Abstract
OBJECTIVE: To introduce a novel infrapatellar fat pad (IPFP) preservation technique for anterior cruciate ligament reconstruction (ACLR) and evaluate its efficacy in reducing postoperative pain and enhancing functional recovery of the knee, assessing its impact on postoperative IPFP fibrosis, intra-articular inflammation, and cartilage degeneration progression. METHODS: This study included 86 anterior cruciate ligament (ACL) tear patients treated at Foshan Hospital of Traditional Chinese Medicine between May 2019 and June 2022. Patients were divided into two groups, the IPFP preservation group (n = 42) and the non-preservation group (n = 44), on the basis of how the IPFP was managed during surgery. The duration of the operations was recorded for both groups. Comparative assessments included the Kujala score, International Knee Documentation Committee (IKDC) score, KT-1000 arthrometer measurements, visual analogue scale (VAS) score, and range of motion (ROM). Additionally, at the 12-month follow-up, synovial fluid IL-6 levels and IPFP fibrosis grading were compared. Cartilage health was evaluated by the ICRS, and the proportion of patients showing cartilage deterioration was compared. RESULTS: There were no significant differences between the two groups in terms of baseline characteristics, surgical duration (P = 0.12), IKDC score (P = 0.80), KT-1000 laxity (P = 0.09). No statistically significant differences in ROM were observed between the two groups at both the 12-month (P = 0.10) and final follow-up (P = 0.19). However, the preservation group had higher Kujala scores (P = 0.01), lower VAS scores (P = 0.00) and significantly improved ROM at 3 and 6 months (P = 0.04, P = 0.00) postoperatively. At the 1-year assessment, the preservation group had notably lower levels of synovial IL-6 (P = 0.00), reduced progression of IPFP fibrosis (P = 0.00), decreased severity of chondral lesions (P = 0.00) and a lower proportion of patients with progressive cartilage deterioration (P = 0.00) than did the non-preservation group. CONCLUSION: This technique represents an effective novel approach for preserving the IPFP. It can significantly reduce IPFP fibrosis, enhance postoperative functional recovery following ACLR, and alleviate knee pain along with cartilage damage.