What is the Tibial Tuberosity Advancement (TTA) procedure?
Tibial Tuberosity Advancement (TTA) is an orthopedic procedure to repair deficient cranial cruciate ligaments in dogs. It has also been used in cats. This injury can occur at any age and in any breed, but most frequently occurs in middle aged, overweight, medium to large breed dogs.
What are the indications for surgery?
The cranial cruciate ligament (CrCL) in dogs stabilizes the knee joint, called the stifle joint in cats and dogs. If your dog ruptures the Cranial Cruciate Ligament, surgery is the only real option. When the ligament is torn, there is a shearing force that results when your dog tries to bear weight on the leg. This shearing force makes the femur slide backwards on the surface of the tibial plateau. This abnormal movement sets up excessive wear and tear on the cartilage surface, which induces further arthritic change in the joint. Additionally, this abnormal motion frequently damages the cartilage pads in the joint, known as the menisci. Damaged menisci also leads to further arthritic change. Many dogs develop such severe arthritis that there leg is in constant pain.
How long will my pet be in the hospital?
Your pet will require an overnight stay up to 24 hours . During this time we will adjust the pain medication specifically to your dog or cat.
What is the prognosis following surgery?
According to the American College of Veterinary Surgeons (ACVS), the long term prognosis for animals undergoing surgical repair of the cranial cruciate ligament is good, with reports of improvement in 85-90% of the cases.
What post-operative care is required after surgery?
Pets should be kept in a comfortable, safe indoor location with no free access to stairs for the initial 24 hours following the procedure. Your pet may be groggy for the next few days. He or she may whine or appear more anxious than usual; this may indicate pain/discomfort or side-effects of the medications. Please call your veterinarian for assistance with any medication adjustments or return for an examination and additional pain medications as needed.
Confine to one level/section of the house on carpeted floors. Limited, supervised access to stairs is recommended for 8 weeks; use baby gates to prevent free access. Use a belly band/sling for safety when walking across slick floors, going up/down stairs and during all physical therapy activities to prevent falling (continue use until pet is steady on operated leg).
Always use a short (6 ft) leash when taking your pet outside to urinate/defecate during this restriction period. Confine your pet to a small area/room/crate when unattended. Please do not allow your pet to run or jump during this restriction period.
What are the complications or risks associated with this surgery?
All surgical procedures carry the risk of complications. The most common complications encountered with this particular procedure are infection, lack of stabilization, and implant failure. The most common complication caused by a torn cranial cruciate ligament is osteoarthritis of the affected joint. Unfortunately, arthritis progresses regardless of treatment, but is much slower when surgery is performed and the knee is stabilized.
Complications that can arise which are specific to TTA surgery include delayed healing of the bone, non-healing of the bone, healing in an incorrect position , fracture of the bone, and failure or breaking of the metal implants. Although they are uncommon, these complications can be serious and may require corrective surgeries
Are any follow-up appointments required during the post-operative period?
The healing process will be monitored by your veterinarian with two follow-up exams. The first is scheduled at two weeks after the surgery and the second is at eight weeks after the surgery. By 8 weeks after surgery, the bone will be healed together. By 16 weeks after surgery, most dogs are fully weight-bearing on the operated limb, and exercise restrictions can be lifted at this time.
The Arkansas Veterinary Surgery Center is a regional referral surgery center for orthopedic surgery on dogs, cats and some exotic species. We are part of South County Animal Hospital in Greenwood, Arkansas. Our chief surgeon is Dr. Mark E. Sharp a graduate of the College of Veterinary Medicine at Oklahoma State University. We do both mobile surgery at your regular vet’s office and surgeries at our hospital. If you have a pet in need of a skilled surgeon for neurological or orthopedic procedures call us at 479-996-6095