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Comparison of desired radiographic advancement distance and true advancement distance required for patellar tendon–tibial plateau angle reduction to the ideal 90° in dogs by use of the modified Maquet technique

Paul Pillard DVM, MS1, Veronique Livet DVM, MS2, Quentin Cabon DVM3, Camille Bismuth DVM, MS4, Juliette Sonet DVM5, Denise Remy DVM6, Didier Fau DVM7, Claude Carozzo DVM, PhD8, Eric Viguier DVM, PhD9, and Thibaut Cachon DVM, MS10
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  • 1 Department of Small Animal Surgery, Vetagro Sup, University of Lyon, 69280 Marcy l'étoile, France.
  • | 2 Department of Small Animal Surgery, Vetagro Sup, University of Lyon, 69280 Marcy l'étoile, France.
  • | 3 Department of Small Animal Surgery, Vetagro Sup, University of Lyon, 69280 Marcy l'étoile, France.
  • | 4 Department of Small Animal Surgery, Vetagro Sup, University of Lyon, 69280 Marcy l'étoile, France.
  • | 5 Department of Small Animal Diagnostic Imaging, Veterinary Teaching Hospital, Vetagro Sup, University of Lyon, 69280 Marcy l'étoile, France.
  • | 6 Department of Small Animal Surgery, Vetagro Sup, University of Lyon, 69280 Marcy l'étoile, France.
  • | 7 Department of Small Animal Surgery, Vetagro Sup, University of Lyon, 69280 Marcy l'étoile, France.
  • | 8 Department of Small Animal Surgery, Vetagro Sup, University of Lyon, 69280 Marcy l'étoile, France.
  • | 9 Department of Small Animal Surgery, Vetagro Sup, University of Lyon, 69280 Marcy l'étoile, France.
  • | 10 Department of Small Animal Surgery, Vetagro Sup, University of Lyon, 69280 Marcy l'étoile, France.

Abstract

OBJECTIVE To evaluate the validity of 2 radiographic methods for measurement of the tibial tuberosity advancement distance required to achieve a reduction in patellar tendon–tibial plateau angle (PTA) to the ideal 90° in dogs by use of the modified Maquet technique (MMT).

SAMPLE 24 stifle joints harvested from 12 canine cadavers.

PROCEDURES Radiographs of stifle joints placed at 135° in the true lateral position were used to measure the required tibial tuberosity advancement distance with the conventional (AM) and correction (AE) methods. The MMT was used to successively advance the tibial crest to AM and AE. Postoperative PTA was measured on a mediolateral radiograph for each advancement measurement method. If none of the measurements were close to 90°, the advancement distance was modified until the PTA was equal to 90° within 0.1°, and the true advancement distance (TA) was measured. Results were used to determine the optimal commercially available size of cage implant that would be used in a clinical situation.

RESULTS Median AM and AE were 10.6 mm and 11.5 mm, respectively. Mean PTAs for the conventional and correction methods were 93.4° and 92.3°, respectively, and differed significantly from 90°. Median TA was 13.5 mm. The AM and AE led to the same cage size recommendations as for TA for only 1 and 4 stifle joints, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE Both radiographic methods of measuring the distance required to advance the tibial tuberosity in dogs led to an under-reduction in postoperative PTA when the MMT was used. A new, more accurate radiographic method needs to be developed.

Contributor Notes

Dr. Bismuth's present address is Department of Small Animal Surgery, Fregis Veterinary Hospital, 43 Ave Aristide Briand, 94110 Arcueil, France.

Address correspondence to Dr. Pillard (paul.pillard@vetagro-sup.fr).