Davut Unsal CAPKAN, Mehmet Hamdi SAHAN
European Archives of Medical Research - 2026;42(3):257-265
Objective: The objective of the study was to evaluate the association between Hoffa's fat pad morphology and Magnetic resonance imaging (MRI)-based posterior horn meniscal grade and to determine whether this association remained after adjustment for age, sex, and body mass index (BMI). Materials and Methods: In this retrospective cross-sectional MRI study, 144 adults were intentionally selected using a grade-balanced sampling strategy, with 36 patients assigned to each MRI-based posterior horn meniscal grade (Grades 0-3). Hoffa fat pad thickness and sagittal cross-sectional area (CSA) were measured. Spearman's analysis was used to examine correlations. Group differences were tested by Kruskal-Wallis and Dunn's multiple comparison tests. Ordinal logistic regression was performed to identify factors independently associated with higher MRI-based posterior horn meniscal grade after adjustment for age, sex, and BMI. Results: Hoffa's fat pad thickness and CSA decreased progressively with increasing meniscal grade. Both parameters showed significant negative correlations with grade severity, stronger for CSA (r=-0.483, p=0.001) than thickness (r=-0.254, p=0.002). Age showed a weak positive correlation with MRI grade (r=0.191, p=0.022); however, this association was not retained after multivariable adjustment. Hoffa's fat pad CSA (odds ratio [OR]=0.985, 95% confidence interval [CI]: 0.980-0.990, p<0.001) and male sex (OR=4.323, 95% CI: 1.921-9.728, p<0.001) were independently associated with higher MRI-based posterior horn meniscal grade. The proportional odds assumption was satisfied. No statistically significant differences in Hoffa fat pad morphology were observed between isolated medial and combined medial+lateral posterior horn involvement. Conclusion: Hoffa fat pad CSA was inversely associated with MRI-based posterior horn meniscal grade and may represent an imaging feature associated with structural meniscal abnormalities.
