Clinical Assessment of Maquet Tibial Tuberosity Advancement

Advancement of the tibial tuberosity (TTA) or Maquet procedure is a controversial procedure. Between 1978 and 1982, 27 consecutive patients were treated by TTA with an average follow-up period of 5.5 years in 25 patients. In eleven cases with concomitant medical compartment osteoarthritis, TTA was combined with high tibial osteotomy (HTO). Patellar pain relief was noted soon after surgery and was sustained in 80% of the patients. Systemic complications included one patient with lethal pulmonary embolus. Local complications occurred as follows: three patients had severe local necrosis of skin, which required a rotation skin flap in two. In one patient, the bone graft displaced, and in two patients, nonunion of this graft was noted. Following appropriate treatment in these six patients their final rating was excellent in two, good in three, and poor in one. Contrary to other reports in the literature, the combination of HTO and TTA was as successful as the Maquet procedure alone. TTA is an important procedure for severe patellofemoral arthritis after all other methods of conservative treatment have been exhausted and no other surgical procedure is clearly indicated.