Deformation analysis of Hoffa's fat pad from CT images of knee flexion and extension

Recent advances in medicine conjecture that certain body fat may have mechanical function in addition to its classical role of energy storage. In particular we aim to analyze if the intra-articular fat pad of Hoffa is merely a space holder or if it changes shape to provide cushioning for the knee bones. Towards this goal, 3D CT images of real knees, as well as a skeletal knee model with fat simulating Hoffa's pad, were acquired in both extension and flexion. Image segmentation was performed to automatically extract the real and simulated fat regions from the extension and flexion images. Utilizing the segmentation results as binary masks, we performed automatic multi-resolution image registration of the fat pad between flexed and extended knee positions. The resulting displacement fields from flexion-extension registration are examined and used to calculate local fat volume changes thus providing insight into shape changes that may have a mechanical component.