Edward J. Kochin DVM, DACVS, Catherine Briere DVM, MS, DACVS, Daniel Beaver DVM, DACVS

Advancement of the tibial tuberosity was first described by Maquet in human medicine. The premise of the procedure was that an increase in the efficiency of the quadriceps mechanism would subsequently decrease retropatellar pressure, thus alleviating pain associated with the patellofemoral joint.1 Other possible effects on the biomechanics of the tibiofemoral joint included evidence that a variable tibiofemoral shear force was present in the knee joint, which was either anteriorly or posteriorly directed depending upon the angle of knee joint extension or flexion (and patellar tendon angle – PTA).2 The magnitude and direction of the tibiofemoral shear force was determined by the PTA.3 The Marquet proceedure was found to be effective in decreasing the femoral tibial contact forces in stifle extension and decreased retropatellar pressure.4 A relationship between tibial tuberosity advancement, knee joint flexion/extension, tibiofemoral shear force, retropatellar pressure (including femorotibial contact forces) and patellar tendon force has been suggested and supported by a variety of experimental studies.1-4

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