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Response to: ‘Infrapatellar fat pad resection during total knee replacement: yet another reason?’ by Ryan
  1. Zhaohua Zhu1,
  2. Weiyu Han2,
  3. Guangfeng Ruan1,3,
  4. Shuang Zheng4,
  5. Changhai Ding1,3,4
  1. 1Clinical Research Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China
  2. 2Department of Orthopedics, Zhujiang Hospital, Southern Medical University, Guangzhou, China
  3. 3Department of Rheumatology and Immunology, Arthritis Research Institute, The First Affiliated Hospital of Anhui Medical University, Hefei, China
  4. 4Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
  1. Correspondence to Dr Changhai Ding, Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China; Changhai.Ding{at}utas.edu.au

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We thank Ryan1 for the interest in our original paper2 and response3 regarding to the associations between infrapatellar fat pad (IPFP) maximal area and knee osteoarthritic measures including symptoms and structural changes.

Our previous studies revealed that IPFP maximal area and volume were associated with reduced knee pain, decreased loss of cartilage volume and reduced risks of cartilage defect progression, indicating a beneficial effect of IPFP size.2 4 On the other hand, our further investigation demonstrated that IPFP signal intensity alteration was negatively associated with maximum area of IPFP and, moreover, associated with increased knee cartilage defects, subchondral bone marrow lesions and knee pain, suggesting IPFP with abnormal quality may play a detrimental role in knee osteoarthritis (OA).5

Based on these findings, we proposed that IPFP with normal qualities, rather than abnormal …

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