A Case of Infrapatellar Fat Pad Ganglion of the Knee

Tsuneari Takahashi1, 2, *, Masashi Kimura2, Takashi Ohsawa3, Naoki Yamaguchi4, Katsushi Takeshita1
1 Department of Orthopedic Surgery, Jichi Medical University, Shimotsuke, Japan
2 Gunma Sports Medicine Research Center, Zenshukai Hospital, Maebashi, Japan
3 Department of Orthopedic Surgery, Faculty of Medicine, Gunma University, Maebashi, Japan
4 The Center for Graduate Medical Education, Jichi Medical University Hospital, Shimotsuke, Japan

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© 2017 Takahashi et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Orthopedic Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan; Tel: +81-28-544-2111; Fax: +81-28-544-1301; E-mail:



A ganglion cyst can induce symptoms around the knee and should be considered as an intra-articular mass in differential diagnosis.

Case Presentation:

A 22-year-old female presented with a persistent medial knee joint pain in her left knee for 2 years. There was soft tissue swelling on the anteromedial aspect of the infrapatellar region on her left knee. Lachman and McMurray tests were negative. MRI showed a multilobular cyst in the infrapatellar fat pad with T1 low intensity and T2 STIR high intensity. The cyst was not attached to either meniscus. ACL and PCL looked normal.

During surgery, the cyst was found to arise from the intra-patellar fat pad and was not attached to the menisci or synovium. The cyst was completely resected.

Histological findings showed a multilobular cyst with a glassy fibrous tissue wall and clear jelly-like consistency, confirming the diagnosis of a ganglion. The patient recovered asymptomatically and has been without recurrence 7 years postoperatively.


Differential diagnoses of an infrapatellar swelling are a meniscal cyst, synovial cyst, or ganglion. Most cases of cysts around the knee generate from fluid collection through meniscal tears. A ganglion cyst is a synovium-lined structure and is common around the wrist joint, but rare in the knee joint. A ganglion cyst in the knee joint often arises from ACL or PCL, but rarely arises from the infrapatellar fat pad. A ganglion cyst is one of the differential diagnoses of parameniscal cysts around the knee. We recommended an open resection with arthroscopic examination.

Keywords: Knee, Meniscus, Ganglion, Arthroscopy, Infrapatellar fat pad.