Author's reply in response to letter to editor Indian J Orthop 2012;46:728-9 titled "Tumor like swellings arising from Hoffa's fat pad: A series of three patients".

Sir,

We thank Vaishya1 for showing interest in our article ‘Tumor like swellings arising from Hoffa's fat pad: A series of three patients.2 In the article the difference between Hoffa's syndrome and Hoffa's disease has been mentioned.2 Hoffa's disease occurs in normal knees; it suggests that there are some pathologies which directly affect Hoffa's fat pad (HFP).234567 Wichham et al.8 suggested that HFP has ability to differentiate into other cell patterns including adipocytes which also suggests that there are some pathologies which can directly arise from HFP due to metaplasia, even though exactly which pathologies has not been established, is still controversial.

Hoffa's syndrome is due to hypertrophy of fat pad secondary to meniscal, capsular, or ligamentous injury which indicates secondary involvement of HFP.

So we agree that your experience may be different from us but we have discussed the cases which came to our institute in whom our experience was consistent with the literature which we have referred. In the cases, you have experienced there is possibility that those were not arising from HFP which is also a fact.