What are fat pad injuries?

The main fat pad in the knee sits behind the tendon that connects the knee cap to the shin bone. It lies between the tendon and the front of the thigh bone. It allows the tendon to move smoothly across the front of the thigh bone as the knee is flexed and extended. When you operate on the knee, the fat pad resembles an oyster: it is extremely soft and slippery and about the same size. Importantly, the fat pad has a very dense nerve and blood supply, meaning it can be painful and scar quickly when injured.

The fat pad can become inflamed, scarred and therefore painful due to a number of causes. The most common is an acute injury, such as a sports injury or a knee cap dislocation that causes bleeding, pain and inflammation in the fat pad. Secondly, the fat pad can be injured by repetitive microtraumas, such as an increase in running or exercise on a knee where the biomechanics of the lower limb isn’t right. We commonly see this in endurance athletes, weight lifters, or those returning to sport after some time off. Finally, the fat pad can be damaged at the time of surgery, particularly key-hole surgery.

What are the symptoms of fat pad injuries?

Symptoms are varied but include pain under and below the knee cap, reduced range of movement, pain on fully extending the knee particularly when there is weight on the knee, tenderness and swelling on the knee. The symptoms tend to be worse on activity and relieved with rest. Patients have often tried and failed to return to sports on a number of occasions.

How are fat pad injuries diagnosed?

The first step is to have a thorough clinical examination by one of our experts. Following this, the imaging technique of choice is an MRI.

What are my options for treatment?

Surgery for fat pad problems is always a last resort. Initially, physical therapy from an experienced musculoskeletal physiotherapist is essential to correct imbalances around the knee. Our specialists can help you find a physiotherapist to help you. Taping can help to offload the knee cap and take pressure off the fat pad. In some cases, depending on examination and imaging findings, targeted injections using ultrasound scans can help break the pain cycle and allow you to rehabilitate more effectively. It is rare to operate on the fat pad, however key-hole surgery or even open surgery can be used once all non-operative measures have been exhausted.

If you or someone you know has suffered an injury or is experiencing pain across their lower limbs or difficulty with mobility and would like a consultant-led review, please contact us. Grosvenor Orthopaedics have extensive experience in the treatment of knee-related injuries with excellent patient outcomes.


Grosvenor Orthopaedics have extensive experience in the treatment of knee-related injuries with excellent patient outcomes.


If you would like to learn about other knee conditions click the button below to find out more


If you would like to learn about other knee treatments click the button below to find out more


The Knee Service at Grosvenor Orthopaedic Partners is led by Mr Luke Jones and Mr Chethan Jayadev, both Oxford PhD educated knee surgeons with London Teaching Hospital NHS consultant posts. They provide a comprehensive range of knee procedures as part of a multidisciplinary team of healthcare professionals including highly specialised physiotherapists, all committed to returning you to optimal function.

Our team are well placed to manage and treat a diverse range of knee problems utilising cutting edge diagnostic technology and treatment approaches, both surgical and conservative. Below is an overview of some of the knee conditions we treat but for a more thorough understanding please contact our team here


Consultant Orthopaedic Knee Surgeon

DPhil(Oxon), FRCS(Tr&Orth), MB BS, BSc(hons)
Luke is a Consultant Knee Surgeon practising at Chelsea and Westminster Hospital NHS Foundation Trust, and the Lister Hospital, Chelsea. He runs a high volume bespoke specialist knee practice that deals with all aspects of knee surgery from minor sports injuries to complex joint reconstructions.


Consultant Orthopaedic Knee Surgeon

MA(Oxon) BMBCh DPhil(PhD) FRCS(Tr&Orth)
Chethan is a Consultant Knee Surgeon practising at the world-renowned Royal National Orthopaedic Hospital Stanmore, Spire Bushey Hospital and King Edward VII’s Hospital. His practice encompasses all aspects of knee surgery, from sports injuries and knee preservation to complex and redo joint replacements. He has a reputation as a thorough, meticulous surgeon offering patients a bespoke and personalised service. He is dedicated to providing the most up-to-date and evidence-based care. Chethan is a strong advocate of patient choice and always puts patients first


Consultant Orthopaedic Knee Surgeon

MBBS MSc FRCS (Tr & Orth)
Mark is a Consultant Orthopaedic Surgeon with a passion for sports related injuries. He strives to not only provide excellent surgical treatments but also rounded, bespoke care that allows his patients to get back to the activities they love. This is evident in his specialist training which includes a Master’s degree in Sports Medicine from University College London to help him when treating all levels of athletes. Alongside surgical treatments, Mr. Webb offers non-operative (conservative) options including using orthobiologics, such as PRP and stem cells, to treat the symptoms of early arthritis, as well as tendon injuries. Treatment plans are tailored to the patient’s requirements and expectations using the best evidence available

What some of our patients say

Mrs JS

Thank you to the whole team for getting me back on my feet again