Canis ISSN: 2398-2942

Tibial tuberosity: advancement

Synonym(s): TTA

Contributor(s): Warrick Bruce, Rob Pettitt

Introduction

  • A surgical procedure aimed at stabilizing a cranial cruciate ligament (CrCL) deficient stifle by advancing the tibial tuberosity sufficiently to achieve a 90° patella tendon tibial plateau angle when the stifle is extended. This will negate the cranial thrust on the stifle.
    This technique should not be attempted by veterinarians without appropriate specialist training.

Uses

Advantages

  • According to proponents, TTA will provide quick recovery and a good to excellent outcome for dogs of all sizes with cruciate ligament disease.

Disadvantages

  • Limited independent verification of technique by surgeons in academia or practice.
  • Numerous techniques for repair of CrCL injury have been publicly described during the past 50 years; uniform success rates of 80-90% have been published for many of these procedures. Initial reports for TTA are similar.
  • Technically challenging procedure with steep initial learning curve.
  • Complications can be more severe than for lateral tibiofabella suture techniques.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Good - excellent.

Further Reading

Publications

Refereed papers

  • Recent references to PubMed and VetMedResource.
  • Boudrieau R J (2009) Tibial plateau leveling osteotomy or tibial tuberosity advancement? Vet Surg 38 (1), 1-22 PubMed.
  • Voss K, Damur D M, Guerrero T et al (2008) Force plate gait analysis to assess limb function after tibial tuberosity advancement in dogs with cranial cruciate ligament disease. Veterinary And Comparative Orthopaedics And Traumatology 21 (3), 243-249 PubMed.
  • Lafaver S, Miller N S, Stubbs W P et al (2007) Tibial tuberosity advancement for stabilization of the canine cranial cruciate ligament-deficient stifle joint: Surgical technique, early results, and complications in 101 dogs. Vet Surg 36 (6), 573-586 PubMed.

Other sources of information

  • Dejardin L (2003) TTA. In:Textbook of Small Animal Surgery, 3rd edn. Ed D Slatter. W B Saunders, Philadelphia, p 2133.


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