With over 30 years of combined clinical surgical experience, our board certified surgeons have the training, experience and a history of successful outcomes performing the Tibial Tuberosity Advancement (TTA) procedure. Please call our office at (518) 887-2260 to schedule a consultation appointment with our surgeons.
Tibial Tuberosity Advancement (TTA) procedure
It has been widely accepted that a major factor causing the cranial cruciate ligament (CCL) to rupture is an abnormal force (shear force) which is a component of the total joint force generated through the stifle (knee) joint when the dog stands and walks. This abnormal force is due in large part to slope at the back of the tibial plateau.
One method to dynamically eliminate the shear force is the Tibial Plateau Leveling Osteotomy (TPLO) designed by Dr. Barkley Slocum. This is accomplished by cutting the tibia and rotating the plateau until it is level to the ground. The TPLO surgery has resulted in great success for stabilization of the stifle joint and restoration of limb function.
A newer surgical procedure, the Tibial Tuberosity Advancement (TTA) was developed at the University of Zurich by Dr. Slobodan Tepic and Professor Pierre Montavon. They determined that the force in the stifle joint is approximately parallel to the patellar ligament. If the angle between the patellar ligament and the tibial plateau (alpha) is 90 degrees, there is no shear force, and the cruciate ligaments are not loaded.
The TTA is designed to stabilize the joint by eliminating the abnormal force (shear force). It is accomplished by advancing the tibial tuberosity cranially (forward) a predetermined distance so the patellar ligament, (and force) is at 90 degrees to the tibial plateau. The procedure causes a slight modification in the geometry of the stifle, yet renders it stable throughout the range of motion.
The advantages of the TTA are less soft tissue disruption, the bone is cut along the non-weight bearing portion of the tibia, and less implant complications. In general, the outcome of the TTA and TPLO are the same in terms of stabilizing the stifle, restoration of function, and minimizing arthritis. The TTA was released for clinical use by the end of 2005. Currently over 200 surgeons worldwide have utilized this procedure in approximately 7000 cases. Veterinary Specialties has performed over 500 TTAs since the spring of 2005 and we are very pleased with the outcome.