Murat DANIŞMAN, Muhammet BOZOĞLAN, Tuğcan DEMİR

Maquet osteotomy for isolated patellofemoral arthritis, a forgotten surgical technique

Aim: The focus of this study is to publish the results of Maquet osteotomy for patients who are classified as physiologically young and suffering from anterior knee pain which is unresponsive to conservative treatment. Materials and Methods: We performed a retrospective review of 11 consecutive patients (5 [45.5%] males, 6 [54.5%] females; mean age, 51.8 years) who underwent Maquet osteotomy for isolated patellofemoral osteoarthritis between May 2017 and August 2018. Thirteen osteotomies were performed in 11 patients; 2 patients underwent bilateral procedures. All patients were clinically rated before surgery and at the final follow-up using International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC 2000) and the Kujala Anterior Knee Pain Scale. Also complications were reported. Results: The median follow-up duration was 25 (range=19-33) months. The median preoperative IKDC score was 50 (range = 42-54) points, which had increased to 67 (range=61- 72) points at the final follow-up visit (p < .001). The median preoperative Kujala score was 59 (range=48-65) points, which had increased to 77 (range = 67-86) points at the final follow-up (p < .001). We observed 1 major and 1 minor complication in 13 procedures. Conclusion: Although it looks like an extensile surgery, Maquet osteotomy is applicable, safe, easy and a strong alternative for arthroplasty in patellofemoral arthritis.

PDF

___

1. Dejour D, Saggin PR, Kuhn VC. Disorders of the patellofemoral joint. In: Scott WN (ed): Insall & Scott, surgery of the knee. Philadelphia: Elsevier, 2012, pp. 843-884.
2. Miller RH, Azar FM. Knee injuries. In: Azar FM (ed): Campbell’s operative orthopaedics. Philadelphia: Elsevier, 2017, pp. 2122-2297.
3. Maquet P. Biomechanical treatment of femoro-patellar arthrosis: advancement of the patellar tendon. Rev Rhum Mal Osteoartic 1963, 30(Dec):779-83.
4. Maquet P. Advancement of the tibial tuberosity. Clin Orthop Relat Res 1976; 115:225-30.
5. Cox AJ. Biomechanics of the patello-femoral joint. Clinical Biomechanics 1990; 5(3):123-30.
6. Levine RB, Stassi J, Karasick D. The maquet principle. Anterior displacement of the tibial tubercle in the treatment of patellofemoral disorders: radiologic appearance. Skeletal Radiol 1985; 13(4):291-4.
7. Ferguson AB, Brown TD, Fu FH, Rutkowski R. Relief of patellofemoral contact stress by anterior displacement of the tibial tubercle. J Bone Joint Surg Am 1979; 61(2):159-66.
8. Hirsh DM, Reddy DK. Experience with maquet anterior tibial tubercle advancement for patellofemoral arthralgia. Clin Orthop Relat Res 1980; 148:136-9.
9. Hadjipavlou A, Helmy H, Dubravcik P, Heller L, Kerner M. Maquet osteotomy for chondromalacia patellae: avoiding the pitfalls. Can J Surg 1982; 25(3):342-5.
10. Liebau J, Nehring G, Hohle B, Hesse B. Results of the maquet/ bandi tibial tuberosity ventralization. Zentralbl Chir 1983; 108(1):17-25.
11. Heatley FW, Allen PR, Patrick JH. Tibial tubercle advancement for anterior knee pain. A temporary or permanent solution. Clin Orthop Relat Res 1986; 208:215-24.
12. Brittberg M, Winalski CS. Evaluation of cartilage injuries and repair. J Bone Joint Surg Am 2003; 85-A Suppl 2:58-69.
13. Anderson AF, Irrgang JJ, Kocher MS, Mann BJ, Harrast JJ. The international knee documentation committee subjective knee evaluation form: normative data. Am, J. Sports Med 2006; 34(1):128-35.
14. Kujala UM, Jaakkola LH, Koskinen SK, Taimela S, Hurme M, Nelimarkka O. Scoring of patellofemoral disorders. Arthroscopy 1993; 9(2):159-63.
15. Coventry MB. Osteotomy of the upper portion of the tibia for degenerative arthritis of the knee. A preliminary report 1965 Jul; 47:984-90.
16. Pan HQ, Kish V, Boyd RD, Burr DB, Radin EL. The maquet procedure: effect of tibial shingle length on patellofemoral pressures. J Orthop Res 1993; 11(2):199-204.
17. Radin EL. The Maquet procedure-anterior displacement of the tibial tubercle. Indications, contraindications, and precautions. Clin Orthop Relat Res 1986; 213:241-8.
18. Mendes DG, Soudry M, Iusim M. Clinical assessment of maquet tibial tuberosity advancement. Clin Orthop Relat Res 1987; 222:228-38.
19. Kadambande SS, Auyeung J, Ghandour A, Mintowt-Czyz W. A review of wound healing following maquet osteotomy. Knee 2004; 11(6):463-7.
20. Radin EL, Pan HQ. Long-term follow-up study on the maquet procedure with special reference to the causes of failure. Clin Orthop Relat Res 1993; 290:253-8.
21. Schmid F. The maquet procedure in the treatment of patellofemoral osteoarthrosis. Long-term results. Clin Orthop Relat Res 1993; 294:254-8.
22. Fonseca F, Oliveira JP, Marques P. Maquet III procedure: what remains after initial complications-long-term results. J Orthop Surg Res 2013; 8:11.
23. Rappoport LH, Browne MG, Wickiewicz TL. The maquet osteotomy. Orthop Clin North Am 1992; 23(4):645-56.