A modified Maquet‐tibial tuberosity advancement technique for treatment of canine cranial cruciate ligament disease: Short term outcome and complications

Retallack, Lauren M.; Daye, R. Mark

doi:10.1111/vsu.12733

Cited by 18 publications

(19 citation statements)

References 23 publications

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“…To our knowledge, despite this change in patellar position, postoperative luxation has not been reported in the literature. [13][14][15][16] These patients might serve as a comparison group for lateral patellar luxation patients with respect to patellar proximodistal positioning.…”

Section: Discussionmentioning

confidence: 99%

Measurement of Patellar Proximodistal Positioning with Limited Joint-Angle Sensitivity

Allberg

Miles

2020

Vet Comp Orthop Traumatol

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Objective Patellar luxation can be associated with abnormal proximodistal positioning of the patella. The current gold standard index (Insall–Salvati) for referencing this position is poorly suited to postoperative use, if the tibial tuberosity is moved surgically, but has the advantage of changing minimally with altered joint angles. The aim of this study was to identify an alternative index, which was simple to use, joint-angle insensitive and suitable for postoperative use. Study Design Candidate indices based on the angle between stifle joint landmarks were screened across a wide range of joint angles for insensitivity to joint angle changes using vulpine and canine stifle radiographs. Intraobserver and interobserver agreements were assessed for a single candidate index using canine radiographs. Results An angular index based on the caudal aspect of the femoral and tibial condyles and the apex of the patella was largely insensitive to joint angle variation. Intra- and interobserver agreements appeared suitable for clinical use, with low within-subject standard deviations (<1.3°) and coefficients of variations (<2.2%), and high intraclass correlation coefficients (>0.89). Conclusion Patellar proximodistal position can be acceptably assessed at a variety of caudal joint angles using the described angular index. Further work is required to define reference intervals across a range of canine breeds.

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Section: Discussionmentioning

confidence: 99%

Measurement of Patellar Proximodistal Positioning with Limited Joint-Angle Sensitivity

Allberg

Miles

2020

Vet Comp Orthop Traumatol

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“…Atualmente são muito utilizadas as técnicas de osteotomias tibiais, tal como o avanço da tuberosidade tibial (TTA) [6]. A TTA pode ser feita por meio de uma osteotomia completa da tuberosidade tibial ou por meio da osteotomia baseando-se no furo de Maquet, o que geralmente possibilita o uso precoce do membro operado [12]. Foi desenvolvida uma variação da técnica de TTA em que se utiliza um espaçador único modificado e dispensa o uso da placa, sendo essa técnica chamada de TTA rapid [14].…”

Section: Discussionunclassified

“…O menisco medial se encontrava lesionado com ruptura em alça de balde, no qual foi realizada meniscectomia parcial. Em seguida, por meio de abordagem medial à superfície proximal da tíbia, realizou-se a osteotomia linear na tuberosidade da tíbia com auxílio de serra oscilatória, baseando-se na técnica do furo de Maquet [12]. A tuberosidade da tíbia foi delicadamente deslocada cranialmente e o espaçador foi inserido no local da osteotomia.…”

Section: Casounclassified

Technique of Tibial Tuberosity Transposition and Advancement (TTTA) With Use of TTA-Maquet Cage-Only in Dog

Dornas

Malta

Muzzi

et al. 2018

Acta Scientiae. Vet.

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Background:The most common conditions that compromise the stifle joint in dogs are medial patellar luxation (MPL) and cranial cruciate ligament (CCL) rupture. Surgical procedures are usually indicated for the treatment of these diseases. One ordinary technique for the treatment of MPL is the tibial tuberosity transposition, and one prominent technique for CCL rupture is the tibial tuberosity advancement. These techniques can be associated in one surgical procedure called tibial tuberosity transposition and advancement (TTTA) for the simultaneous treatment of both stifle diseases. The aim of this study is to report the surgical treatment of a dog with MPL and CCL rupture affecting the same joint by the TTTA technique with the use of a TTA-Maquet cage-only. Case: A 3-year-old Pitbull dog weighing 39 kg was attended at Veterinary Hospital with a history of marked lameness in the left pelvic limb. The orthopedic examination showed positive results for cranial drawer motion and tibial compression tests, and a complete CCL rupture was diagnosed. The presence of patellar luxation was evaluated by manual pressure on the patella, and grade 3 of MPL was diagnosed. Both conditions were affecting the same stifle joint. In addition, survey radiographs of the affected joint were performed. Surgical treatment was indicated by the TTTA technique. Radiographic measurements were taken to calculate the cranial tibial tuberosity advancement by the tibial plateau and the common tangent methods, and a titanium TTA-Maquet cage-only of 10.5 x 20.0 mm was selected. Linear osteotomy was performed on the tibial tuberosity with the aid of an oscillating saw, based on the Maquet hole technique. The tibial tuberosity was carefully displaced cranially and the cage was inserted at the site of osteotomy. The cage ears were molded on the tibial surface and fixed with 2.4 mm self-tapping cortical screws. At the moment of the cage attachment to the tibial tuberosity, orthopedic washers of 2 mm wide were placed between the cranial ears of the cage and the tibial tuberosity, thus promoting a lateral transposition of the tibial tuberosity. The patient was maintained in the early postoperative period with Robert Jones bandage, and with antibiotic, analgesic and antiinflammatory drugs. On the second day after the procedure partial limb support with presence of mild lameness was observed. At three months postoperatively, the animal had no claudication and MPL was corrected. The radiographic examination showed the proper process of bone repair at the osteotomy site. In the clinical evaluation performed at one year after surgery the patient was in good condition without lameness and with proper limb support and muscular gain. Discussion: The studies that evaluated the association of tibial tuberosity transposition and tibial tuberosity advancement techniques (TTTA) for the simultaneous treatment of MPL and CCL rupture demonstrated that this is a viable and effective procedure. In this report, the accomplishment of tibial osteotomy based on the Maquet hole ...

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“…Sci. 2019, 6, x 2 of 7 predetermined location [5,6]. Nevertheless, the risk of fracture of the distal tibial tuberosity, or even the tibia, from propagation of the osteotomy was described in 20% of procedures [5].…”

Section: Populationmentioning

confidence: 99%

“…Later, the modified Maquet technique was derived from human surgery and applied to dogs [5]. This technique uses a preplaced drill hole (Maquet hole) at the proposed termination site of the osteotomy to prevent fissure or propagation of the osteotomy past this predetermined location [5,6]. Nevertheless, the risk of fracture of the distal tibial tuberosity, or even the tibia, from propagation of the osteotomy was described in 20% of procedures [5].…”

Section: Introductionmentioning

confidence: 99%

Role of Tibial Tuberosity Fracture/Fissure through the Maquet Hole in Stifle Osteoarthritis after Porous Tibial Tuberosity Advancement in Dogs at Mid-Term Follow-Up

Crovace

Staffieri

Monopoli

et al. 2019

Veterinary Sciences

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Tibial tuberosity advancement (TTA) is used to treat cranial cruciate ligament rupture of the stifle joint in dogs. Tibial tuberosity fracture/fissure is a complication of TTA that may have a favorable prognosis. The aim of this study was to detect how tibial tuberosity fracture/fissure through the Maquet hole worsens the progression of osteoarthritis (OA) in the stifle joint of dogs treated with porous TTA. Seventeen cases were included in the study, divided into two groups. The first group (n = 10) included subjects that had tibial tuberosity fracture/fissure through the Maquet, and the second group included subjects that had no complications (n = 7). Both groups showed significant progression compared to OA at 3 months after surgery. We observed that at T0, the control group showed a higher level of OA. For this reason, we normalized the OA scores, evaluating the percentage difference from T0 and T1. We verified that there were no statistically significant differences between the two groups. The results confirm that OA progression in subjects undergoing TTA was not significantly influenced by fracture/fissure of the tibial tuberosity through the Maquet hole. Therefore, fracture fissure through the Maquet hole should be considered as a common minor complication during TTA.

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A modified Maquet‐tibial tuberosity advancement technique for treatment of canine cranial cruciate ligament disease: Short term outcome and complications

Cited by 18 publications

References 23 publications

Measurement of Patellar Proximodistal Positioning with Limited Joint-Angle Sensitivity

Measurement of Patellar Proximodistal Positioning with Limited Joint-Angle Sensitivity

Technique of Tibial Tuberosity Transposition and Advancement (TTTA) With Use of TTA-Maquet Cage-Only in Dog

Role of Tibial Tuberosity Fracture/Fissure through the Maquet Hole in Stifle Osteoarthritis after Porous Tibial Tuberosity Advancement in Dogs at Mid-Term Follow-Up

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