Fulkerson-based oblique novel technique (FONT) to treat concurrent cranial cruciate ligament disease and medial patellar luxation in the dog.

Oblique tibial tuberosity osteotomy simultaneously corrects cruciate ligament disease and patellar luxation via single procedure.

This study presents the Fulkerson-based oblique novel technique (FONT), a new surgical approach combining tibial tuberosity advancement with lateralization using a single oblique osteotomy to simultaneously address cranial cruciate ligament disease and medial patellar luxation in dogs. Using computational modeling and ex vivo cadaveric analysis on 14 canine tibiae (15.8-25.3 kg), researchers evaluated four osteotomy angles (0°, 25°, 30°, 35°) to determine optimal tibial tuberosity displacement. Results demonstrated that a 30° oblique osteotomy achieved approximately 50% lateralization and 86.7% advancement. While the technique successfully combined both surgical objectives through a single procedure, freehand osteotomies showed limited accuracy (mean 32.27° vs. target 30°), with lateral translation consistently exceeding targets and cranial translation falling short. The findings suggest that surgical cutting guides could improve consistency and accuracy. This novel approach potentially streamlines surgical management of concurrent orthopedic conditions, reducing operative time and tissue trauma compared to separate procedures.

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