New FONT technique targets dual canine stifle disorders
Bottom line
A new Journal of Small Animal Practice study describes a Fulkerson-based oblique novel technique, or FONT, aimed at treating two stifle problems at once in dogs: cranial cruciate ligament disease and medial patellar luxation. The paper, published in 2026, evaluated an oblique tibial tuberosity osteotomy designed to both advance and lateralize the tibial tuberosity in a single construct, using computational modeling and cadaveric analysis rather than live clinical cases. The concept builds on the longstanding challenge of managing concurrent cruciate disease and patellar instability, where surgeons often combine or modify established procedures such as tibial tuberosity transposition, trochleoplasty, TPLO, or TTA depending on anatomy and surgeon preference. (onlinelibrary.wiley.com)
Why it matters: Concurrent medial patellar luxation and cranial cruciate ligament injury isn't rare, with one clinical review cited by Today’s Veterinary Practice noting concurrent cruciate injury in 13% to 25% of patients with medial patellar luxation. For veterinary professionals, FONT is notable because it reflects continued interest in reducing the number of separate osteotomies needed to realign the extensor mechanism while also addressing cranial tibial thrust. But the evidence here is still early: this is a proof-of-concept study based on modeling and cadaver specimens, not outcomes in clinical patients, so it’s best viewed as a technical development rather than a practice-changing standard. Existing literature also suggests there’s limited high-quality evidence proving superiority among established cruciate procedures such as TPLO and TTA on some postoperative endpoints, underscoring how careful surgeons should be about adopting new constructs before clinical validation. (todaysveterinarypractice.com)
What to watch: The next step is whether the authors or other groups publish prospective clinical case data on complications, fixation stability, reluxation, and functional outcomes in dogs treated with FONT. (onlinelibrary.wiley.com)
Key facts
- Study
- 2026 Journal of Small Animal Practice paper
- Technique
- Fulkerson-based oblique novel technique (FONT)
- Target conditions
- Concurrent cranial cruciate ligament disease and medial patellar luxation in dogs
- Procedure
- Oblique tibial tuberosity osteotomy
- Intended effect
- Advance and lateralize the tibial tuberosity in one construct
- Study type
- Computational modeling and cadaveric analysis
- Evidence stage
- Preclinical proof-of-concept
A 2026 Journal of Small Animal Practice paper introduces a new orthopedic concept for dogs with two difficult stifle conditions occurring together: cranial cruciate ligament disease and medial patellar luxation. The technique, called the Fulkerson-based oblique novel technique, or FONT, uses an oblique tibial tuberosity osteotomy intended to both advance and lateralize the tibial tuberosity, with the goal of addressing cruciate biomechanics and patellar tracking in the same procedure. The study reported computational modeling and cadaveric analysis, placing it at the early, preclinical stage of evidence development. (onlinelibrary.wiley.com)
That matters because concurrent patellar luxation and cruciate disease has long complicated surgical planning. Patellar luxation in dogs is a developmental orthopedic disorder tied to limb malalignment and skeletal deformity, and standard surgical management may include tibial tuberosity transposition, trochleoplasty, soft tissue balancing, antirotational techniques, implants, or corrective osteotomies depending on severity and conformation. In dogs with medial patellar luxation, clinicians are also advised to assess for cranial cruciate injury during workup, and one clinical review for practitioners notes that 13% to 25% of those patients may have concurrent cruciate ligament injury. (merckvetmanual.com)
The JSAP report appears to position FONT as a combined-mechanics solution for that overlap case. Based on the abstracted description available through Wiley, the procedure is a Fulkerson-inspired oblique tibial tuberosity osteotomy that simultaneously advances and lateralizes the tibial tuberosity. In practical terms, that means it is trying to merge goals that are often handled separately: reducing cranial tibial thrust, as in tibial tuberosity advancement-based cruciate surgery, while also improving extensor mechanism alignment for medial patellar luxation. The paper’s methods, however, were computational and cadaveric, so the current evidence addresses feasibility and biomechanics more than patient-centered outcomes like return to function, reluxation, implant failure, or osteoarthritis progression. (onlinelibrary.wiley.com)
The broader literature supports the need for innovation, but also some caution. Merck Veterinary Manual notes that moderate to severe patellar luxation generally requires surgery, and severe cases may need corrective osteotomy to restore limb alignment. Today’s Veterinary Practice also highlights that complication rates for patellar luxation surgery reported across studies are substantial, with major issues including implant-associated morbidity and reluxation. Meanwhile, a Veterinary Evidence systematic review found only minimal evidence to conclude that TPLO or TTA is superior for reducing postoperative radiographic osteoarthritis in dogs with ruptured cranial cruciate ligament, a reminder that even widely used procedures still have evidence gaps on important long-term endpoints. (merckvetmanual.com)
I didn’t find a press release or substantial outside expert commentary specifically reacting to the FONT paper, which likely reflects how new and technical the report is. Still, the surrounding orthopedic discussion is consistent: clinicians managing medial patellar luxation are being pushed toward more anatomy-specific planning, including radiographic or CT assessment of deformity, and toward earlier intervention when clinical signs progress. That context makes a combined osteotomy concept like FONT understandable, especially for referral surgeons looking for ways to treat mixed pathology without stacking multiple separate procedures. This is an inference from the available background literature and the study abstract, rather than a direct claim from the authors. (todaysveterinarypractice.com)
Why it matters: For veterinary professionals, FONT is less about an immediate shift in standard of care and more about where canine stifle surgery may be heading. If a single oblique osteotomy can reliably deliver both advancement and lateralization, it could eventually simplify some concurrent cruciate-luxation repairs, reduce surgical staging or construct complexity in selected dogs, and expand the toolbox for referral orthopedics. But until clinical series are published, questions remain about case selection, fixation strength, learning curve, postoperative rehabilitation, complication rates, and whether the technique performs as well in living dogs as it does in models and cadavers. (onlinelibrary.wiley.com)
What to watch: The key next milestone is a prospective clinical study or multicenter case series reporting real-world outcomes, including short-term complications, patellar stability, cruciate function, and longer-term osteoarthritis trends. If those data emerge in late 2026 or beyond, FONT could move from an interesting biomechanical idea to a technique worth broader discussion in specialty practice. (onlinelibrary.wiley.com)