One of the most common causes of limping in the hind limb of a dog is a torn cranial cruciate ligament. In humans the equivalent ligament is the anterior cruciate ligament (ACL) in the knee. This ligament is involved in maintaining stability in the stifle (knee joint). When the cranial cruciate ligament ruptures, the subsequent instability in the stifle leads to limping and there can also be damage to the cartilage and menisci (padding structures) inside the joint. This leads to pain and arthritis.
There are several surgical procedures designed to treat injuries of the cranial cruciate ligament. One of these is a Tibial Tuberosity Advancement or TTA. The TTA procedure is performed by making a cut (osteotomy) in the top part of the tibia (shin bone) and repositioning it. This changes the biomechanics of the stifle joint so that it is more stable in the absence of an intact cruciate ligament. The newly positioned tibia is then held in place by a specially designed titanium tension band plate, bone spacer cage and screws so that the bone can heal. In our hands, we see dogs being able to bear weight on their repaired knee within 24-48hours.
Each animal is different, so the procedure must be individually planned for each dog’s weight and bone shape. To do this, a very specific set of x-rays are needed for the measurements to be made and the correct implants chosen before the surgery.
TTA vs OTHER SURGERIES
TTA has several potential advantages over other surgical options for cruciate ligament rupture. The long term outcome appears to be similar to other procedures such as TPLO and TTO. Because the bone cut is made in an area that is less invasive, there may be fewer risks during surgery and fewer post operative complications when compared with other surgeries. TTA surgery is performed on a non-weight bearing area of the tibia bone, which may make it easier for your dog to use the leg and recover faster compared with other procedures that involve cutting into weight bearing bone.
Ultimately, the choice of procedure performed comes down to the surgeon and which procedure they are experienced in, and feel comfortable performing accurately. In our hands, the TTA procedure has produced very good outcomes for dogs with ruptured cruciate ligaments. To discuss this procedure please feel free to call the clinic with any questions and to allow our surgeon to assess your dog’s suitability.