Dr. Tony Cambridge; Veterinary Surgical Specialists

April, 2009          

“Reduced complications,” “faster recovery” and “less invasive,” are terms that when applied to surgical procedures, elevate the level of care we can offer our patients.  We would like to share with you a technique we have now established as our primary treatment of choice at Veterinary Surgical Specialists for cruciate ligament injury in the dog.

Tibial Tuberosity Advancement- TTA

Two years ago VSS implemented a transition from TPLO surgery to TTA for the management of CCL injury.  Now with over 25,000 procedures performed, claims of TTA being less invasive, associated with fewer and less consequential post-operative complications, and a faster recovery time led to our use of TTA as the primary corrective treatment for CCL injury in our practice.

TTA has also proved to be a better procedure to treat concurrent MPL/CCL tears as it allows more control in repositioning the tibial tuberosity. We began TTA for a select number of cases, and our observations persuaded our surgeons at VSS to switch to TTA. 

Our opinion is that the procedure provides a consistent excellent outcome. The few that have complications rarely require surgical revision. Owner’s of patients that had TPLO surgery on one stifle and later TTA surgery on the other side, consistently report a faster recovery with TTA. 

The mechanism of effect for TPLO and TTA are still debated.  

The February edition of the ACVS Journal carries a detailed review (Vet Surg 38; 1-22, 2009). Our website provides basic information on TTA and how it provides dynamic stabilization using the quadriceps muscle and the patellar tendon to assume the roll of the CCL, while utilizing a tibial osteotomy, leaving the joint anatomy unaltered.