Tibial Tuberosity Advancement

This is the newest stabilization procedure in veterinary medicine. As with the TPLO the TTA is chosen for larger breed, very active dogs. Early results are very positive. These patients are returning to function more quickly than the extra-capsular repair patients. A surgeon would choose this procedure for the same reasons as the TPLO.

The hallmark of this procedure is to eliminate cranial tibial translation by placing the patellar tendon perpendicular to the shear forces in the knee. This is accomplished by performing an osteotomy of the tibial tuberosity. Once this is completed the tuberosity is advanced or moved forward to place the tendon perpendicular to the tibial plateau. The advancement is maintained by an implant called a cage and the osteotomy is stabilized by a plate.

The tibial tuberosity advancement requires approximately 8 weeks for healing. Ideally radiographs should be performed at 8 weeks to assess healing. During the healing process controlled exercise is the only allowed activity. Once healed your pet may be released to normal activity.

There is no evidence to suggest that this procedure will result in any less osteoarthritis than the TPLO or extra-capsular repair.

In conclusion there are 3 primary procedures available to stabilize the canine stifle. Small breed to medium size dogs are more suited to extra-capsular repair. The TTA and TPLO can be chosen for medium to large breed active dogs. It is important to discuss the options with your surgeon to make the best choice possible. It does not matter how you get to a stable joint just that we achieve that result. In many cases the TPLO or TTA are better in the short term.

Mobile Surgery Services
Jacqueline J Mair, DVM, Diplomate of the American College of Veterinary Surgeons

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