Cruciate Repair / Tibial Tuberosity Advancement (TTA)

Providing the BEST surgery for your dog's knee.

Whether a best friend or devoted companion, we know that your dog is not "just a pet" to you.  We know that we are caring for a loving member of your family and that is why our team delivers the highest quality of care. 

The most common knee injury seen in veterinary practice today is rupture of the cranial cruciate ligament (CCL).

Anatomy   

The knee, or stifle, is a joint that is formed by three bones - - the femur (thigh bone), tibia (shin bone) and patella (knee cap).  Two cruciate ligaments, the cranial and caudal cross in the joint from the femur to the tibia.  These ligaments provide "forward and backward" as well as rotational stability to the knee.  The meniscus is a fibrous "cushion" between the femur and tibia.

Diagnosis

The diagnosis of a ruptured CCL is usually made by your veterinarian by palpation of the knee.  Physical exam will reveal instability, pain and swelling.  The doctor will likely want to take radiographs of both knees and the hips.  This will help confirm the diagnosis and rule out other problems.  Additionally, the radiographs will be used to measure the knee for the proper size implants for a corrective surgery to stabilize the knee.

Treatment

All dogs with a ruptutred cruciate ligament should be treated surgically.  The sooner a knee can be repaired, the better.  There are several methods used to repair the knee joint when a CCL is torn.  The newest and most effective procedure used at DVC is the tibial tuberosity advancement (TTA) surgery.  This is a procedure in which the front portion of the tibia is cut and moved forward.  The bones are held in position using a titanium plate and screws as well as a titanium "cage".  The defect produced by moving portion of the tibial forward is implanted with a synthetic bone graft material.  The implant will remain in your dog and the tibia will be allowed to heal at a different angle to change the mechanical stresses on the joint.  If a dog with a ruptured CCL is not treated, severe degenerative joint disease (arthritis), meniscal tears and chronic pain usually result.  In addition, because the dog favors the affected leg, he will generally put more weight on the unaffected leg.  It is not unusual for the dog to then rupture the cruciate ligament on that leg as well because of the increased stress on the leg.

TTA Benefits

TTA versus traditional repair:  1.  Better results - - 20-25% of larger dogs have disappointing results with traditional procedures.  2.  Quicker recovery - - traditional CCL surgeries often result in long recovery times and more muscle wasting.  3.  Ability to operate on both knees at once- - TTA has been successfully performed in dogs up to 140 pounds on both knees.                                                                          

TTA versus TPLO repair:  1.  Less invasive procedure.  2.  Less post-op complications - - complications can occur with any procedure but post-op infections, implant failures etc. are less likely.   3.  Less Cost - -while TTA costs more than traditional repair it is significantly less than TPLO procedures.  4.  Better "joint dynamics" - - TTA results in superior, more physiologic joint forces.

More Information:  For more information please contact our office at 260-637-7676.  We would like to meet with you and your dog for a consultation prior to scheduling surgery.  For convenience sake, appointments are often scheduled a day prior to surgery.  Your dog would spend the night, have surgery the following day and usually go home two days later.