We are excited to be offering limited orthopaedic procedures, including the Modified Maquet Procedure (also known as MMP), a surgery to stabilise the stifle (knee) joint after cranial cruciate ligament rupture.
Cranial Cruciate Ligament Rupture is a common cause of hindlimb lameness in dogs. Without an intact cruciate ligament, the knee is unstable. Wear between the bones and cartilage becomes abnormal, and the joint begins to develop degenerative changes (arthritis). This process can be arrested or slowed by surgery, but cannot be reversed. This kind of joint disease is substantially more difficult for dogs over 15kg to bear, though all dogs will ultimately show degenerative changes.
Surgical repair of cruciate rupture helps to stabilise the joint. There are multiple options for types of surgical repairs that can be done; techniques and success vary. We can offer the MMP technique. Information about this procedure and what to expect is found below.
More than 75% of dogs will return to previous levels of unrestricted activity and function without significant complications, if post-operative rehab is well followed. All dogs are expected to be pain-free following MMP surgery, but some dogs with pre-existing arthritis will retain some stiffness and mild lameness following the operation. Complications from surgery can include swelling, bruising, infection, meniscal injury (damage to the cartilage), and fracture. These mainly occur when post-operative instructions are not followed.
Prior to surgery: We will sedate your dog and take radiographs of the affected and non-affected knee to confirm diagnosis, assess the level of damage, and determine what size equipment to use in surgery. This will generally be done on a different day from the surgery itself.
Surgery: Your pet will arrive at the clinic at 8:30 a.m. on the day of the procedure, FASTED. They will stay with us overnight to ensure a good recovery from the anaesthetic and good pain control prior to discharge.
MMP operation: An incision is made through the skin and muscle, and then a cut is made in the bone with a wedge placed in the tibia to change the angle of the knee joint. This is secured with a staple and pin, and the surgery site is closed. Following surgery, we will repeat radiographs to confirm everything has gone to plan, and then your dog will recover from anaesthesia.
Improvement post-surgery: Dogs will start to tentatively weight-bear on the operated limb within 2 days of surgery. Within 2 weeks, your dog should be using their operated limb with increasing confidence. By 4 weeks, while some lameness remains, they should be walking quite strongly. Post-operative x-rays are taken at 6 weeks before unrestricted activity levels are gradually increased. At 8-10 weeks, we can expect to see some mild lameness and some stiffness in the morning, and by 6 months, we should see a full return of function.
Rehabilitation: The importance of your role as an owner cannot be emphasised enough. All dogs MUST be kept ON LEASH for 6 weeks after their procedure, until post-operative x-rays are done and the vet gives the all clear to increase activity. Activity will then be increased slowly as per instructions.
Do not be misled by your dog appearing ‘bright and bouncy’ soon after the operation, strict after-care instructions need to be followed to reduce complications.