Like humans, dogs commonly experience knee injuries; and Tibial Tuberosity Advancement surgery addresses this issue in dogs. Today our Benicia 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
The cranial cruciate ligament (CCL) is one of the two ligaments in a dog's knee (the other is the caudal cruciate ligament). The CCL is a band of connective tissue that helps connect the femur and tibia (the bones located above and under the knee), allowing the knee to function. This is also the ligament that is most prone to getting injured.
A dog's cranial cruciate ligament 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 gradually tear, worsening until complete rupture.
Tibial Tuberosity Advancement (TTA) Surgery
Tibial Tuberosity Advancement surgery is a less invasive surgery than many other types of surgical procedures used to treat a torn CCL, such as TPLO surgery (Tibial Plateau Leveling Osteotomy).
When TTA surgery is performed, the front part of the tibia is cut and separated from the rest of the bone after which a special orthopedic spacer is screwed into the space between the two sections of the tibia in order to move the front section forward and up. By doing this, the patellar ligament running along the front of the knee is moved into better alignment and helps to prevent much of the abnormal movement. Once this process has been completed, a bone plate will be attached to hold the front section of the tibia in its new correct position.
Tibial Tuberosity Advancement surgery is typically performed in dogs with a steep tibial plateau (the angle of the top section of the tibia). Your veterinarian will assess your dog's knee to decide if TTA surgery is the best surgical treatment for their torn CCL.
What Does TTA Surgery for Dogs Involve?
Your veterinarian will start by evaluating your dog's knee to determine the area and severity of the injury 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 the same day these tests are conducted or may be booked for a later date.
Your dog will be sedated with anesthesia before the start of their surgery and your vet will also provide your pup with painkillers and antibiotics. They will then clip the fur short on your dog's limb from their hip to the ankle. A small cut or incision is made in the knee to enable the inspection of its internal structures. The damaged parts of the cartilage then are removed and any remaining ruptured ligaments will be trimmed.
At the end of your pet'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 bandaged, and can often 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 their wound, they 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 monitor the recovery process and remove any sutures.
It's critical to your dog's recovery that you restrict their activity level and motions, keeping it to essential movement only (e.g. toileting outside). You must keep them on a leash to prevent running, stair climbing, and jumping. When they are off of their leash you must keep your pet in a small room or pen to prevent them from causing injury to their healing body. After several weeks have passed you may gradually increase your dog's activity and movement.
About 6 to 8 weeks after your pooch's procedure, you will have a follow-up appointment with your veterinarian. During this visit, your vet will check the function of your dog's leg, take X-rays to assess the healing of the surgical site, and provide you with advice about safely increasing your dog's daily activity. Additional tests and evaluations may be recommended depending on the particulars of your dog's case.
Benefits of TTA Surgery for Dogs
There are several 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 some other CCL repair surgeries
- Up to 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:
- Loosening implants
Another possible complication is when dogs without injured cartilage undergo TTA surgery and later tear their CLL. This requires a second surgical procedure to remove the damaged cartilage, but this occurs only in a very small percentage of dogs.
If your dog experiences post-surgery complications, your veterinary surgeon will advise you on the next steps for the treatment of your dog's condition.
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.