Follow Raven’s modified maquet procedure as we stabilise her ACL tear

Raven, a 3 year old Golden Retriever, was the 43rd dog that we treated for a torn anterior cruciate ligament (ACL) tear using the Modified Maquet Procedure (MMP). This method takes only 30 minutes of surgery time, and most dogs have recovered to 80 – 90% health in as little as four weeks following the procedure. By 12 weeks, the majority of our patients are running freely again. We have performed this surgery on a wide range of breeds, big and small, young and old – from dogs as small as Maltese Terriers and Pomeranians, to very large dogs such as Great Danes and Mastiffs.

First, we make an incision in the skin over the medial (inside) surface of the stifle.

Then, we position the saw guide over the medial stifle and hold it in place with locating pins. We drill a hole over the proximal tibia at the end of the tibial crest.

We leave the drill bit in place to ensure the saw guide remains in position.

Then, we cut the tibial crest with a sagittal saw, using the saw guide.

Once we remove the saw guide, we attach bone-holding forceps to the tibial crest to allow for location of the titanium wedge.

We then use a wedge inserter to move the titanium foam wedge into place.

A stainless-steel bone pin is the placed through the tibial crest and continues through a pre-drilled hole in the titanium wedge and into the tibia. This ensures the wedge remains in the correct position during the healing process.

Next, we use a guide to accurately drill holes for the titanium staple. This will apply pressure to the tibial crest whilst the injury is healing. This is also where the MMP is set apart from the crowd – the bone will actually grow into the foam wedge, forming a very strong and permanent union with the bone.

A staple is placed into the holes the pre-drilled holes.

We then tap the staple into place, forming a very secure grip on the tibial crest, ensuring it remains in place.

You can now see the completed procedure with the wedge, staple and pin in the correct position.

We then close the tissue over the implant.

Then the skin is closed and sutured.

The surgery is almost complete for Raven – she has been a brave girl.

The MMP method provides a very quick return to normal function for the vast majority of dogs that we treat, yet the surgery itself takes only 30 minutes. We perform it for approximately $1,600 to $1,900 depending on the size of your pet and the medication that they require. We have heard of quotes for as high as $3,500 for this same procedure! If a TPLO method was undertaken (which is currently the most common method for ACL stabilisation), pet owners could expect to pay around $4,000 to $5,500. These videos below show another dog that we helped; Phoebe, a 12 year old Pomeranian, was recovering remarkably well from stabilisation of her right hind ACL tear, at only four weeks after surgery. This video was taken when removed her sutures.

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