Year: 2026 | Month: October | Volume: 13 | Issue: 10 | Pages: 392-398
DOI: https://doi.org/10.52403/ijrr.20261035
A Review Comparasion of the Effectiveness of Reconstruction Anterior Cruciate Ligament with or Without Fat Pad in the Treatment of Anterior Cruciate Ligament Tear: A Systematic Review
I Made Ngurah Angga Prabawa1, I Gusti Ngurah Wien Aryana2
1Resident, Dept. Orthopaedic & Traumatology, Ngoerah Hospital, Udayana University, Bali, Indonesia
2Orthopaedic Surgeon, Dept. Orthopaedic & Traumatology, Ngoerah Hospital, Udayana University, Bali, Indonesia
Corresponding Author: I Made Ngurah Angga Prabawa
ABSTRACT
Introduction: Anterior Cruciate Ligament (ACL) reconstruction is widely performed to restore knee stability after injury. Optimizing surgical techniques is vital for better outcomes and fewer complications. One debated factor is the management of the infrapatellar fat pad (IPFP). This systematic review evaluates the impact of preserving versus resecting the IPFP during ACL reconstruction, focusing on knee function, pain, and graft revascularization.
Method: A systematic search of four databases identified clinical studies published from January 2019 to June 2025. Eligible studies compared ACL reconstruction with and without IPFP preservation and reported outcomes on function, pain, or revascularization. Six studies met the criteria for final analysis.
Method: Preserving the IPFP improved postoperative knee function, as shown by KOOS, Lysholm, and anterior knee pain (AKP) scores. Patients experienced less pain, reduced inflammation, and earlier recovery of knee range of motion. Preservation was also associated with reduced cartilage degeneration. Furthermore, the posterior cruciate ligament (PCL) fat pad transfer technique enhanced synovial coverage, promoted graft revascularization, and supported long-term graft viability.
Discussion: Evidence suggests IPFP preservation enhances functional recovery and creates a favorable biomechanical environment by reducing inflammation and supporting healing. The PCL fat pad transfer further strengthens graft revascularization, offering a promising strategy to improve reconstruction outcomes. Nevertheless, most studies provide short-term data, limiting conclusions on long-term benefits and cost-effectiveness.
Conclusion: Preserving the IPFP and exploring innovative methods like PCL fat pad transfer show significant potential to improve ACL reconstruction success. Future long-term, multi-center trials are needed to validate these promising results.
Keywords: Anterior Cruciate Ligament reconstruction, Infrapatellar fat par, Graft revascularization
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