Tibial Tuberosity Advancement (TTA)
What is the procedure for TTA?
TTA is a procedure for repair of a damaged or ruptured Anterior Cruciate Ligament in the dog and rarely in the cat. The Cranial Cruciate is analogues to the Anterior Cruciate in humans that aids in stabilizing the Stifle or (knee) joint by limiting the forward movement of the Tibia in relation to the Femur and prevents over-extension or rotation. TTA is a surgical procedure where we move the Tibial Tuberosity forward to change the angle of the Patellar Ligament to neutralize the tibeofemoral shear force during weight bearing.
There are at least two major reasons that damage to the Anterior Cruciate in humans is treated differently than it is in the dog. Most cases of damage to the Anterior Cruciate in humans are caused by some sort of trauma during a sporting event such as Football or some other form of trauma. In the dog the most common cause is degeneration of the fibers of the ligament. Exact cause is not fully known, genetic factors are certainly a factor. Also the size of the ligaments in humans is much larger than in most dogs, thus affording different options in people.
What is the Cranial Cruciate repair procedure?
Many surgical procedures have been developed over the last several years for the repair of the Cranial Cruciate Ligament. TTA is a more recent procedure that has proved to be less traumatic and less invasive than some of the older methods but provides excellent success. The procedure is less invasive with less soft tissue damage and the bone is cut in an area that does not have direct weight bearing.
The TTA implants are made from Titanium that provides better biocompatibility with less pain and swelling of tissues and quicker resolution of lameness.
What are the indications for surgery?
Your pet will generally exhibit marked lameness with a torn or ruptured CCL.The lameness and confirmation from your veterinarian are all that is needed to demonstrate the need for Cranial Cruciate Repair.
How long will my pet be in the hospital?
Time of recovery is always a big question but with proper handling after surgery to make sure that the pet remains quiet and the proper bandaging is in place, the pet may be able to go home the next day after surgery. If the pet demonstrates excess pain or other complications, release may be delayed. The attending surgeon should make the final decision for release.
What is the prognosis following surgery?
After healing it is rare to develop problems related to the surgery. Since this condition is a result of degeneration of the ligament, it is not uncommon especially in large breed dogs for the other leg to develop the same condition.
What post-operative care is required after surgery?
As with all orthopedic procedures it is imperative that strict rest be required for several days to allow proper healing. No running or jumping for the first month. After a month of strict rest, gradual mild exercise may be introduced but there should be only controlled activity for a three month period. Physical therapy can speed up the healing process.
What are the complications or risk associated with this surgery?
As with all orthopedic procedures strict rest and controlled activity must be followed. If the Dr’s recommendations are followed, it is rare to develop any problems and those that do develop can usually be traced to poor supervision by the owner.
Are any follow-up appointments required during post-op period?
Yes, it is very important to follow the schedule set by your surgeon to examine the healing process. Generally an X-ray will be taken to properly assess the alignment and healing of the surgery site.
All in all this is a practical and very effective procedure for a damage Cranial Cruciate Ligament.