Change in T2∗ relaxation time of Hoffa fat pad correlates with histologic change in a rat anterior cruciate ligament transection model

The Hoffa fat pad (infrapatellar fat pad) is a source of post-traumatic anterior knee pain, and Hoffa disease is a syndrome leading to chronic inflammation of the fat pad. Herein, change in T2∗ relaxation time of the fat pad was measured in a rodent anterior cruciate ligament transection (ACLX) model in order to (i) examine the causal relationship of anterior cruciate ligament (ACL) deficiency and Hoffa disease and (ii) demonstrate the feasibility of using T2∗ as an imaging biomarker to monitor disease progression. Three groups of male Sprague Dawley rats (n=6 each group), received either (i) no intervention; (ii) sham surgery at the right knee; or (iii) right ACLX. T2∗ relaxation time was measured and histology was examined in the Hoffa fat pad after surgery. At 13 and 18 weeks after surgery, T2∗ values were significantly higher in the right fat pad than the left (p<0.001) and significantly higher in the ACLX group than the control and sham groups (p<0.001). Histology showed fibrosis and degeneration of adipocytes in the right knees of the ACLX group. We conclude that ACL deficiency and Hoffa disease are causally related and that MRI T2∗ value can serve as an imaging biomarker of Hoffa disease progression.