Patella fractures in cats with persistent deciduous teeth — Knees and Teeth Syndrome (KaTS)

et al. 2018

Objectives The aim of this study was to document the incidence of preceding and subsequent fractures to the patellar fractures in cats with patellar fractures and dental anomaly syndrome. Methods Records of cats with patellar fracture and dental anomaly syndrome were retrieved from the combined databases at the University of Bristol, UK, and Exclusively Cats Veterinary Hospital, USA. A request was made to complete a questionnaire to obtain long-term follow-up of these cats with respect to their current status and fractures to other bones; radiographs and histories were requested and were reviewed for treatment of ongoing fractures and outcome. Results Of the 191 cases reported with this syndrome, 92 cats (48.2%) had dental anomalies and 78 (40.8%) had fractures to other bones; 21 cats sustained the fractures preceding the patellar fractures and 57 subsequently. In total, there were 175 fractures: acetabulum (25%), tibia (22%), ischium (15.4%), humeral condyle (13.7%), calcaneus (5.1%), ilium (5.1%), pubis (3.4%) and other bones (10.2%). The majority of these fractures were characteristic of insufficiency (stress) fractures with a very similar configuration in each bone. Conclusions and relevance A high proportion of cats with patellar fracture and dental anomaly syndrome will have preceding or subsequent fractures to their patellar fractures. In this study, >10% of cats suffered characteristic fractures preceding the patellar fractures. The presence of these fractures should alert the veterinarian to the possibility that the cat is affected by patellar fracture and dental anomaly syndrome.

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Incidence and types of preceding and subsequent fractures in cats with patellar fracture and dental anomaly syndrome

Reyes

Longley

et al. 2018

“…A pathological disorder, ‘patellar fracture and dental anomaly syndrome’ (PADS), formerly known as ‘knees and teeth syndrome’, has been identified in cats. 1 The syndrome involves stress fractures of the patella and dental abnormalities, including persistent deciduous teeth and unerupted permanent teeth. These dental anomalies can lead to the development of osteomyelitis or abscesses.…”

Section: Introductionmentioning

confidence: 99%

“… 2 Additionally, many of these cats develop non-traumatic fractures to another bone(s), either preceding or subsequent to the patellar fracture(s). 1 , 3 – 5 Of these other fractures, the pelvis, tibia and humeral condyle are the sites most frequently affected. To our knowledge, at the time of writing, no reports exist of atraumatic fractures of the humeral condyle in cats that do not meet the criteria for PADS.…”

Section: Introductionmentioning

confidence: 99%

Treatment of humeral condylar fractures and humeral intracondylar fissures in cats with patellar fracture and dental anomaly syndrome

Chan

Rodriguez

et al. 2020

Objectives The aim of this study is to describe the treatment and outcome of humeral condylar fractures and humeral intracondylar fissures in cats with patellar fracture and dental anomaly syndrome (PADS) and to provide advice on how to manage these cases in practice. Methods Data were collated on cats with PADS that were reported to have sustained humeral fractures or had fractures or fissures of the humerus identified on radiographs. The details of the fractures were recorded in addition to any treatment and outcome information. Results Of the 207 cases reported with PADS, 18 cats (8.7%) were found to have humeral condylar fractures, none of which was known to have resulted from significant trauma. Where treatment occurred, it involved the placement of transcondylar positional or lag screws. In some cases additional implants, including supracondylar bone plates and screws or Kirschner wires (K-wires), were used. Follow-up data revealed that only two cats were euthanased owing to the presence of the humeral fractures, with at least eight achieving some degree of recovery of function. Conclusions and relevance These humeral fractures all have the characteristics of stress insufficiency fractures, being simple isolated fractures that are short oblique, with increased radio-density at the fracture line and occurring following minimal or no trauma. Humeral intracondylar fissures were identified in two cats and it is possible that some of the other fractures may have occurred secondary to pre-existing fissures. To our knowledge, no prior reports exist of fissures in cats that do not meet the criteria for PADS. Surgical repair primarily consisted of the placement of transcondylar lag or positional screws with, in some cases, adjunct implants such as bone plates and screws or K-wires. Though there were insufficient data to determine the prognosis for these fractures in the long term, unlike patellar fractures, many of these fractures will heal if treated appropriately.

“…Pelvic fractures are the most frequent additional insufficiency fractures in cats suspected to be suffering from PADS. [1][2][3] An insufficiency fracture occurs when physiological muscular forces are applied to abnormal bone. 4 Surgical treatment for patellar insufficiency fractures has been reported, but it is challenging and often results in failure of the repair, non-union or further fragmentation of the patella.…”

Section: Introductionmentioning

confidence: 99%

Treatment of pelvic fractures in cats with patellar fracture and dental anomaly syndrome

Rodriguez

Langley‐Hobbs

2020

Objectives The aim of this study was to describe the treatment and outcome of acetabular and other pelvic fractures in cats with patellar fracture and dental anomaly syndrome (PADS) and to provide advice on how to manage these cases in practice. Methods Data were collated on cats with PADS that were reported to have sustained pelvic fractures or had fractures or fissures of the pelvis identified on submitted radiographs. The details of the fractures were recorded, in addition to any treatment and outcome information. Results Of the 215 cases reported with PADS, 58 cats (27%) were found to have pelvic fractures, none of which were known to have resulted from significant trauma. There were 101 fractures in total and of these 15 were treated with surgery, including 10 acetabular fractures, two ilial, two pubic and one ischial fracture. Screw loosening and loss of fracture reduction was seen in four of the surgically treated fractures (two pubic fractures, one ilial and one acetabular fracture). Fourteen cats were euthanased as a direct result of a fracture occurring. While most pelvic fractures healed uneventfully, some cats remained intermittently lame, but it was not always possible to determine the cause of the lameness from the information available and because all cats had concurrent patellar fractures. Conclusions and relevance Many of the pelvic fractures healed with conservative management. Fractures involving articular surfaces such as acetabular fractures may benefit from surgical stabilisation as surgery may offer the benefits of articular fracture repair with improved joint congruency and a faster return to normal activity.