Planned wedge size compared to achieved advancement in dogs undergoing the modified Maquet procedure

Abstract

Summary Objectives: To evaluate the patellar ligament to tibial plateau angle (PL-TPA) and amount of achieved advancement in dogs that underwent the modified Maquet procedure; compare wedge sizes recommended using two different planning techniques (Orthomed and modified tibial tuberosity advancement); and evaluate anatomical factors that predict the wedge size required to obtain a 90° PL-TPA. Methods: Pre- and postoperative radio-graphs of dogs that had a modified Maquet procedure performed were evaluated for the following: calculated wedge size using two different planning techniques, the actual wedge size used, the achieved tibial tuberosity advancement, and the changes in PL-TPA. Anatomical measurements of the tibia were evaluated and correlated with the actual wedge size. Results: Of the 38 modified Maquet procedures identified, 53% (n = 20) had a PLTPA of 90° ± 5°. Actual achieved advancement of the tibial tuberosity was 30% less than the wedge size used. Changes in PL-TPA and tibial width persisted at eight weeks postoperatively without loss of advancement. The two planning techniques did not result in a significantly different selection of wedge size. Clinical relevance: Current planning techniques for the modified Maquet procedure result in under-advancement of the tibial tuberosity. Both measurement techniques evaluated do not result in appropriate advancement.