Vergleichende Langzeitergebnisse zwischen Tibial Plateau Leveling Osteotomy und Modified Maquet Procedure nach Ruptur des vorderen Kreuzbandes beim Hund

Abstract

This study aims to compare the Modified Maquet Procedure (MMP) with the Tibial Plateau Leveling Osteotomy (TPLO) using long-term follow-up examinations over the period of more than one year (∅ 3,15 years) by clinical examination, radiographic assessment of osteoarthritis progression, and gait analysis by treadmill examination. Additional aim is to review the influence of surgeons' experience in TPLO technique. This clinical study included 67 stifle joints of 50 dogs of different breeds between 20 and 40 kilograms body weight that were treated by TPLO (n = 48) or MMP (n = 19) following the rupture of the cranial cruciate ligament. The TPLO group was further divided into a group operated by two experienced surgeons (TPLO1, n = 25) and a second group operated by several surgeons with different experience (TPLO2, n = 23). Following a post-operative time period of more than one year in the least (mean, 3.15 ± 1.21 years) orthopedic and radiographic examinations as well as separate unilateral and bilateral gait analyses were conducted. In addition, gait analysis data were compared with an orthopedically healthy control group. No significant and clinically relevant differences were observed between the 3 groups in the results of their orthopedic examination.Osteoarthritis progression showed similar values in all 3 surgical groups. On average per year this feature was slightly but statistically significantly lower in the TPLO2 group in comparison to the TPLO1 and MMP groups.Gait analysis during walking exhibited significant differences in bilateral ruptures at the Peak Vertical Force and the Vertical Impulse, especially when compared to the healthy control group. Stance phase duration did not show any significant differences. At trot, no significant differences were found between the 3 surgical groups. Both surgical techniques achieved good clinical, radiological, and gait analysis results in the 3 groups at long-term follow-up, even when compared with a healthy control group. MMP can be considered a rapid feasible alternative to the established TPLO method also bearing satisfactory results in dogs. The degree of the surgeon's experience does not seem to influence the outcome.