Vet Comp Orthop Traumatol 2021; 34(02): 137-143
DOI: 10.1055/s-0040-1719058
Clinical Communication

Prospective Evaluation of a Citrate-Based Biomaterial Wedge for a Modified Maquet Procedure in the Treatment of Cranial Cruciate Ligament Rupture in Dogs

1   Ohio Veterinary Surgery and Neurology, Metropolitan Veterinary Hospital, Akron, Ohio, United States
,
R. Mark Daye
1   Ohio Veterinary Surgery and Neurology, Metropolitan Veterinary Hospital, Akron, Ohio, United States
› Author Affiliations
Funding Implant donation and financial support was provided by New Generation Devices.

Abstract

Objective The aim of this study was to describe short- and mid-term outcomes, complications, implant bioabsorption and owner satisfaction for a modified Maquet procedure (MMP) in which a novel bioabsorbable citrate-based implant is used as the wedge component to treat cranial cruciate ligament rupture in client-owned dogs.

Study Design Prospective clinical study of dogs (n = 13) undergoing MMP (n = 15). Intraoperative complications, postoperative complications, clinical follow-up using a 5-point lameness score and radiographs at 8 weeks and 6 months postoperatively were obtained. Mid-term outcome was assessed via physical examination, radiographs, canine orthopaedic index and owner satisfaction questionnaires.

Results No catastrophic complications occurred. Major complications occurred in 3/15 stifles. All were surgical site infections and one case required implant removal. Minor complications occurred in 9/15 stifles. Non-displaced cortical hinge fractures were the most common minor complication, and these occurred intraoperatively (4/15) or postoperatively (2/15). Three dogs achieved full function, eight dogs acceptable function and the outcome was unacceptable in two dogs. Most owners were satisfied with the procedure (11/13). Complete implant bioabsorption was not confirmed on mid-term radiographs.

Conclusion The described MMP with a citrate-based implant can produce satisfactory mid-term results. However, the long-term outcome of this procedure must be evaluated and technical modifications need to be implemented prior to larger-scale use of this implant.

Authors' Contributions

Both authors contributed to the conception, acquisition of data, data analysis and interpretation, drafting of the article and approval for submission.


Supplementary Material



Publication History

Received: 22 October 2019

Accepted: 26 August 2020

Article published online:
06 November 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Witsberger TH, Villamil JA, Schultz LG, Hahn AW, Cook JL. Prevalence of and risk factors for hip dysplasia and cranial cruciate ligament deficiency in dogs. J Am Vet Med Assoc 2008; 232 (12) 1818-1824
  • 2 Boudrieau RJ. Tibial tuberosity advancement. In: Muir P. ed. Advances in the Canine Cranial Cruciate Ligament. 2nd edition. Hoboken, NJ: Wiley; 2018: 243-252
  • 3 Etchepareborde S, Brunel L, Bollen G, Balligand M. Preliminary experience of a modified Maquet technique for repair of cranial cruciate ligament rupture in dogs. Vet Comp Orthop Traumatol 2011; 24 (03) 223-227
  • 4 Samoy Y, Verhoeven G, Bosmans T. et al. TTA rapid: description of the technique and short term clinical trial results of the first 50 cases. Vet Surg 2015; 44 (04) 474-484
  • 5 Ramirez J, Barthélémy N, Noël S. et al. Complications and outcome of a new modified Maquet technique for treatment of cranial cruciate ligament rupture in 82 dogs. Vet Comp Orthop Traumatol 2015; 28 (05) 339-346
  • 6 Ness MG. The modified Maquet procedure (MMP) in dogs: technical development and initial clinical experience. J Am Anim Hosp Assoc 2016; 52 (04) 242-250
  • 7 Retallack LM, Daye RM. A modified Maquet-tibial tuberosity advancement technique for treatment of canine cranial cruciate ligament disease: short term outcome and complications. Vet Surg 2018; 47 (01) 44-51
  • 8 Costa M, Craig D, Cambridge T, Sebestyen P, Su Y, Fahie MA. Major complications of tibial tuberosity advancement in 1613 dogs. Vet Surg 2017; 46 (04) 494-500
  • 9 Piermattei D, Flo G, DeCamp C. Handbook of Small Animal Orthopedics and Fracture Repair. 6th edition. St Louis, MO: Elsevier Health Science; 2016: 133-136
  • 10 Tran RT, Yang J, Ameer GA. Citrate-based biomaterials and their applications in regenerative engineering. Annu Rev Mater Res 2015; 45 (45) 277-310
  • 11 Ma C, Gerhard E, Lu D, Yang J. Citrate chemistry and biology for biomaterials design. Biomaterials 2018; 178 (178) 383-400
  • 12 Su LC, Xie Z, Zhang Y, Nguyen KT, Yang J. Study on the antimicrobial properties of citrate-based biodegradable polymers. Front Bioeng Biotechnol 2014; 2: 23
  • 13 Chung EJ, Sugimoto MJ, Ameer GA. The role of hydroxyapatite in citric acid-based nanocomposites: surface characteristics, degradation, and osteogenicity in vitro. Acta Biomater 2011; 7 (11) 4057-4063
  • 14 de Lima Dantas B, Sul R, Parkin T, Calvo I. Incidence of complications associated with tibial tuberosity advancement in Boxer dogs. Vet Comp Orthop Traumatol 2016; 29 (01) 39-45
  • 15 Bednarski R, Grimm K, Harvey R. American Animal Hospital Association. et al; AAHA anesthesia guidelines for dogs and cats. J Am Anim Hosp Assoc 2011; 47 (06) 377-385
  • 16 Cook JL, Evans R, Conzemius MG. et al. Proposed definitions and criteria for reporting time frame, outcome, and complications for clinical orthopedic studies in veterinary medicine. Vet Surg 2010; 39 (08) 905-908
  • 17 Brown DC. The Canine Orthopedic Index. Step 3: responsiveness testing. Vet Surg 2014; 43 (03) 247-254
  • 18 Oxley B, Gemmill TJ, Renwick AR, Clements DN, McKee WM. Comparison of complication rates and clinical outcome between tibial plateau leveling osteotomy and a modified cranial closing wedge osteotomy for treatment of cranial cruciate ligament disease in dogs. Vet Surg 2013; 42 (06) 739-750
  • 19 Hart JL, May KD, Kieves NR. et al. Comparison of owner satisfaction between stifle joint orthoses and tibial plateau leveling osteotomy for the management of cranial cruciate ligament disease in dogs. J Am Vet Med Assoc 2016; 249 (04) 391-398
  • 20 Schulz KS, Ash KJ, Cook JL. Clinical outcomes after common calcanean tendon rupture repair in dogs with a loop-suture tenorrhaphy technique and autogenous leukoreduced platelet-rich plasma. Vet Surg 2019; 48 (07) 1262-1270
  • 21 Lefebvre MD, Broux OR, Barthélémy NP. et al. Risk factors for tibial damage associated with the modified Maquet technique in 174 stifles. Vet Surg 2018; 47 (01) 30-35
  • 22 Brunel L, Etchepareborde S, Barthélémy N, Farnir F, Balligand M. Mechanical testing of a new osteotomy design for tibial tuberosity advancement using the modified Maquet technique. Vet Comp Orthop Traumatol 2013; 26 (01) 47-53
  • 23 Homer LM, Gomes BAJ, Murphy MC, Hammond GJC, Parkin TDH, Broome CJA. Effect of osteoarthritis on the repeatability of patella tendon angle measurement in dogs. Vet Surg 2019; 48 (02) 180-185
  • 24 Apelt D, Kowaleski MP, Boudrieau RJ. Effect of tibial tuberosity advancement on cranial tibial subluxation in canine cranial cruciate-deficient stifle joints: an in vitro experimental study. Vet Surg 2007; 36 (02) 170-177
  • 25 Wolf RE, Scavelli TD, Hoelzler MG, Fulcher RP, Bastian RP. Surgical and postoperative complications associated with tibial tuberosity advancement for cranial cruciate ligament rupture in dogs: 458 cases (2007-2009). J Am Vet Med Assoc 2012; 240 (12) 1481-1487
  • 26 Hoffmann DE, Miller JM, Ober CP, Lanz OI, Martin RA, Shires PK. Tibial tuberosity advancement in 65 canine stifles. Vet Comp Orthop Traumatol 2006; 19 (04) 219-227
  • 27 Millet M, Bismuth C, Labrunie A. et al. Measurement of the patellar tendon-tibial plateau angle and tuberosity advancement in dogs with cranial cruciate ligament rupture. Reliability of the common tangent and tibial plateau methods of measurement. Vet Comp Orthop Traumatol 2013; 26 (06) 469-478
  • 28 Kapler MW, Marcellin-Little DJ, Roe SC. Planned wedge size compared to achieved advancement in dogs undergoing the modified Maquet procedure. Vet Comp Orthop Traumatol 2015; 28 (06) 379-384
  • 29 Castilho M, Rodrigues J, Vorndran E. et al. Computational design and fabrication of a novel bioresorbable cage for tibial tuberosity advancement application. J Mech Behav Biomed Mater 2017; 65: 344-355
  • 30 De Sousa R, Egan P, Parsons K. et al. Treatment of tibial diaphyseal fractures following plateless tibial tuberosity advancement to manage cranial cruciate disease. J Small Anim Pract 2017; 58 (07) 372-379
  • 31 Impellizeri JA, Tetrick MA, Muir P. Effect of weight reduction on clinical signs of lameness in dogs with hip osteoarthritis. J Am Vet Med Assoc 2000; 216: 1089-1091