autre a rapport\u00e9 une activation significativement plus tardive et une amplitude de contraction r\u00e9duite du quadriceps aux marches d&rsquo;escalier apr\u00e8s avoir injecter dans le pad graisseux, une solution saline hypertonique douloureuse <sup id=\"cite_ref-13\" class=\"reference\"><a href=\"#cite_note-13\">(13)<\/a><\/sup>. L&rsquo;inhibition du pad graisseux a donc entra\u00een\u00e9 une augmentation de la charge f\u00e9moro-patellaire et une r\u00e9duction de l&rsquo;activation du <a href=\"\/Quadriceps_Muscle_Contusion\" title=\"Quadriceps Muscle Contusion\">quadriceps<\/a><sup id=\"cite_ref-:0_5-5\" class=\"reference\"><a href=\"#cite_note-:0-5\">(5)<\/a><\/sup>. Toutefois, l&rsquo;association exacte du pad graisseux et de la biom\u00e9canique du genou doit faire l&rsquo;objet d&rsquo;\u00e9tudes plus approfondies.<\/p>\n<h2><span class=\"mw-headline\" id=\"Metabolic_influence_of_the_Infrapatellar_fat_pad\">Influence m\u00e9tabolique du pad graisseux infrapatellaire <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;veaction=edit&amp;section=3\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Metabolic influence of the Infrapatellar fat pad\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;action=edit&amp;section=3\" title=\"Edit section: Metabolic influence of the Infrapatellar fat pad\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Selon les premi\u00e8res \u00e9tudes, le pad graisseux serait une structure lubrifiante qui facilite l&rsquo;\u00e9coulement du liquide synovial \u00e0 l&rsquo;int\u00e9rieur de l&rsquo;articulation <sup id=\"cite_ref-:0_5-6\" class=\"reference\"><a href=\"#cite_note-:0-5\">(5)<\/a><\/sup>. Par la suite, il est devenu \u00e9vident que le pad graisseux infrapatellaire remplit des fonctions plus sophistiqu\u00e9es en raison de sa neurovascularisation complexe.<\/p>\n<p>Le pad graisseux infrapatellaire est consid\u00e9r\u00e9 comme un producteur de nombreuses substances m\u00e9diatrices de l&rsquo;inflammation que l&rsquo;on retrouve en association avec l&rsquo;arthrose <sup id=\"cite_ref-14\" class=\"reference\"><a href=\"#cite_note-14\">(14)<\/a><\/sup>. En tant que tissu adipeux, le pad graisseux infrapatellaire s\u00e9cr\u00e8te principalement des acides gras, bien connus pour leurs effets pro-inflammatoires <sup id=\"cite_ref-:2_15-0\" class=\"reference\"><a href=\"#cite_note-:2-15\">(15)<\/a><\/sup>. Le tissu adipeux stocke \u00e9galement des cellules immunitaires, une autre source potentielle de substances m\u00e9diatrices inflammatoires <sup id=\"cite_ref-:2_15-1\" class=\"reference\"><a href=\"#cite_note-:2-15\">(15)<\/a><\/sup>. En outre, une \u00e9tude a montr\u00e9 que le pad graisseux infrapatellaire s\u00e9cr\u00e8te activement l&rsquo;IL-6 et son r\u00e9cepteur soluble sIL-6R, \u00e0 des niveaux relativement plus \u00e9lev\u00e9s par rapport aux autres tissus adipeux <sup id=\"cite_ref-16\" class=\"reference\"><a href=\"#cite_note-16\">(16)<\/a><\/sup>.<\/p>\n<p>Il a \u00e9t\u00e9 constat\u00e9 que le pad graisseux infrapatellaire lib\u00e8re des cellules souches m\u00e9senchymateuses avec une activit\u00e9 chondrog\u00e9nique accrue, mais cette d\u00e9couverte n\u00e9cessite d&rsquo;avantage d&rsquo;investigations <sup id=\"cite_ref-:2_15-2\" class=\"reference\"><a href=\"#cite_note-:2-15\">(15)<\/a><\/sup>.<\/p>\n<p>La r\u00e9gulation de la lib\u00e9ration du glycosaminoglycane <sup id=\"cite_ref-17\" class=\"reference\"><a href=\"#cite_note-17\">(17), <\/a><\/sup>source de cellules r\u00e9paratrices <sup id=\"cite_ref-:3_11-2\" class=\"reference\"><a href=\"#cite_note-:3-11\">(11), <\/a><\/sup>la lb\u00e9ration de cytokines pro-inflammatoires associ\u00e9es \u00e0 un IMC \u00e9lev\u00e9 <sup id=\"cite_ref-18\" class=\"reference\"><a href=\"#cite_note-18\">(18)<\/a><\/sup> et la lib\u00e9ration de collag\u00e8ne <sup id=\"cite_ref-19\" class=\"reference\"><a href=\"#cite_note-19\">(19)<\/a><\/sup> seraient \u00e9galement des fonctions du pad graisseux infrapatellaire.<\/p>\n<p>Duran et al <sup id=\"cite_ref-20\" class=\"reference\"><a href=\"#cite_note-20\">(20)<\/a><\/sup> ont \u00e9tudi\u00e9 le volume du pad graisseux infrapatellaire et ont trouv\u00e9 qu&rsquo;il \u00e9tait diminu\u00e9 en pr\u00e9sence de d\u00e9fauts du cartilage <a href=\"\/Patellar_Fractures\" title=\"Patellar Fractures\">rotulien<\/a>.<\/p>\n<h2><span id=\"Pathophysiology\/Clinical_Picture\"><\/span><span class=\"mw-headline\" id=\"Pathophysiology.2FClinical_Picture\">Physiopathologie \/ Tableau clinique <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;veaction=edit&amp;section=4\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Pathophysiology\/Clinical Picture\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;action=edit&amp;section=4\" title=\"Edit section: Pathophysiology\/Clinical Picture\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>On sait peu de choses sur le d\u00e9veloppement du syndrome du pad graisseux. La localisation anatomique du pad graisseux infrapatellaire l&rsquo;expose \u00e0 une charge m\u00e9canique, notamment lors de l&rsquo;extension <sup id=\"cite_ref-:5_1-5\" class=\"reference\"><a href=\"#cite_note-:5-1\">(1)<\/a><\/sup>. La surutilisation ou les microtraumatismes r\u00e9p\u00e9t\u00e9s dus au sport ou aux chutes entra\u00eenent une hypertrophie. Si le pad graisseux ne se r\u00e9tablit pas, il peut devenir en inflammation chronique qui, si elle n&rsquo;est pas correctement prise en charge, peut entra\u00eener une fibrose et une ossification <sup id=\"cite_ref-:5_1-6\" class=\"reference\"><a href=\"#cite_note-:5-1\">(1)<\/a><\/sup>.<\/p>\n<p>Principalement observ\u00e9s chez les jeunes femmes, les sports de saut et la laxit\u00e9 ligamentaire sont \u00e9galement consid\u00e9r\u00e9s comme des facteurs de risque de la maladie de Hoffa <sup id=\"cite_ref-:5_1-7\" class=\"reference\"><a href=\"#cite_note-:5-1\">(1)<\/a><\/sup>.<\/p>\n<h2><span id=\"Diagnosis\/Physical_Examination\"><\/span><span class=\"mw-headline\" id=\"Diagnosis.2FPhysical_Examination\">Diagnostic \/ examen physique <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;veaction=edit&amp;section=5\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Diagnosis\/Physical Examination\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;action=edit&amp;section=5\" title=\"Edit section: Diagnosis\/Physical Examination\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Un pad graisseux enflamm\u00e9 est souvent \u00e9largi, de consistance ferme et facile \u00e0 palper. Le <b>test de Hoffa<\/b> peut \u00eatre effectu\u00e9. Pour \u00e9viter la provocation de la douleur dans les structures adjacentes et les faux r\u00e9sultats, Krumar et al <sup id=\"cite_ref-:1_21-0\" class=\"reference\"><a href=\"#cite_note-:1-21\">(21)<\/a><\/sup> ont sugg\u00e9r\u00e9 une modification du test de Hoffa. Il s&rsquo;agit de mettre le genou en hyperextension passive forc\u00e9e en soulevant le talon et en maintenant une pression ant\u00e9rieure sur le tibia. Cette position stimule la douleur exclusivement dans le coussinet adipeux, s&rsquo;il est enflamm\u00e9 <sup id=\"cite_ref-:0_5-7\" class=\"reference\"><a href=\"#cite_note-:0-5\">(5)<\/a><\/sup>.<\/p>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 648px;\">\n<div class=\"embedvideo autoResize\" style=\"\">\n<div class=\"embedvideowrap\" style=\"width: 640px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/kbu9nybRV0M?\" width=\"640\" height=\"360\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-22\" class=\"reference\"><a href=\"#cite_note-22\">(22)<\/a><\/sup><\/p>\n<p>Le <b>glissement de<\/b> la rotule dans les quatre directions (m\u00e9diale, lat\u00e9rale, sup\u00e9rieure et inf\u00e9rieure) est important pour d\u00e9tecter une adh\u00e9sion ou une restriction de mouvement pendant le mouvement du genou, en particulier en hyperextension. <b>La douleur en hyperextension est un indicateur fort de la pr\u00e9sence d&rsquo;une pad graisseux infrapatellaire enflamm\u00e9 <sup id=\"cite_ref-:3_11-3\" class=\"reference\"><a href=\"#cite_note-:3-11\">(11)<\/a><\/sup>.<\/b><\/p>\n<p>L&rsquo;examen doit \u00e9galement viser \u00e0 exclure toute autre pathologie irradiante, notamment au niveau de la colonne vert\u00e9brale et de la hanche.<\/p>\n<h3><span class=\"mw-headline\" id=\"Differentiation\">Diff\u00e9renciation<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;veaction=edit&amp;section=6\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Differentiation\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;action=edit&amp;section=6\" title=\"Edit section: Differentiation\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Le syndrome du pad graisseux infrapatellaire peut \u00eatre un trouble primaire ou secondaire \u00e0 d&rsquo;autres pathologies telles que des <a href=\"\/Meniscal_Lesions\" title=\"Meniscal Lesions\">l\u00e9sions m\u00e9niscales<\/a> ou des d\u00e9chirures ligamentaires. La pr\u00e9valence n&rsquo;est pas largement \u00e9tudi\u00e9e, cependant, deux \u00e9tudes ont rapport\u00e9 un trouble du pad graisseux infrapatellaire isol\u00e9 dans 1% <sup id=\"cite_ref-:4_23-0\" class=\"reference\"><a href=\"#cite_note-:4-23\">(23)<\/a><\/sup> des cas de douleurs ant\u00e9rieures du genou et dans 6,8% des cas <sup id=\"cite_ref-:1_21-1\" class=\"reference\"><a href=\"#cite_note-:1-21\">(21)<\/a><\/sup> comme trouble secondaire. Une synovite et un gonflement du pad graisseux infrapatellaire ont \u00e9t\u00e9 signal\u00e9s apr\u00e8s une rupture du ligament crois\u00e9 ant\u00e9rieur (LCA) <sup id=\"cite_ref-24\" class=\"reference\"><a href=\"#cite_note-24\">(24)<\/a><\/sup>.<\/p>\n<p>Une anamn\u00e8se d\u00e9taill\u00e9e et les r\u00e9sultats de l&rsquo;\u00e9valuation fonctionnelle sont importants pour distinguer le syndrome du pad graisseux d&rsquo;autres affections telles que : le syndrome f\u00e9moro-patellaire, le <a href=\"\/Plica_Syndrome\" title=\"Plica Syndrome\">conflit de la plica infrapatellaire<\/a> et le \u00ab\u00a0syndrome du cyclope\u00a0\u00bb d&rsquo;arthrofibrose localis\u00e9e. <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2211568414002009#bib0035\">Reportez-vous \u00e0 la discussion de cet article pour conna\u00eetre les caract\u00e9ristiques de chaque affection.<\/a><\/p>\n<p>Les sympt\u00f4mes du syndrome du pad graisseux sont une douleur ant\u00e9rieure au genou,<sup id=\"cite_ref-25\" class=\"reference\"><a href=\"#cite_note-25\">(25)<\/a><\/sup> souvent r\u00e9tropatellaire et infrapatellaire. Des cr\u00e9pitements f\u00e9moro-patellaires peuvent \u00eatre pr\u00e9sents, avec une mise en charge sur le genou, comme \u00e0 la n\u00e9gociation d&rsquo;un escalier <sup id=\"cite_ref-:0_5-8\" class=\"reference\"><a href=\"#cite_note-:0-5\">(5)<\/a><\/sup>, le squat, le saut et la course <sup id=\"cite_ref-:3_11-4\" class=\"reference\"><a href=\"#cite_note-:3-11\">(11)<\/a><\/sup>. Un \u00e9panchement et une diminution de la mobilit\u00e9 sont souvent observ\u00e9s en cas d&rsquo;inflammation du pad graisseux infrapatellaire.<\/p>\n<p>Les douleurs et\/ou les g\u00eanes provoqu\u00e9es par de longues marches, les chaussures plates et la station debout prolong\u00e9e sont principalement li\u00e9es au syndrome du pad graisseux. La douleur r\u00e9sultant de la marche en mont\u00e9e ou en descente est une caract\u00e9ristique du <a href=\"\/Patellofemoral_Pain_Syndrome\" title=\"Patellofemoral Pain Syndrome\">syndrome de douleur f\u00e9moro-patellaire<\/a>.<\/p>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 648px;\">\n<div class=\"embedvideo autoResize\" style=\"\">\n<div class=\"embedvideowrap\" style=\"width: 640px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/eiwKkb1SulU?\" width=\"640\" height=\"360\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-26\" class=\"reference\"><a href=\"#cite_note-26\">(26)<\/a><\/sup><\/p>\n<h3><span class=\"mw-headline\" id=\"Imaging\">Imagerie<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;veaction=edit&amp;section=7\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Imaging\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;action=edit&amp;section=7\" title=\"Edit section: Imaging\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>L&rsquo;<a href=\"\/MRI_Scans\" title=\"MRI Scans\">IRM<\/a> est la meilleure technique d&rsquo;imagerie pour diagnostiquer une inflammation du pad graisseux infrapatellaire <sup id=\"cite_ref-:5_1-8\" class=\"reference\"><a href=\"#cite_note-:5-1\">(1)<\/a><\/sup>. L&rsquo;\u0153d\u00e8me du pad graisseux sup\u00e9rieur &#8211; post\u00e9rieur et l&rsquo;<a href=\"\/Bursitis\" title=\"Bursitis\">inflammation de la bourse infrapatellaire<\/a> sont facilement d\u00e9tect\u00e9s par r\u00e9sonance magn\u00e9tique. Cependant, il est recommand\u00e9 d&rsquo;adresser le patient \u00e0 l&rsquo;IRM uniquement pour exclure toute autre pathologie, en particulier en cas d&rsquo;ant\u00e9c\u00e9dents de traumatisme <sup id=\"cite_ref-:0_5-9\" class=\"reference\"><a href=\"#cite_note-:0-5\">(5)<\/a><\/sup>.<\/p>\n<p>L&rsquo;\u00e9valuation par sonographie dynamique a r\u00e9v\u00e9l\u00e9 un conflit du pad graisseux infrapatellaire sus-lat\u00e9ral associ\u00e9 \u00e0 la perception d&rsquo;une <a href=\"\/Iliotibial_Band_Syndrome\" title=\"Iliotibial Band Syndrome\">bandelette ilio-tibiale tendue<\/a> <sup id=\"cite_ref-:0_5-10\" class=\"reference\"><a href=\"#cite_note-:0-5\">(5)<\/a><\/sup>.<\/p>\n<h2><span class=\"mw-headline\" id=\"Management\">Traitement<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;veaction=edit&amp;section=8\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Management\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;action=edit&amp;section=8\" title=\"Edit section: Management\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Les traitements conservateurs qui ont \u00e9t\u00e9 rapport\u00e9s comme pouvant soulager les sympt\u00f4mes incluent les tapings, la physioth\u00e9rapie, les anti-inflammatoires non st\u00e9ro\u00efdiens, les injections d&rsquo;anesth\u00e9siques locaux et\/ou de corticost\u00e9ro\u00efdes. Lorsque ces interventions ne sont pas efficaces, la chirurgie peut \u00eatre l&rsquo;\u00e9tape suivante.<sup id=\"cite_ref-27\" class=\"reference\"><a href=\"#cite_note-27\">(27)<\/a><\/sup><\/p>\n<p>Les injections diagnostiques et th\u00e9rapeutiques d&rsquo;anesth\u00e9siques locaux et de st\u00e9ro\u00efdes dans le coussinet adipeux ont entra\u00een\u00e9 un soulagement imm\u00e9diat de la douleur et la reconstitution des mouvements <sup id=\"cite_ref-:0_5-11\" class=\"reference\"><a href=\"#cite_note-:0-5\">(5)<\/a><\/sup>.<\/p>\n<p>Dans deux \u00e9tudes, la r\u00e9section arthroscopique a entra\u00een\u00e9 une am\u00e9lioration du <a rel=\"nofollow\" class=\"external text\" href=\"http:\/\/fysio.net\/pdf\/Knie%20Cincinatti%20Knee%20Rating%20System.pdf\">syst\u00e8me d&rsquo;\u00e9valuation de Cincinnati<\/a> et du <a rel=\"nofollow\" class=\"external text\" href=\"http:\/\/www.lakarhuset.com\/docs\/lysholmkneescoringscale.pdf\">score de Lysholm pour le genou<\/a><sup id=\"cite_ref-:4_23-1\" class=\"reference\"><a href=\"#cite_note-:4-23\">(23) <\/a><\/sup><sup id=\"cite_ref-:1_21-2\" class=\"reference\"><a href=\"#cite_note-:1-21\">(21)<\/a><\/sup>.<\/p>\n<p>Une am\u00e9lioration moyenne de 4,83 sur l&rsquo;<a href=\"\/Visual_Analogue_Scale\" title=\"Visual Analogue Scale\">EVA<\/a> a \u00e9t\u00e9 signal\u00e9e \u00e0 la suite de l&rsquo;ablation guid\u00e9e par ultrasons par House et Connell <sup id=\"cite_ref-28\" class=\"reference\"><a href=\"#cite_note-28\">(28)<\/a><\/sup>.<\/p>\n<p><a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2211568414002009#bib0035\">Reportez-vous aux histoires de cas de cet article pour conna\u00eetre les diff\u00e9rentes approches de traitement.<\/a><\/p>\n<h3><span class=\"mw-headline\" id=\"Management_of_Acute_Fat_Pad_Syndrome\">Traitement du syndrome du pad graisseux aigu <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;veaction=edit&amp;section=9\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Management of Acute Fat Pad Syndrome\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;action=edit&amp;section=9\" title=\"Edit section: Management of Acute Fat Pad Syndrome\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<ul>\n<li>Le syndrome aigu se produit g\u00e9n\u00e9ralement \u00e0 la suite d&rsquo;une chute, d&rsquo;un traumatisme direct du genou ou apr\u00e8s une op\u00e9ration du genou de par l&rsquo;\u00e9quipement arthroscopique<\/li>\n<li>Le <u>massage \u00e0 la glace<\/u> est tr\u00e8s utile pour soulager les sympt\u00f4mes aigus <sup id=\"cite_ref-:5_1-9\" class=\"reference\"><a href=\"#cite_note-:5-1\">(1)<\/a><\/sup> Elle peut \u00eatre suivie d&rsquo;un taping pour all\u00e9ger la pression sur le pad graisseux<\/li>\n<li>Le port de chaussures sans support d&rsquo;arche doit \u00eatre \u00e9vit\u00e9 pour minimiser la mise en charge sur le pad graisseux infrapatellaire<\/li>\n<li>Conseillez au patient d&rsquo;\u00e9viter les activit\u00e9s provocant les sympt\u00f4mes jusqu&rsquo;\u00e0 la disparition des sympt\u00f4mes aigus<\/li>\n<\/ul>\n<div class=\"row\">\n<div class=\"col-md-6\">\n<div class=\"thumb embedvideo autoResize\" style=\"width: 258px;\">\n<div class=\"embedvideo autoResize\" style=\"\">\n<div class=\"embedvideowrap\" style=\"width: 250px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/6CRarRzStrU?\" width=\"250\" height=\"141\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"text-right\"><sup id=\"cite_ref-29\" class=\"reference\"><a href=\"#cite_note-29\">(29)<\/a><\/sup><\/div>\n<\/div>\n<div class=\"col-md-6\">\n<div class=\"thumb embedvideo autoResize\" style=\"width: 258px;\">\n<div class=\"embedvideo autoResize\" style=\"\">\n<div class=\"embedvideowrap\" style=\"width: 250px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/aE6-EGAFkfI?\" width=\"250\" height=\"141\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"text-right\"><sup id=\"cite_ref-30\" class=\"reference\"><a href=\"#cite_note-30\">(30)<\/a><\/sup><\/div>\n<\/div>\n<\/div>\n<div class=\"row\">\n<div class=\"col-md-6\">\n<div class=\"thumb embedvideo autoResize\" style=\"width: 258px;\">\n<div class=\"embedvideo autoResize\" style=\"\">\n<div class=\"embedvideowrap\" style=\"width: 250px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/Xy7CibqEUtQ?\" width=\"250\" height=\"141\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"text-right\"><sup id=\"cite_ref-31\" class=\"reference\"><a href=\"#cite_note-31\">(31)<\/a><\/sup><\/div>\n<\/div>\n<div class=\"col-md-6\">\n<div class=\"thumb embedvideo autoResize\" style=\"width: 258px;\">\n<div class=\"embedvideo autoResize\" style=\"\">\n<div class=\"embedvideowrap\" style=\"width: 250px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/WbHXYnwUwws?\" width=\"250\" height=\"141\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"text-right\"><sup id=\"cite_ref-32\" class=\"reference\"><a href=\"#cite_note-32\">(32)<\/a><\/sup><\/div>\n<\/div>\n<\/div>\n<div class=\"row\">\n<div class=\"col-md-6\">\n<div class=\"thumb embedvideo autoResize\" style=\"width: 258px;\">\n<div class=\"embedvideo autoResize\" style=\"\">\n<div class=\"embedvideowrap\" style=\"width: 250px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/KR_peakgyi4?\" width=\"250\" height=\"141\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"text-right\"><sup id=\"cite_ref-33\" class=\"reference\"><a href=\"#cite_note-33\">(33)<\/a><\/sup><\/div>\n<\/div>\n<\/div>\n<h3><span class=\"mw-headline\" id=\"Management_of_Chronic_Fat_Pad_Syndrome\">Traitement du syndrome du pad graisseux chronique <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;veaction=edit&amp;section=10\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Management of Chronic Fat Pad Syndrome\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;action=edit&amp;section=10\" title=\"Edit section: Management of Chronic Fat Pad Syndrome\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<ul>\n<li>Il n&rsquo;y a g\u00e9n\u00e9ralement pas d&rsquo;ant\u00e9c\u00e9dents de traumatisme<\/li>\n<li>Les anomalies biom\u00e9caniques, telles qu&rsquo;une hyperextension excessive, doivent \u00eatre trait\u00e9es pour diminuer la charge sur le pad graisseux infrapatellaire<\/li>\n<li>Pour corriger l&rsquo;hyperextension, une chaussure relativement haute est conseill\u00e9e<\/li>\n<li>La sensibilisation et l&rsquo;\u00e9ducation au mouvement sont importantes \u00e0 ce stade<\/li>\n<li>Mettez en place des exercices d&rsquo;allongement du genou<\/li>\n<li>Les \u00e9tirements du quadriceps et de la hanche ant\u00e9rieure am\u00e9liorent les sympt\u00f4mes de restriction dpad graisseux infrapatellaire <sup id=\"cite_ref-34\" class=\"reference\"><a href=\"#cite_note-34\">(34)<\/a><\/sup><\/li>\n<li>L&rsquo;IMC \u00e9lev\u00e9 et l&rsquo;ob\u00e9sit\u00e9 ont un impact significatif sur l&rsquo;arthrose du genou et le syndrome du pad graisseux infrapatellaire. Un ECR de 18 mois a \u00e9tudi\u00e9 l&rsquo;effet d&rsquo;un programme de perte de poids (Exercice et\/ou r\u00e9gime) sur le pad graisseux infrapatellaire. L&rsquo;\u00e9tude a fait \u00e9tat d&rsquo;une r\u00e9duction significative du volume du pad graisseux infrapatellaire \u00e0 la suite d&rsquo;une perte de poids et d&rsquo;une modification du pourcentage de graisse corporelle, obtenue principalement en combinant exercice physique et r\u00e9gime <sup id=\"cite_ref-35\" class=\"reference\"><a href=\"#cite_note-35\">(35)<\/a><\/sup>.<\/li>\n<\/ul>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 648px;\">\n<div class=\"embedvideo autoResize\" style=\"\">\n<div class=\"embedvideowrap\" style=\"width: 640px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/xPouEzBmVJk?\" width=\"640\" height=\"360\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-36\" class=\"reference\"><a href=\"#cite_note-36\">(36)<\/a><\/sup><\/p>\n<h2><span class=\"mw-headline\" id=\"References\">R\u00e9f\u00e9rences<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;veaction=edit&amp;section=11\" class=\"mw-editsection-visualeditor\" title=\"Edit section: References\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Fat_Pad_Syndrome&amp;action=edit&amp;section=11\" title=\"Edit section: References\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<div class=\"mw-references-wrap mw-references-columns\">\n<ol class=\"references\">\n<li id=\"cite_note-:5-1\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:5_1-0\">1.0<\/a><\/sup> <sup><a href=\"#cite_ref-:5_1-1\">1.1<\/a><\/sup> <sup><a href=\"#cite_ref-:5_1-2\">1.2<\/a><\/sup> <sup><a href=\"#cite_ref-:5_1-3\">1.3<\/a><\/sup> <sup><a href=\"#cite_ref-:5_1-4\">1.4<\/a><\/sup> <sup><a href=\"#cite_ref-:5_1-5\">1.5<\/a><\/sup> <sup><a href=\"#cite_ref-:5_1-6\">1.6<\/a><\/sup> <sup><a href=\"#cite_ref-:5_1-7\">1.7<\/a><\/sup> <sup><a href=\"#cite_ref-:5_1-8\">1.8<\/a><\/sup> <sup><a href=\"#cite_ref-:5_1-9\">1.9<\/a><\/sup><\/span> <span class=\"reference-text\">Larbi A, Cyteval C, Hamoui M, Dallaudiere B, Zarqane H, Viala P. et al. Hoffa&rsquo;s disease: A report on 5 cases. Diagnostic and interventional imaging. 2014;95(11):1079-84.<\/span><\/li>\n<li id=\"cite_note-2\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-2\">\u2191<\/a><\/span> <span class=\"reference-text\">Kitagawa T, Ozaki N, Aoki Y. <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/journals.plos.org\/plosone\/article?id=10.1371\/journal.pone.0265333\">Effect of physical therapy on the flexibility of the infrapatellar fat pad: A single-blind randomised controlled trial.<\/a> PloS one. 2022 Mar 17;17(3):e0265333.<\/span><\/li>\n<li id=\"cite_note-3\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-3\">\u2191<\/a><\/span> <span class=\"reference-text\">Leese J, Davies DC. <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1111\/joa.13177\">An investigation of the anatomy of the infrapatellar fat pad and its possible involvement in anterior pain syndrome: a cadaveric study<\/a>. Journal of Anatomy. 2020 Jul;237(1):20-8.<\/span><\/li>\n<li id=\"cite_note-4\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-4\">\u2191<\/a><\/span> <span class=\"reference-text\">Edama M, Otsuki T, Yokota H, Hirabayashi R, Sekine C, Maruyama S, Kageyama I. <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.nature.com\/articles\/s41598-022-12859-1\">Morphological characteristics of the infrapatellar fat pad<\/a>. Scientific Reports. 2022 May 27;12(1):1-9.<\/span><\/li>\n<li id=\"cite_note-:0-5\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:0_5-0\">5.00<\/a><\/sup> <sup><a href=\"#cite_ref-:0_5-1\">5.01<\/a><\/sup> <sup><a href=\"#cite_ref-:0_5-2\">5.02<\/a><\/sup> <sup><a href=\"#cite_ref-:0_5-3\">5.03<\/a><\/sup> <sup><a href=\"#cite_ref-:0_5-4\">5.04<\/a><\/sup> <sup><a href=\"#cite_ref-:0_5-5\">5.05<\/a><\/sup> <sup><a href=\"#cite_ref-:0_5-6\">5.06<\/a><\/sup> <sup><a href=\"#cite_ref-:0_5-7\">5.07<\/a><\/sup> <sup><a href=\"#cite_ref-:0_5-8\">5.08<\/a><\/sup> <sup><a href=\"#cite_ref-:0_5-9\">5.09<\/a><\/sup> <sup><a href=\"#cite_ref-:0_5-10\">5.10<\/a><\/sup> <sup><a href=\"#cite_ref-:0_5-11\">5.11<\/a><\/sup><\/span> <span class=\"reference-text\">Mace J, Bhatti W, Anand S. Infrapatellar fat pad syndrome: a review of anatomy, function, treatment and dynamics. Acta Orthopaedica Belgica. 2016;82(1):94-101.<\/span><\/li>\n<li id=\"cite_note-6\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-6\">\u2191<\/a><\/span> <span class=\"reference-text\">Macchi V, Stocco E, Stecco C, Belluzzi E, Favero M, Porzionato A et al. The infrapatellar fat pad and the synovial membrane: an anatomo-functional unit. J Anat. 2018;233(2):146-54. <\/span><\/li>\n<li id=\"cite_note-7\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-7\">\u2191<\/a><\/span> <span class=\"reference-text\">Bohnsack M, Wilharm A, Hurschler C, R\u00fchmann O, Stukenborg-Colsman C, Wirth CJ. Biomechanical and kinematic influences of a total infrapatellar fat pad resection on the knee. The American journal of sports medicine. 2004;32(8):1873-80.<\/span><\/li>\n<li id=\"cite_note-8\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-8\">\u2191<\/a><\/span> <span class=\"reference-text\">Bohnsack M, Meier F, Walter GF, Hurschler C, Schmolke S, Wirth CJ. et al. Distribution of substance-P nerves inside the infrapatellar fat pad and the adjacent synovial tissue: a neurohistological approach to anterior knee pain syndrome. Archives of orthopaedic and trauma surgery. 2005;125(9):592-7.<\/span><\/li>\n<li id=\"cite_note-9\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-9\">\u2191<\/a><\/span> <span class=\"reference-text\">Culvenor AG, Cook JL, Warden SJ, Crossley KM. Infrapatellar fat pad size, but not patellar alignment, is associated with patellar tendinopathy. Scandinavian journal of medicine &amp; science in sports. 2011;21(6):e405-11.<\/span><\/li>\n<li id=\"cite_note-10\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-10\">\u2191<\/a><\/span> <span class=\"reference-text\">Clockaerts S, Bastiaansen-Jenniskens YM, Runhaar J, Van Osch GJ, Van Offel JF, Verhaar JA. et al. The infrapatellar fat pad should be considered as an active osteoarthritic joint tissue: a narrative review. Osteoarthritis and Cartilage. 2010;18(7):876-82.<\/span><\/li>\n<li id=\"cite_note-:3-11\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:3_11-0\">11.0<\/a><\/sup> <sup><a href=\"#cite_ref-:3_11-1\">11.1<\/a><\/sup> <sup><a href=\"#cite_ref-:3_11-2\">11.2<\/a><\/sup> <sup><a href=\"#cite_ref-:3_11-3\">11.3<\/a><\/sup> <sup><a href=\"#cite_ref-:3_11-4\">11.4<\/a><\/sup><\/span> <span class=\"reference-text\">Hannon J, Bardenett S, Singleton S, Garrison JC. Evaluation, Treatment, and Rehabilitation Implications of the Infrapatellar Fat Pad. Sports health. 2016;8(2):167-71.<\/span><\/li>\n<li id=\"cite_note-12\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-12\">\u2191<\/a><\/span> <span class=\"reference-text\">Mellor R, Hodges PW. Motor unit syncronization is reduced in anterior knee pain. The Journal of pain. 2005;6(8):550-8.<\/span><\/li>\n<li id=\"cite_note-13\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-13\">\u2191<\/a><\/span> <span class=\"reference-text\">Hodges PW, Mellor R, Crossley K, Bennell K. Pain induced by injection of hypertonic saline into the infrapatellar fat pad and effect on coordination of the quadriceps muscles. Arthritis Care &amp; Research. 2009;61(1):70-7.<\/span><\/li>\n<li id=\"cite_note-14\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-14\">\u2191<\/a><\/span> <span class=\"reference-text\">Jiang LF, Fang JH, Wu LD. <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.wjgnet.com\/2307-8960\/full\/v7\/i16\/2134.htm\">Role of infrapatellar fat pad in pathological process of knee osteoarthritis: Future applications in treatment<\/a>. World Journal of Clinical Cases. 2019 Aug 8;7(16):2134.<\/span><\/li>\n<li id=\"cite_note-:2-15\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:2_15-0\">15.0<\/a><\/sup> <sup><a href=\"#cite_ref-:2_15-1\">15.1<\/a><\/sup> <sup><a href=\"#cite_ref-:2_15-2\">15.2<\/a><\/sup><\/span> <span class=\"reference-text\">Ioan-Facsinay A, Kloppenburg M. An emerging player in knee osteoarthritis: the infrapatellar fat pad. Arthritis research &amp; therapy. 2013;15(6):225.<\/span><\/li>\n<li id=\"cite_note-16\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-16\">\u2191<\/a><\/span> <span class=\"reference-text\">Distel E, Cadoudal T, Durant S, Poignard A, Chevalier X, Benelli C. The infrapatellar fat pad in knee osteoarthritis: An important source of interleukin\u20106 and its soluble receptor. Arthritis &amp; Rheumatism: Official Journal of the American College of Rheumatology. 2009;60(11):3374-7.<\/span><\/li>\n<li id=\"cite_note-17\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-17\">\u2191<\/a><\/span> <span class=\"reference-text\">Caspar-Bauguil S, Cousin B, Galinier A, Segafredo C, Nibbelink M, Andre M et al. Adipose tissues as an ancestral immune organ: site\u2010specific change in obesity. FEBS letters. 2005;579(17):3487-92.<\/span><\/li>\n<li id=\"cite_note-18\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-18\">\u2191<\/a><\/span> <span class=\"reference-text\">Dragoo JL, Samimi B, Zhu M, Hame SL, Thomas BJ, Lieberman JR, et al. Tissue-engineered cartilage and bone using stem cells from human infrapatellar fat pads. The Journal of bone and joint surgery. British volume. 2003;85(5):740-7.<\/span><\/li>\n<li id=\"cite_note-19\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-19\">\u2191<\/a><\/span> <span class=\"reference-text\">Kim CS, Lee SC, Kim YM, Kim BS, Choi HS, Kawada T. et al. Visceral fat accumulation induced by a high\u2010fat diet causes the atrophy of mesenteric lymph nodes in obese mice. Obesity. 2008;16(6):1261-9.<\/span><\/li>\n<li id=\"cite_note-20\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-20\">\u2191<\/a><\/span> <span class=\"reference-text\">Duran S, Ak\u015fahin E, Kocadal O, Aktekin CN, Hapa O, Genct\u00fcrk ZB. Effects of body mass index, infrapatellar fat pad volume and age on patellar cartilage defect. Orthopaedic journal of sports medicine. 2014;2(11_suppl3):2325967114S00159.<\/span><\/li>\n<li id=\"cite_note-:1-21\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:1_21-0\">21.0<\/a><\/sup> <sup><a href=\"#cite_ref-:1_21-1\">21.1<\/a><\/sup> <sup><a href=\"#cite_ref-:1_21-2\">21.2<\/a><\/sup><\/span> <span class=\"reference-text\">Kumar D, Alvand A, Beacon JP. Impingement of infrapatellar fat pad (Hoffa\u2019s disease): results of high-portal arthroscopic resection. Arthroscopy: The Journal of Arthroscopic &amp; Related Surgery. 2007;23(11):1180-6.<\/span><\/li>\n<li id=\"cite_note-22\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-22\">\u2191<\/a><\/span> <span class=\"reference-text\">Lenny Macrina. Fat Pad Assessment. Available from: https:<a rel=\"nofollow\" class=\"external free\" href=\"https:\/\/www.youtube.com\/watch?v=https:\/\/youtu.be\/kbu9nybRV0M\">https:\/\/www.youtube.com\/watch?v=https:\/\/youtu.be\/kbu9nybRV0M<\/a><\/span><\/li>\n<li id=\"cite_note-:4-23\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:4_23-0\">23.0<\/a><\/sup> <sup><a href=\"#cite_ref-:4_23-1\">23.1<\/a><\/sup><\/span> <span class=\"reference-text\">Ogilvie-Harris DJ, Giddens J. Hoffa&rsquo;s disease: arthroscopic resection of the infrapatellar fat pad. Arthroscopy: The Journal of Arthroscopic &amp; Related Surgery. 1994 ;10(2):184-7.<\/span><\/li>\n<li id=\"cite_note-24\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-24\">\u2191<\/a><\/span> <span class=\"reference-text\">Wito\u0144ski D, W\u0105growska-Danielewicz M. Distribution of substance-P nerve fibers in the knee joint in patients with anterior knee pain syndrome A preliminary report. Knee Surgery, Sports Traumatology, Arthroscopy. 1999;7(3):177-83.<\/span><\/li>\n<li id=\"cite_note-25\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-25\">\u2191<\/a><\/span> <span class=\"reference-text\">Genin J, Faour M, Ramkumar PN, Yakubek G, Khlopas A, Chughtai M et al. Infrapatellar Fat Pad Impingement: A Systematic Review. J Knee Surg. 2017;30(7):639-46. <\/span><\/li>\n<li id=\"cite_note-26\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-26\">\u2191<\/a><\/span> <span class=\"reference-text\">Claire Patella. Infographic:Differentiating fat pad and pfj pain. Available from: <a rel=\"nofollow\" class=\"external free\" href=\"https:\/\/youtu.be\/eiwKkb1SulU\">https:\/\/youtu.be\/eiwKkb1SulU<\/a><\/span><\/li>\n<li id=\"cite_note-27\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-27\">\u2191<\/a><\/span> <span class=\"reference-text\">Kim YM, Joo YB. <a rel=\"nofollow\" class=\"external text\" href=\"http:\/\/www.jksrr.org\/journal\/view.html?doi=10.5792\/ksrr.18.026\">Arthroscopic treatment of infrapatellar fat pad impingement between the patella and femoral trochlea: comparison of the clinical outcomes of partial and subtotal resection<\/a>. Knee surgery &amp; related research. 2019 Mar;31(1):54.<\/span><\/li>\n<li id=\"cite_note-28\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-28\">\u2191<\/a><\/span> <span class=\"reference-text\">House CV, Connell DA. Therapeutic ablation of the infrapatellar fat pad under ultrasound guidance: a pilot study. Clinical radiology. 2007;62(12):1198-201.<\/span><\/li>\n<li id=\"cite_note-29\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-29\">\u2191<\/a><\/span> <span class=\"reference-text\">How to ice massage for knee tendonitis my Physio SA Adelaide Physiotherapist. Available from: <a rel=\"nofollow\" class=\"external free\" href=\"https:\/\/www.youtube.com\/watch?v=6CRarRzStrU\">https:\/\/www.youtube.com\/watch?v=6CRarRzStrU<\/a><\/span><\/li>\n<li id=\"cite_note-30\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-30\">\u2191<\/a><\/span> <span class=\"reference-text\">Claire Patella. Ice-It-Away Instructions-Fat Pad Available from: <a rel=\"nofollow\" class=\"external free\" href=\"https:\/\/www.youtube.com\/watch?v=aE6-EGAFkfI\">https:\/\/www.youtube.com\/watch?v=aE6-EGAFkfI<\/a><\/span><\/li>\n<li id=\"cite_note-31\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-31\">\u2191<\/a><\/span> <span class=\"reference-text\">Union Physical Therapy. McConnel fat pad taping. Available from: <a rel=\"nofollow\" class=\"external free\" href=\"https:\/\/www.youtube.com\/watch?v=Xy7CibqEUtQ\">https:\/\/www.youtube.com\/watch?v=Xy7CibqEUtQ<\/a><\/span><\/li>\n<li id=\"cite_note-32\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-32\">\u2191<\/a><\/span> <span class=\"reference-text\">McConnell Physiotherapy Group. MCCONNELL KNEE TAPING (OFFICIAL). Available from: <a rel=\"nofollow\" class=\"external free\" href=\"https:\/\/youtu.be\/WbHXYnwUwws\">https:\/\/youtu.be\/WbHXYnwUwws<\/a><\/span><\/li>\n<li id=\"cite_note-33\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-33\">\u2191<\/a><\/span> <span class=\"reference-text\">Motion Guidance. infrapatellar fat pad mobilization. Available from: <a rel=\"nofollow\" class=\"external free\" href=\"https:\/\/www.youtube.com\/watch?v=KR_peakgyi4\">https:\/\/www.youtube.com\/watch?v=KR_peakgyi4<\/a><\/span><\/li>\n<li id=\"cite_note-34\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-34\">\u2191<\/a><\/span> <span class=\"reference-text\">Dragoo JL, Johnson C, McConnell J. Evaluation and treatment of disorders of the infrapatellar fat pad. Sports medicine. 2012;42(1):51-67.<\/span><\/li>\n<li id=\"cite_note-35\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-35\">\u2191<\/a><\/span> <span class=\"reference-text\">Murillo AL, Eckstein F, Wirth W, Beavers D, Loeser RF, Nicklas BJ. et al. Impact of diet and\/or exercise intervention on infrapatellar fat pad morphology: secondary analysis from the intensive diet and exercise for arthritis (IDEA) trial. Cells Tissues Organs. 2017;203(4):258-66.<\/span><\/li>\n<li id=\"cite_note-36\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-36\">\u2191<\/a><\/span> <span class=\"reference-text\">Infrapatellar Fat Pad Knee Pain (Hoffa&rsquo;s Syndrome) Clinical Treatment &#8211; Dr Mandell. Available from: <a rel=\"nofollow\" class=\"external free\" href=\"https:\/\/www.youtube.com\/watch?v=xPouEzBmVJk\">https:\/\/www.youtube.com\/watch?v=xPouEzBmVJk<\/a><\/span><\/li>\n<\/ol>\n<\/div>\n<p><!-- NewPP limit report Cached time: 20221214184409 Cache expiry: 0 Dynamic content: true Complications: () CPU time usage: 0.166 seconds Real time usage: 0.189 seconds Preprocessor visited node count: 640\/1000000 Post\u2010expand include size: 258\/2097152 bytes Template argument size: 0\/2097152 bytes Highest expansion depth: 3\/40 Expensive parser function count: 0\/100 Unstrip recursion depth: 0\/20 Unstrip post\u2010expand size: 23785\/5000000 bytes --><br \/>\n<!-- Transclusion expansion time report (%,ms,calls,template) 100.00% 33.949 1 Special:Contributors\/Fat_Pad_Syndrome 100.00% 33.949 1 -total --><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>\u00c9diteur original &#8211; Mariam Hashem Principaux contributeurs &#8211; Mariam Hashem, Tarina van der Stockt, Kim Jackson, Tony Lowe, Simisola Ajeyalemi , Uchechukwu Chukwuemeka, Wanda van Niekerk, Jess Bell, Marleen Moll et Robin Tacchetti Propri\u00e9taire d&rsquo;une page &#8211; Marleen Moll dans le cadre du projet One Page Contenu 1 Introduction 2 Anatomie \/ Biom\u00e9canique 3 Influence [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-4324","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/4324","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/comments?post=4324"}],"version-history":[{"count":2,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/4324\/revisions"}],"predecessor-version":[{"id":4327,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/4324\/revisions\/4327"}],"wp:attachment":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/media?parent=4324"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}