Patellar fractures in cats: Repair techniques and treatment decision-making

Abstract

Practical relevance: While feline patellar fractures are not commonly encountered in practice, they tend to be found more often in younger cats; no breed or sex predispositions are recognised. If there is no evidence of a traumatic aetiology, the cat may be suspected of having patellar fracture and dental anomaly syndrome (PADS). Patellar fractures are easy to diagnose on lateral radiographs and there are several different fracture types. The type of fracture, the age of the cat at fracture occurrence and whether there is suspicion of a pathological aetiology are all relevant when considering treatment technique. Clinical challenges: While some cats with patellar fractures will do well with conservative management, surgical treatment is often indicated and decision-making can be challenging. Evidence base: Information and recommendations provided in this review are based on the literature and the author’s own clinical experience. There are several publications on PADS, but there is limited evidence as to what the underlying cause of this condition is, and the best method for managing patellar fractures is still an area where more research is needed. Aim: This review aims to gather the papers, case series and case reports published over the past few decades in order to discuss how best to manage different types of patellar fractures.

Biomechanical evaluation of three fixation methods in a feline transverse patella fracture model

“…The sizes of the implants were selected based on a previous biomechanical study and a clinical report. 2,10 Group 2: combination of circumferential and figure-of-eight wires. A combination of CFEW techniques was applied to the second group (Figure 1b).…”

“…A report has dealt with 52 fractures in 34 cats, and a clinical review of feline patella fracture has been published more recently. 1,2 In humans, the incidence of patella fractures is about 1% of all skeletal injuries, and in dogs, the incidence is reported to be up to 0.1% of all bone fractures; however, in cats, limited information is available on its prevalence. 3,4 Apart from humans and dogs, in cats, pathological patella fractures have been reported, related to patella fracture and dental anomaly syndrome (PADS).…”

“…5,6 The aetiology of such a syndrome is unknown, but PADS must be suspected when non-traumatic or stressed unilateral or, more often, bilateral transverse patellar fracture is presented. 2,5 In human medicine, surgery is indicated when displacement is >1-4 mm, but there is no consensus on the indications for surgical intervention in feline medicine. 7 A retrospective study showed good clinical results with conservative treatment in feline transverse patella fractures; however, it provides weak evidence, dealing with only three cases.…”

“…16,17 However, due to the small size of the patella in cats, screw placement is almost impossible, and in a feline-specific pathological condition such as PADS, drilling into the patella can cause disastrous results, such as additional fracture or implant failure. 2 To date, there is no biomechanical study of the repair methods using sutures in feline patella fractures. The high complication rates using the PTBW technique in feline patella fractures indicate that an alternative surgical option is required to potentially increase the success rate.…”

“…A report has dealt with 52 fractures in 34 cats, and a clinical review of feline patella fracture has been published more recently. 1 , 2 …”