Cruciate Ligament tears are common knee injuries seen in dogs, and Tibial Tuberosity Advancement surgery is one of the ways this condition can be treated. Today our Beacon vets discuss Tibial Tuberosity Advancement (TTA) Surgery for dogs, including how it works, its benefits, and what the procedure involves.
A Dog's Cranial Cruciate Ligament
One of the two ligaments in a dog's knee, the cranial cruciate ligament is a band of connective tissue that aids in connecting the femur and tibia (the bones above and below the knee), allowing the knee to function. Additionally, this ligament is the one that is most vulnerable to damage.
A dog's cranial cruciate ligament (CCL) is similar to the anterior cruciate ligament (ACL) in humans and just like the rupture of the cruciate ligament in dogs, people are often subject to ACL tears.
A dog's cruciate ligament can rupture suddenly (acute rupture) or slowly tear, getting worse until a complete rupture occurs.
Tibial Tuberosity Advancement (TTA) Surgery
Tibial Tuberosity Advancement surgery is a less invasive surgery than other types of surgical procedures used to treat a torn CCL such as TPLO surgery (Tibial Plateau Leveling Osteotomy).
The front portion of the tibia is cut and separated from the remaining bone during TTA surgery. The front section of the tibia is then moved forward and up using an orthopedic spacer that is specifically designed for the job. This helps to prevent much of the abnormal sliding movement by better aligning the patellar ligament, which runs along the front of the knee. The front portion of the tibia will then be secured in place with the aid of a bone plate after this procedure is complete.
Tibial Tuberosity Advancement surgery is typically performed in dogs with a steep tibial plateau (angle of the top section of the tibia). Your veterinarian will assess the geometry of your dog's knee to decide if TTA surgery is the best surgical treatment for your dog's torn CCL.
What Does TTA Surgery for Dogs Involve?
Your veterinarian will start by assessing your dog's knee to determine the extent of the injury, its severity, and if Tibial Tuberosity Advancement surgery is the best option for your dog's treatment. Some tests and diagnostics your vet might conduct include:
- X-rays of the stifle and tibia
- Laboratory analysis of fluid drawn from the knee
- Palpation (your dog may be sedated or given light anesthesia for this)
Your dog's surgery might be scheduled for the same day these tests are conducted or at a later date.
Your dog will receive anesthesia during surgery, and your veterinarian will also give your dog painkillers and antibiotics at that time. Then they will cut your dog's limb from the hip level to the ankle. In order to examine the knee's internal structures, a small cut or incision will be made there before the procedure begins. Any remaining ruptured ligaments will be trimmed after the damaged cartilage has been removed.
At the end of your pup's surgery X-rays will be taken to evaluate the angle of the top of the shin bone (the tibial plateau) in relation to the patellar tendon and to inspect the position of the implant.
After the surgery, your dog may be given a bandage, and oftentimes patients can go home the day after their TTA procedure.
After Surgery Care
Your dog's rehabilitation after their surgery may take several months and it's imperative to follow the post-operative care instructions your vet gives you carefully. Your vet will prescribe a course of antibiotics and painkillers at the time your dog is sent home after their surgery. If your dog has a habit of licking its wound it may also need to wear an Elizabethan collar while the incision site heals.
You will need to visit your vet during the first couple of weeks following your dog's surgery so they can check in on the recovery process, as well as remove any sutures.
You must limit your dog's activity and motion, allowing them to move only for toiletry needs, in order for them to recover. To stop them from running, climbing stairs, or jumping, you must keep them on a leash. You must confine your dog to a small space or a pen when they are not on a leash to stop these movements. You can gradually increase your dog's activity and movement after a few weeks have passed.
After approximately 6 to 8 weeks have gone by since your pooch's procedure you will have a follow-up appointment with your veterinarian. At this visit, your vet will monitor the function of your dog's leg, take X-rays to assess the healing of the cut bone, and provide you with advice about increasing your dog's daily activity. Additional tests and evaluations may be recommended based on your dog's individual case.
The Benefits of TTA Surgery in Dogs
There are a handful of benefits for dogs that have their torn CCL treated with Tibial Tuberosity Advancement surgery including:
- Increased range of motion in the knee
- Faster healing time than with some other surgeries used to treat CCL tears
- 90% surgery success rate
- Dogs can return to their normal activities quicker
Risks of TTA Surgery
While the success rate is high and most dogs go on to make a smooth and complete recovery there are several complications associated with TTA surgery including:
- Infections
- Fractures
- Loosening implants
In a very small percentage of dogs who have had TTA surgery without having injured cartilage, there is a second potential complication in which the dog tears their CCL and needs a second surgical procedure to have the torn cartilage removed.
Note: The advice provided in this post is intended for informational purposes and does not constitute medical advice regarding pets. For an accurate diagnosis of your pet's condition, please make an appointment with your vet.
