Arthroscopic management of a rare multiloculated prefemoral fat pad cyst associated with Hoffa’s fat pad edema: A case report

Abstract

Cystic lesions arising from the prefemoral fat pad of the knee are rare. They may present with nonspecific symptoms, such as anterior knee pain and restricted movement, thus making diagnosis challenging. Magnetic resonance imaging (MRI) plays a pivotal role in identifying these uncommon lesions and differentiating them from other intra-articular pathologies. We report a 40-year-old man who presented with progressive anterior knee pain and discomfort during knee movement. MRI results revealed a 15 × 12 mm multiloculated cystic lesion within the lateral prefemoral fat pad associated with secondary Hoffa’s fat pad edema. Due to persistent symptoms despite conservative management, the patient underwent arthroscopic excision of the cyst and partial resection of the inflamed fat pad. Histopathological examination confirmed a benign cystic lesion. The patient experienced substantial postoperative pain relief, restoration of knee function, and no recurrence during follow-up. This case highlights a rare presentation of a multiloculated prefemoral fat pad cyst causing secondary Hoffa’s fat pad impingement and edema. Early MRI evaluation and arthroscopic management facilitated accurate diagnosis, symptom resolution, and favorable clinical outcomes.