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Lipoma arborescens of the knee.
Knee Surg Sports Traumatol Arthrosc. 2015 Aug; 23(8):2196-2201.KS

Abstract

PURPOSE

Lipoma arborescens (LA) is a benign lesion described as replacement of mature fat cells with sub-synovial tissue, which causes the formation of villous projections. Underlying inflammatory conditions might predispose LA. This study demonstrates the treatment, post-operative survey and MRI demonstrations of this rare entity.

METHODS

Five patients (6 knees) diagnosed and treated with arthroscopic (5/6) and open (1/6) synovectomy were reviewed retrospectively. An additional mini-transquadricipital incision is used for excision of the extensive suprapatellar lesions. The patients had post-operative follow-ups at first and sixth months and then yearly. Radiographs and MRI of the affected knees were taken at the final follow-up.

RESULTS

The median follow-up was 59 (4-105) months. Major symptom was painless swelling of the joint. The presenting age was under 18 years in four patients. Recurrent lesions were detected in MRI scan of three patients with JRA, ARF and Tbc. Two out of three were located adjacent to the posterior capsule. The median of the Kujala questionnaire scores was 88 (74-95), and the median of the Knee Society Clinical Rating System scores was 95 (80-100) at the final follow-up.

CONCLUSIONS

Lipoma arborescens should be considered in the differential diagnosis of paediatric patients who have painless swelling of the knee joint. The lesion is totally curable. However, underlying persistent disease might aggravate the inflammatory process and might cause recurrent lesions. Although resecting the lesion adjacent to the posterior capsule of the knee joint is technically demanding, arthroscopic treatment is an effective procedure and transquadricipital approach may help resection of the extensive lesions in suprapatellar pouch.

LEVEL OF EVIDENCE

Case series, Level IV.

Authors+Show Affiliations

Department of Orthopaedics and Traumatology, Faculty of Medicine, Hacettepe University, Sihhiye, 06100, Ankara, Turkey.Department of Orthopaedics and Traumatology, Faculty of Medicine, Hacettepe University, Sihhiye, 06100, Ankara, Turkey. mndoral@gmail.com.Department of Radiology, Faculty of Medicine, Hacettepe University, Sihhiye, 06100, Ankara, Turkey.Department of Orthopaedics and Traumatology, Faculty of Medicine, Hacettepe University, Sihhiye, 06100, Ankara, Turkey.Department of Orthopaedics, University of Missouri-Kansas City, 2301 Holmes Street, Kansas City, MO, USA.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

24752536

Citation

Kamaci, Saygin, et al. "Lipoma Arborescens of the Knee." Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, vol. 23, no. 8, 2015, pp. 2196-2201.
Kamaci S, Doral MN, Ergen FB, et al. Lipoma arborescens of the knee. Knee Surg Sports Traumatol Arthrosc. 2015;23(8):2196-2201.
Kamaci, S., Doral, M. N., Ergen, F. B., Yucekul, A., & Cil, A. (2015). Lipoma arborescens of the knee. Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, 23(8), 2196-2201. https://doi.org/10.1007/s00167-014-2996-3
Kamaci S, et al. Lipoma Arborescens of the Knee. Knee Surg Sports Traumatol Arthrosc. 2015;23(8):2196-2201. PubMed PMID: 24752536.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lipoma arborescens of the knee. AU - Kamaci,Saygin, AU - Doral,M Nedim, AU - Ergen,F Bilge, AU - Yucekul,Altug, AU - Cil,Akin, Y1 - 2014/04/22/ PY - 2014/01/08/received PY - 2014/04/07/accepted PY - 2014/4/23/entrez PY - 2014/4/23/pubmed PY - 2016/2/13/medline SP - 2196 EP - 2201 JF - Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA JO - Knee Surg Sports Traumatol Arthrosc VL - 23 IS - 8 N2 - PURPOSE: Lipoma arborescens (LA) is a benign lesion described as replacement of mature fat cells with sub-synovial tissue, which causes the formation of villous projections. Underlying inflammatory conditions might predispose LA. This study demonstrates the treatment, post-operative survey and MRI demonstrations of this rare entity. METHODS: Five patients (6 knees) diagnosed and treated with arthroscopic (5/6) and open (1/6) synovectomy were reviewed retrospectively. An additional mini-transquadricipital incision is used for excision of the extensive suprapatellar lesions. The patients had post-operative follow-ups at first and sixth months and then yearly. Radiographs and MRI of the affected knees were taken at the final follow-up. RESULTS: The median follow-up was 59 (4-105) months. Major symptom was painless swelling of the joint. The presenting age was under 18 years in four patients. Recurrent lesions were detected in MRI scan of three patients with JRA, ARF and Tbc. Two out of three were located adjacent to the posterior capsule. The median of the Kujala questionnaire scores was 88 (74-95), and the median of the Knee Society Clinical Rating System scores was 95 (80-100) at the final follow-up. CONCLUSIONS: Lipoma arborescens should be considered in the differential diagnosis of paediatric patients who have painless swelling of the knee joint. The lesion is totally curable. However, underlying persistent disease might aggravate the inflammatory process and might cause recurrent lesions. Although resecting the lesion adjacent to the posterior capsule of the knee joint is technically demanding, arthroscopic treatment is an effective procedure and transquadricipital approach may help resection of the extensive lesions in suprapatellar pouch. LEVEL OF EVIDENCE: Case series, Level IV. SN - 1433-7347 UR - https://www.unboundmedicine.com/medline/citation/24752536/Lipoma_arborescens_of_the_knee_ L2 - https://dx.doi.org/10.1007/s00167-014-2996-3 DB - PRIME DP - Unbound Medicine ER -