The infrapatellar fat pad (IPFP) or Hoffa’s fat pad is often resected during total knee arthroplasty in order to improve visibility. However, the management of the IPFP during total knee arthroplasty (TKA) is the subject of an ongoing debate that has no clear consensus. The purpose of this review was to appraise if resection of the IPFP affects clinical outcomes. We conducted a meta-analysis to identify relevant randomized controlled trials involving infrapatellar fat pad resection and infrapatellar fat pad preservation during total knee arthroplasty in electronic databases, including Web of Science, Embase, PubMed, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CBM, CNKI, VIP, and Wanfang database, up to March 2020. Nine randomized controlled trials, involving 783 TKAs (722 patients), were included in the systematic review. Outcome measures included patellar tendon length (PTL), Insall-Salvati ratio (ISR), rate of anterior knee pain, Knee Society Scores (KSS), and knee range of motion. The meta-analysis identified a trend toward the shortening of the patellar tendon with IPFP resection at 6 months (P = 0.0001) and 1 year (P = 0.001). We found no statistical difference in ISR (P = 0.87), rate of anterior knee pain within 6 months (p = 0.45) and 1 year (p = 0.38), KSS at 1 year (p = 0.77), and knee range of motion within 6 months (p = 0.61) and 1 year (0.46). Based on the available level I evidence, we were unable to conclude that one surgical technique of IPFP can definitively be considered superior over the other. More adequately powered and better-designed randomized controlled trial (RCT) studies with long-term follow-up are required to produce evidence-based guidelines regarding IPFP resection.

中文翻译：

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全膝关节置换术中pat下脂肪垫切除术或保存：一项随机对照试验的荟萃分析。

total骨脂肪垫（IPFP）或霍法氏脂肪垫通常在全膝关节置换术中切除，以提高视野。但是，全膝关节置换术（TKA）期间IPFP的管理仍是一个正在进行的辩论的主题，目前尚无明确共识。这篇综述的目的是评估切除IPFP是否会影响临床结果。我们进行了一项荟萃分析，以鉴定相关的随机对照试验，这些试验涉及电子数据库中包括全膝关节置换术中pat下脂肪垫切除和preservation下脂肪垫保存的电子数据库，其中包括Web of Science，Embase，PubMed，Cochrane对照试验注册，Cochrane图书馆，Highwire，CBM ，截止到2020年3月的CNKI，VIP和Wanfang数据库。系统评价包括9项随机对照试验，涉及783例TKA（722例患者）。结果测量包括pa肌腱长度（PTL），Insall-Salvati比（ISR），膝前疼痛率，膝关节社会评分（KSS）和膝关节活动范围。荟萃分析确定了在6个月（P = 0.0001）和1年（P = 0.001）时采用IPFP切除toward骨肌腱的趋势。我们发现ISR（P = 0.87），6个月内（p = 0.45）和1年（p = 0.38）的膝前疼痛发生率，1年时的KSS（p = 0.77）和膝关节活动度无统计学差异。在6个月（p = 0.61）和1年（0.46）之内。根据现有的I级证据，我们无法得出结论，可以认为IPFP的一种外科手术技术可以肯定地优于另一种。