Tibial Tuberosity Advancement (TTA) (For cruciate ligament injuries)

By: Brisbane Veterinary Specialist Centre

Tibial Tuberosity Advancement (TTA)

Bruce Smith BVSc, MS, FACVSc, Dip ACVS
Lyn Minhinnett BVSc MACVSc

 

What is the TTA Procedure?
TTA is a surgical procedure specifically developed to treat injuries of the cranial cruciate ligament (CrCL) in the knee of dogs.

The cranial cruciate ligament is a major stabilising ligament in the stifle (knee) of the dog. Rupture of the cranial cruciate ligament results in instability between the femur (thigh bone) and tibia (shin bone) causing damage of cartilage and menisci. This causes pain and arthritis. For more general information on cranial cruciate ligament rupture and treatment please see the information sheet Cranial Cruciate Ligament Injury on our website.

The TTA procedure involves a realignment of the tibial part of the stifle joint (the tibial crest). The surgery changes the biomechanics of the stifle joint (redirecting the strong muscular forces of muscles on the front of the thigh) so that stability is created with out applying an artificial physical restraint across the joint.

What are the Advantages of TTA over other Surgical Treatments?
The procedure is individually planned for each dog’s size and bone shape, and procedure specific implants used. Dogs of almost any size and shape can be equally effectively treated.

Although TTA involves the cutting and repositioning of bone, it avoids the need to cut through the tibia completely as is required with other currently available realignment techniques such as the TPLO, TTO and TWO.

 

Is my Dog a Candidate for TTA?
Your veterinarian can diagnose CrCL injury by a physical examination, and will recommend referral for TTA if appropriate. On occasion sedated examination, radiographs and possibly a specialist assessment will be required for confirmation.

Almost any size and shape of dog with CrCL injury can benefit from TTA however it is most chiefly indicated in larger dogs (over 20kg) that more commonly suffer loosening of extracapsular stabilisation repairs. For more information on the latter technique, please see the Extracapsular Stabilisation Surgery information sheet on our website.

 

How long will my Dog be in hospital?
Two to three days in hospital is usual. Your dog will be admitted the morning of surgery for preoperative checks, planning and pre-emptive pain control. Continuous observation and pain control is provided postoperatively until your dog is comfortably up and about.

 

What after-care will my Dog need?
Rechecks are required at two weeks postoperatively for suture removal. We recommend a consultation with our physiotherapist at this time to commence a rehabilitation program. To learn more abut Physiotherapy you can visit our physiotherapist’s website www.holisticanimalphysiotherapy.com.au.

Another recheck is required at eight weeks postoperatively. X-Rays may be required at this check to confirm bone healing.
Antibiotic and anti-inflammatory pain medication is required once or twice daily until suture removal.

Activity restriction is essential for your dog’s comfort and healing. The physiotherapist will guide you on controlled activity and more specific rehabilitation. Typically restricted activity means room confinement when not attended, and short leashed walks over an eight week period.

 

Will my Dog return to Normal Activity?
Return normal activity is almost always achieved. Unrestricted activity can usually resume following confirmation of bone healing at eight weeks, however improvement in muscular strength will continue for up to six months.

 

Are their any Complications with TTA?
TTA is a complex surgical procedure requiring general anaesthesia and exposure of the knee joint and bone.

Wound bleeding, swelling and infection may occur as with any orthopaedic procedure but are uncommon and temporary.

Movement or loosening of the bone or metal implants is uncommon but may result from early postoperative activity. This complication may require re-operation.

 

Financing surgical treatment for your pet.

BVSC understands that surgical treatments are both unexpected and costly. To assist you, access to third party external finance companies is available. These companies require a detailed application and credit check. BVSC is not an agent for these companies and may request a deposit to allow treatment to proceed if finance approval is pending.

 

Where is BVSC and how do I make an appointment for my pet?

BVSC is located on Brisbane’s north side on the corner of Old Northern & Keong Roads, Albany Creek 4035.

 

To make an appointment for your pet you will be required to have a referral from your vet, to get a referral contact your veterinarian and request referral to BVSC then contact our friendly reception staff on (07) 3264 9400