J Knee Surg 2015; 28(03): 229-238
DOI: 10.1055/s-0034-1378192
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Infrapatellar Fat Pad Osteochondroma: Three Cases and a Systematic Review

Nathan Evaniew
1   Department of Surgery, Center for Evidence-Based Orthopaedics, McMaster University, Hamilton, Ontario, Canada
,
Darius Bayegan
1   Department of Surgery, Center for Evidence-Based Orthopaedics, McMaster University, Hamilton, Ontario, Canada
,
Snezana Popovic
2   Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
,
Naveen Parasu
3   Department of Radiology, Juravinski Hospital, McMaster University, Hamilton, Ontario, Canada
,
Michelle Ghert
4   Department of Surgery, Juravinski Hospital, McMaster University, Hamilton, Ontario, Canada
› Author Affiliations
Further Information

Publication History

12 August 2013

13 April 2014

Publication Date:
29 May 2014 (online)

Abstract

Extraskeletal para-articular osteochondromas of the infrapatellar fat pad are unique soft-tissue tumors whose etiology and clinical history remain poorly understood. We report three cases and a systematic review of the literature. Three females, aged 47, 54, and 70 years, presented with pain and a parapatellar knee mass. All three underwent marginal excision with no complications and no recurrence. In the literature, 32 reports describing 42 cases were identified. Mean age at presentation was 51.1 years (range: 12–75). There were 25 females and 20 males. Seven patients (15.6%) had a history of antecedent trauma. Mean duration of presenting symptoms was 63.9 months (range: 2–300). All patients except for one underwent open excision. Mean follow-up was 14.9 months (range: 3–96). There were no reports of recurrence or malignant transformation. Para-articular extraskeletal osteochondromas of the infrapatellar fat pad have a benign clinical history regardless of whether they are managed by arthroscopic or open marginal excision.

 
  • References

  • 1 Unni KK. Cartilaginous lesions of bone. J Orthop Sci 2001; 6 (5) 457-472
  • 2 Chung EB, Enzinger FM. Chondroma of soft parts. Cancer 1978; 41 (4) 1414-1424
  • 3 Steiner GC, Meushar N, Norman A, Present D. Intracapsular and paraarticular chondromas. Clin Orthop Relat Res 1994; (303) 231-236
  • 4 Turhan E, Doral MN, Atay AO, Demirel M. A giant extrasynovial osteochondroma in the infrapatellar fat pad: end stage Hoffa's disease. Arch Orthop Trauma Surg 2008; 128 (5) 515-519
  • 5 Helpert C, Davies AM, Evans N, Grimer RJ. Differential diagnosis of tumours and tumour-like lesions of the infrapatellar (Hoffa's) fat pad: pictorial review with an emphasis on MR imaging. Eur Radiol 2004; 14 (12) 2337-2346
  • 6 Jaffe HL. Tumors and Tumorous Conditions of the Bones and Joints. Philadelphia: Lea and Febiger; 1958: 558-567
  • 7 Zhang BX, Chew D, Critchley I. Review of para-articular soft tissue osteochondromas of the knee. ANZ J Surg 2012; 82 (12) 878-884
  • 8 Moher D, Liberati A, Tetzlaff J, Altman DG ; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 2009; 62 (10) 1006-1012
  • 9 Sackett D, Haynes R, Guyatt G, Tugwell P. Clinical Epidemiology: A Basic Science for Clinicians. 2nd ed. Boston: Little Brown; 1991: 30
  • 10 González-Lois C, García-de-la-Torre P, SantosBriz-Terrón A, Vilá J, Manrique-Chico J, Martínez-Tello J. Intracapsular and para-articular chondroma adjacent to large joints: report of three cases and review of the literature. Skeletal Radiol 2001; 30 (12) 672-676
  • 11 Wickham MQ, Erickson GR, Gimble JM, Vail TP, Guilak F. Multipotent stromal cells derived from the infrapatellar fat pad of the knee. Clin Orthop Relat Res 2003; (412) 196-212
  • 12 Ushiyama T, Chano T, Inoue K, Matsusue Y. Cytokine production in the infrapatellar fat pad: another source of cytokines in knee synovial fluids. Ann Rheum Dis 2003; 62 (2) 108-112
  • 13 Ratcliff JR, Naqvi A, de la Roza G, Strauss JA, Damron TA. Soft tissue osteochondroma: case report and immunohistochemistry for parathyroid hormone-related protein. Ann Diagn Pathol 2006; 10 (4) 222-229
  • 14 Milgram JW, Dunn EJ. Para-articular chondromas and osteochondromas: a report of three cases. Clin Orthop Relat Res 1980; (148) 147-151
  • 15 Purser DW. Extraskeletal osteochondromata. J Bone Joint Surg Br 1956; 38-B (4) 871-873
  • 16 Suermondt WF. Tumours of the joint capsule. Arch Chir Neerl 1950; 2 (3) 278-289
  • 17 González-Lois C, García-de-la-Torre P, SantosBriz-Terrón A, Vilá J, Manrique-Chico J, Martínez-Tello J. Intracapsular and para-articular chondroma adjacent to large joints: report of three cases and review of the literature. Skeletal Radiol 2001; 30 (12) 672-676
  • 18 Kudawara I, Ueda T, Araki N. Extraskeletal chondroma around the knee. Clin Radiol 2001; 56 (9) 779-782
  • 19 Sakai H, Tamai K, Iwamoto A, Saotome K. Para-articular chondroma and osteochondroma of the infrapatellar fat pad: a report of three cases. Int Orthop 1999; 23 (2) 114-117
  • 20 Mosher Jr JF, Kettelkamp DB, Campbell CJ. Intracapsular or para-articular chondroma. A report of three cases. J Bone Joint Surg Am 1966; 48 (8) 1561-1569
  • 21 Veras E, Abadeer R, Khurana H, Tan D, Ayala A. Solitary synovial osteochondroma. Ann Diagn Pathol 2010; 14 (2) 94-99
  • 22 Sarmiento A, Elkins RW. Giant intra-articular osteochondroma of the knee. J Bone Joint Surg Am 1975; 57 (4) 560-561
  • 23 Milgram JW, Jasty M. Case report 238: para-articular osteochondroma of the knee. Skeletal Radiol 1983; 10 (2) 121-125
  • 24 Böstman O, Karaharju E, Heikkonen L, Holmström T. Extraskeletal ossifying chondroma in the knee. A case report. Acta Orthop Scand 1985; 56 (1) 87-89
  • 25 Pettrone FA, Stay EJ. Chondroma. An unusual presentation of an extraarticular soft tissue mass about the knee. Am J Sports Med 1990; 18 (5) 536-538
  • 26 Krebs VE, Parker RD. Arthroscopic resection of an extrasynovial ossifying chondroma of the infrapatellar fat pad: end-stage Hoffa's disease?. Arthroscopy 1994; 10 (3) 301-304
  • 27 Allahabadia VN, Kulkarni SS, Dogra AS, Bhosale PB. Solitary synovial osteochondroma of the knee. J Postgrad Med 1995; 41 (4) 113-114
  • 28 Reith JD, Bauer TW, Joyce MJ. Paraarticular osteochondroma of the knee: report of 2 cases and review of the literature. Clin Orthop Relat Res 1997; (334) 225-232
  • 29 Rodriguez-Peralto JL, Lopez-Barea F, Gonzalez-Lopez J. Intracapsular chondroma of the knee: an unusual neoplasm. Int J Surg Pathol 1997; 5 (1–2) 49-53
  • 30 Dhillon MS, Sharma R, Vaiphei K, Nagi ON. Para-articular extra-osseous osteochondroma of the knee. The Knee 1999; 6 (2) 155-158
  • 31 Cohen AP, Giannoudis PV, Hinsche A, Smith RM, Matthews SJ. Post-traumatic giant intraarticular synovial osteochondroma of the knee. Injury 2001; 32 (1) 87-89
  • 32 Hung J, Huang G, Peng Y, Wu S, Chau K. Fat pad osteochondroma of the knee. J Med Sci 2005; 25 (6) 315-318
  • 33 Oliva F, Marconi A, Fratoni S, Maffulli N. Extra-osseous osteochondroma-like soft tissue mass of the patello-femoral space. BMC Musculoskelet Disord 2006; 7: 57
  • 34 Rizzello G, Franceschi F, Meloni MC , et al. Para-articular osteochondroma of the knee. Arthroscopy 2007; 23 (8) e1-e4
  • 35 Carmont MR, Davies S, Gey van Pittius D, Rees R. Accelerated para-articular osteochondroma formation within the knee: a case report. Cases J 2008; 1 (1) 6-1626
  • 36 Demir MK, Unlu E, Usta U. A curious mass of the anterior compartment in the knee. Br J Radiol 2009; 82 (977) 435-437
  • 37 Singh VK, Shah G, Singh PK, Saran D. Extraskeletal ossifying chondroma in Hoffa's fat pad: an unusual cause of anterior knee pain. Singapore Med J 2009; 50 (5) e189-e192
  • 38 Ozturan KE, Yucel I, Cakici H, Guven M, Gurel K, Dervisoglu S. Patellar tendinopathy caused by a para-articular/extraskeletal osteochondroma in the lateral infrapatellar region of the knee: a case report. Cases J 2009; 2: 9341
  • 39 Nouri H, Ben Hmida F, Ouertatani M , et al. Tumour-like lesions of the infrapatellar fat pad. Knee Surg Sports Traumatol Arthrosc 2010; 18 (10) 1391-1394
  • 40 Mulcahy H, Hoch B. An extraskeletal para-articular osteochondroma of hoffa's fat pad. Radiology Case Reports. 2010; 5 (4) 420
  • 41 Ogura K, Goto T, Nemoto T, Imanishi J. Para-articular osteochondroma of the infrapatellar fat pad. J Knee Surg 2011; 24 (3) 209-213
  • 42 De Maio F, Bisicchia S, Potenza V, Caterini R, Farsetti P. Giant intra-articular extrasynovial osteochondroma of the knee: a report of two cases. Open Orthop J 2011; 5: 368-371
  • 43 Ingabire MI, Deprez FC, Bodart A, Puttemans T. Soft tissue chondroma of Hoffa's fat pad. JBR-BTR 2012; 95 (1) 15-17
  • 44 Singh R, Jain M, Siwach R, Rohilla S, Sen R, Kaur K. Large para-articular osteochondroma of the knee joint: a case report. Acta Orthop Traumatol Turc 2012; 46 (2) 139-143
  • 45 Sen D, Satija L, Kumar KS, Rastogi V, Sunita BS. Giant intra-articular extrasynovial osteochondroma of the Hoffa's fat pad: a case report. Medical Journal Armed Forces India 2013; ; doi: 10.1016/j.mjafi.2012.11.005