Tibial Tuberosity Advancement (TTA) is a relatively new surgical technique for repair of cranial cruciate rupture in dogs. Approximately 30,000 cases have been performed worldwide in the last five years with results equal to that of a TPLO procedure.¹ Of course, long term results are not available as compared to a 20 year observation and critique of the TPLO procedure.
TTA, simply explained, requires a vertical cut through the proximal tibia, allowing the tibial crest with its patellar tendon attachment to be moved forward. The new position is held in place by a cage and the fragment is stabilized with a tension band plate. For additional security, all of the implants are made from titanium. The tuberosity advancement effectively restores normal joint mechanics, hence may impart a more favorable mechanical environment within CrCL-deficient stifles.²
The available literature tells us that this procedure can be done for most dogs, and is especially helpful if there is a concurrent medial patellar luxation problem which can be corrected at the same time. Because there is less soft tissue movement during the procedure as compared to a TPLO, it is slightly less stressful to the patient and recovery may be slightly faster. The same strict post surgical aftercare required for a TPLO is also necessary for the TTA to allow proper healing of the bone.
Kyon Pharma, Inc, CH-8005 Zurich, Switzerland.
Kim SE; Pozzi A; Banks SA; Lewis DD; Conrad BP, Effect of Tibial Plateau Leveling Osteotomy and Tibial Tuberosity Advancement on Femorotibial Contact Mechanics, 35th Annual Conference Veterinary Orthopedic Society Proceedings, March 8-15, 2008, Page 33.