Innovative TTA Procedures: A Good Solution for Large Breed Dogs With Ruptured ACLs

Unfortunately ACL tears or injuries are altogether too common in dogs. Dupont Veterinary Clinic's head veterinarian Dr. Steve Harry has expertise in ACL repair, including more advanced techniques like TTA (tibial tuberosity advancement).

What Causes the Need for ACL Repair?

Rottweiler Portrait

Genetics, obesity, athleticism, and arthritis can all play a role in this disease. The most common physical reason the cranial cruciate ligament tears is thought to be a result of excessive internal rotation with the knee in slight extension. Your pet will usually let out a yelp when this happens and will limp either slightly or very severely afterwards. To some degree, affected pets appear to get better in the next few days or so, only to become chronically lame over the next few weeks. During this time, your pet will shift their weight to the good rear leg, increasing strain on it. Tearing of the cranial cruciate ligament destabilizes the knee.

The Importance of ACL Repair

Left untreated, most dogs with damaged ACLs develop severe degenerative joint disease (arthritis) and meniscal tears, resulting in chronic pain. For that reason, ruptured ACLs should be repaired unless there is some extenuating circumstance.

What is TTA?

Little Girl Hugging her Dog

TTA is a newcomer to the arena of procedures advocated to stabilize the cranial cruciate deficient knee. TTA moves the patellar tendon forward to the point that it is perpendicular to the tibial plateau in a standing angle, relieving the load on the cranial cruciate ligament. The net result being that the patellar tendon takes over the load of the cranial cruciate ligament. Since the patellar tendon is capable of loads many times greater than what the cranial cruciate ligament withstood, the joint reaction should not be capable of exceeding the force of the patellar tendon. The net result is a stable knee. TTA literally changes how your dog’s knee functions, so the ACL is no longer needed for stable, pain-free use.

The advancement of the tibial tuberosity in the TTA procedure is accomplished by cutting the tibial crest (the front part of the tibia bone) and moving it forward. The bones are held in position using a titanium plate and screws as well as a titanium cage. The defect produced by moving a portion of the tibia forward is implanted with a synthetic bone graft material. The implant material will remain in your dog.

Benefits of TTA Repair

We perform and recommend the TTA for some of the following reasons:

TTA versus traditional repair:

  1. Better results
    30-35% 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 100 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, healthier function.

Learn more about TTA by downloading these useful handouts.

We would like to meet with you and your dog for a consultation prior to scheduling surgery. For your convenience, 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.

"Dupont Veterinary Clinic has been amazing with every animal my family has had. They treat our pets like family, which is what they are to us. Thank you!"
— Natalie W.