Inflammation of the fatty cushion just below the kneecap — a frequently overlooked cause of front-of-knee pain
Hoffa's disease is inflammation of the infrapatellar fat pad — a soft cushion that sits just below the kneecap and helps the joint move smoothly.
This pad is rich in pain-sensitive nerves, so when it becomes inflamed it produces sharp, focal pain.
Because it mimics meniscus tears and patellar tendinitis, it is often missed without a careful exam and imaging.
A direct blow, hard landing, or repeated jumping/running irritates the fat pad
Tiny injuries trigger an inflammatory reaction inside the soft cushion
Persistent inflammation causes enlargement and loss of its natural softness
When the knee fully extends, the swollen pad is pinched and produces sharp pain
With activity adjustment and rehabilitation, the majority of patients recover. For stubborn cases that don't respond to 3–6 months of conservative treatment, arthroscopic partial resection of the hypertrophic fat pad has shown good long-term outcomes.
Diagnosis matters.
Hoffa's disease can mimic meniscus tears, patellar tendinitis, and knee osteoarthritis. MRI and ultrasound are valuable in distinguishing them. If front-of-knee pain has lasted more than 6 months, please ask for an evaluation that includes imaging.