Cruciate Ligament tears are relatively common in dogs, and Tibial Tuberosity Advancement (TTA) surgery can be an effective treatment. Our Bonita Springs vets explain everything you need to know about the procedure.
A Dog's Cranial Cruciate Ligament
The cranial cruciate ligament is one of the two ligaments in a dog's knee. It is a band of connective tissue that connects the femur and tibia, allowing the knee to function properly. This ligament is prone to injury.
In humans, a dog's cranial cruciate ligament (CCL) is similar to the anterior cruciate ligament (ACL). Just like the cruciate ligament rupture in dogs, people are often subject to ACL tears.
A dog's cruciate ligament can rupture suddenly (acute rupture) or slowly tear, progressively worsening until a complete rupture occurs.
Tibial Tuberosity Advancement (TTA) Surgery
Tibial Tuberosity Advancement surgery is less invasive than other types of surgery, such as TPLO surgery (tibial plateau leveling osteotomy), used to treat a torn CCL.
When TTA surgery is performed, the front part of the tibia is cut and separated from the rest of the bone. Next, a special orthopedic spacer is screwed into the space between the two sections of the tibia to move the front section forward and up. By doing this, the patellar ligament, which runs along the front of the knee, is moved into better alignment and helps to prevent much of the abnormal sliding movement. Once this process has been completed, a bone plate will be attached to hold the front section of the tibia in its proper position.
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 begin by examining your dog's knee to assess the extent of the injury, its severity, and whether Tibial Tuberosity Advancement surgery is the best treatment option. Some tests and diagnostics your vet might perform 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 later.
Your dog will be sedated with anesthesia for their surgery, and at this time, your vet will also provide your pup with painkillers and antibiotics. They will then clip your dog's limb from the level of their hip to the ankle. Before the surgery starts, they will then make a small cut or incision in the knee to be able to inspect its internal structures. The damaged parts of the cartilage are then removed, and any remaining ruptured ligaments will be trimmed.
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 often, patients can go home the day after their TTA procedure.
After Surgery Care
After your dog's surgery, their rehabilitation may take several months. It's crucial to follow the post-operative care instructions your vet provides carefully. Your vet will prescribe a course of antibiotics and painkillers for your dog when they are sent home after the surgery. If your dog tends to lick their wound, they may need to wear an Elizabethan collar until the incision site heals.
During the first couple of weeks after the surgery, you will need to visit your vet so they can monitor the recovery process and remove any sutures. Restricting your dog's activity and movement during this time is important, allowing only essential toiletry purposes. Keeping them on a leash would be best to prevent running, stair climbing, and jumping. Keep your dog in a small room or pen to limit their movements when off their leash. After several weeks, you can gradually increase your dog's activity and movement.
Around six to eight weeks after the procedure, you will have a follow-up appointment with your veterinarian. During this visit, your vet will monitor your dog's leg function, take X-rays to assess the healing of the bone and provide advice on 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, most dogs recover smoothly. However, there are several complications associated with TTA surgery, including:
- Infections
- Fractures
- Loosening implants
Another possible complication occurs in a very small percentage of dogs that have undergone TTA surgery without having injured cartilage, where they later go on to tear their CCL and require 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.