Risk factors for tibial damage associated with the modified Maquet technique in 174 stifles

Objective: To identify risk factors for tibial damage associated with the modified Maquet technique (MMT) in dogs with cranial cruciate ligament (CCL) disease. Study design: Retrospective study. Sample population: One hundred and seventy-four stifles from 147 client-owned dogs. Methods: Medical records of dogs diagnosed with CCL disease and treated with the current version of MMT were reviewed. Dogs were included if immediate postoperative radiographs were available. Cortical hinge fracture or fissure, tibial tuberosity fracture, and diaphyseal fractures of the tibia were recorded. Age, body weight (BW), thickness of the tibial cortical hinge, and angle of opening of the osteotomy were tested as potential risk factors for tibial damage by univariate logistic regression analysis. Results: Tibial damage included intraoperative tibial fissures in 37% of MMTs, intraoperative fractures of the cortical hinge in 3.4% of MMTs, postoperative tibial fractures in 14% of MMTs. Risk factors for intraoperative fissure included BW (P =.0153) and thickness of cortical hinge (P =.0006). The angle of opening of the osteotomy was identified as a risk factor for intraoperative cortical hinge fracture (P =.0034), angles below 11° being preventive. No risk factor was identified for postoperative fracture. Conclusion: Based on these results, preventive measures against tibial damage associated with MMT should include: a thickness of cortical hinge based on the equation related to the BW; a length of osteotomy adjusted to the amount of TTA with an osteotomy angle below 10°; and slow advancement of the tibial tuberosity.