Abstract：
BACKGROUND: We have previously reported our experience of the effect of complete excision of Hoffa\'s fat pad on patella height post TKR. In this study, we compared the change of patellar height post TKR before and after the senior author changed his practice to preserving Hoffa\'s fat pad.
METHODS: This was a retrospective analysis of a prospective series of TKRs performed or directly supervised by the senior author. In Group 1 were 72 patients performed before April 2011 who had complete excision of Hoffa\'s fat pad to maximise exposure during the procedure. In Group 2 were 138 patients performed after April 2011 who had the minimum excision of Hoffa\'s fat pad to allow adequate surgical exposure. The surgical technique and rehabilitation protocol were identical in all other respects. Patellar height was assessed using the Caton-Deschamps Index both immediately postoperative and at a minimum follow up of 1 year.
RESULTS: Group 1 included 28 males, 44 females with mean age 68.36 years. The mean CDI in this group changed from 0.54 immediately post-operatively to 0.46 at minimum one year follow-up (P = 0.001) indicating progressive patella baja. Group 2 included 56 males, 82 females with mean age 65 years. The mean CDI changed from 0.67 immediately post-operative to 0.68 at minimum one year post follow-up (P = 0.32) indicating no statistically or clinically relevant post-operative change in patellar height.
CONCLUSIONS: Total excision of Hoffa\'s fat pad is associated with progressive post-operative patella baja. This can be avoided by resecting the minimum amount of fat pad to allow adequate exposure during the procedure.
METHODS: This was a retrospective analysis of a prospective series of TKRs performed or directly supervised by the senior author. In Group 1 were 72 patients performed before April 2011 who had complete excision of Hoffa\'s fat pad to maximise exposure during the procedure. In Group 2 were 138 patients performed after April 2011 who had the minimum excision of Hoffa\'s fat pad to allow adequate surgical exposure. The surgical technique and rehabilitation protocol were identical in all other respects. Patellar height was assessed using the Caton-Deschamps Index both immediately postoperative and at a minimum follow up of 1 year.
RESULTS: Group 1 included 28 males, 44 females with mean age 68.36 years. The mean CDI in this group changed from 0.54 immediately post-operatively to 0.46 at minimum one year follow-up (P = 0.001) indicating progressive patella baja. Group 2 included 56 males, 82 females with mean age 65 years. The mean CDI changed from 0.67 immediately post-operative to 0.68 at minimum one year post follow-up (P = 0.32) indicating no statistically or clinically relevant post-operative change in patellar height.
CONCLUSIONS: Total excision of Hoffa\'s fat pad is associated with progressive post-operative patella baja. This can be avoided by resecting the minimum amount of fat pad to allow adequate exposure during the procedure.
摘要：
背景：我们之前报道了完全切除Hoffa脂肪垫对TKR后髌骨高度影响的经验。在这项研究中,我们比较了TKR前后髌骨高度的变化。
方法：这是对由资深作者进行或直接监督的一系列前瞻性TKR的回顾性分析。在第1组中，72例患者在2011年4月之前完成了Hoffa脂肪垫的完全切除，以在手术过程中最大限度地暴露。在第2组中，有138例患者在2011年4月之后进行了Hoffa脂肪垫的最小切除，以允许足够的手术暴露。手术技术和康复方案在所有其他方面都相同。使用Caton-Deschamps指数在术后立即和至少随访1年时评估髌骨高度。
结果：第一组包括28名男性，44名女性，平均年龄68.36岁。该组的平均CDI从术后立即的0.54变为至少一年随访时的0.46（P=0.001），表明pat骨进行性baja。第二组包括56名男性，82名女性，平均年龄65岁。平均CDI从术后立即的0.67变化到随访后至少一年的0.68（P=0.32），表明pat骨高度没有统计学或临床相关的术后变化。
结论：完全切除Hoffa脂肪垫与术后进行性髌骨baja相关。这可以通过切除最小量的脂肪垫以允许在手术过程中充分暴露来避免。
方法：这是对由资深作者进行或直接监督的一系列前瞻性TKR的回顾性分析。在第1组中，72例患者在2011年4月之前完成了Hoffa脂肪垫的完全切除，以在手术过程中最大限度地暴露。在第2组中，有138例患者在2011年4月之后进行了Hoffa脂肪垫的最小切除，以允许足够的手术暴露。手术技术和康复方案在所有其他方面都相同。使用Caton-Deschamps指数在术后立即和至少随访1年时评估髌骨高度。
结果：第一组包括28名男性，44名女性，平均年龄68.36岁。该组的平均CDI从术后立即的0.54变为至少一年随访时的0.46（P=0.001），表明pat骨进行性baja。第二组包括56名男性，82名女性，平均年龄65岁。平均CDI从术后立即的0.67变化到随访后至少一年的0.68（P=0.32），表明pat骨高度没有统计学或临床相关的术后变化。
结论：完全切除Hoffa脂肪垫与术后进行性髌骨baja相关。这可以通过切除最小量的脂肪垫以允许在手术过程中充分暴露来避免。
