Leach ES, Krotscheck U, Goode KJ, Hayes GM, Böttcher P. Vet Surg. May 30, 2013 MedVet Indianapolis Cranial cruciate ligament rupture is the most common orthopedic injury in dogs. Progression of osteoarthrosis in dogs treated by TPLO may be partly caused by an abnormal cartilage pressure distribution. Told me TPLO surgery has to long of a recovery time vs TTA. However, the bone is cut in a linear fashion, in order for the tibia to be moved to a different angle. The TTA-procedure aims at achieving the same goal as the TPLO, however, a different stabilization is used. eCollection 2019. These findings suggest that TPLO does not reestablish normal joint biomechanics following leveling the tibial plateau to 6°. Johnston SA. 1,168 Posts. We had planned to take a hike as a family, up to Sedona Arizona on the West Fork Trail. Vet Surg. Unable to load your collection due to an error, Unable to load your delegates due to an error. The TTA procedure is more commonly performed in dogs with a steep tibial plateau, or angle of the top part of the tibia. Osteoarthritis: joint anatomy, physiology, and pathobiology. #4 • Mar 2, 2008. Animals: Client-owned dogs with ≥3 years follow-up (118 dogs, 166 stifles). Thus, medial swelling of the proximal tibial region is more usually more prominent in TPLO-treated than in TTA-treated dogs. Best of luck with your baby. Some people try to use an external brace to support the knee during the healing period. TPLO vs. TTA vs. – Why TTA requires less rotation than TPLO. They are pretty much the same. Dr. Wodiske has been specially trained to perform this procedure, which means referral to an orthopedic specialist is not necessary. 2019 Dec 27;10:249-255. doi: 10.2147/VMRR.S204321. When 90° patellar tendon-to-tibial plateau angle was obtained (this required mean advancement of 13.5 ± 1mm), TTA restored normal femoro-tibial contact parameters. CONCLUSION: Tibial plateau leveling osteotomy and TTA caused an angle dependent decrease in craniocaudal translation of the tibia in the CCL deficient stifle. DeSandre-Robinson DM, Tano CA, Fiore KL, Prytherch B. J Am Vet Med Assoc. Follow-up examination and radiography were performed in dogs meeting the inclusion criteria. His surgery, tomorrow, Tuesday, April 23. Therefore, swelling on the inside of the knee tends to be more pronounced in TPLO-treated dogs then TTA-treated dogs. Surgical treatment is advised for most dogs with CrCLD. Prevention and treatment information (HHS). Complications, Cost of Surgery, featured, Recovery, tplo, tta, veterinary surgery. J Small Anim Pract. Long-term effects of tibial plateau leveling osteotomy and tibial tuberosity advancement on tibial plateau subchondral bone density in dogs. Thus, medial swelling of the proximal tibial region is more usually more prominent in TPLO-treated than in TTA-treated dogs. Low Versus High Patellar Tendon Insertion Point. Colorado State UniversityCollege of Veterinary MedicineFort Collins, CO, USA, Antonio Pozzi, DVM, MS, DACVS Conversely, TPLO failed to restore normal femoro-tibial contact pressure patterns (femoro-tibial contact area remained smaller and peak contact pressures were positioned more caudally on the tibial plateau, when compared with CrCL intact stifles). Surgery STAT: TTA vs. TPLO: Recovery time remains an important consideration Nov 01, 2008 By Stephen H. Levine, DVM, MS, Dipl. Angular and Torsional Tibial Deformity. Also the number of vets framillar with the procedure is far less than TPLO. TPLO and TTA are the most commonly used geometry altering techniques for cruciate deficient stifles in dogs. TTA vs TPLO Surgery | KYON. #TTA vs #TTA debate: Mike Kowaleski, Andy Torrington and Otto Lanz at Kyon Symposium 2019 in Boston We got ourselves packed, setup lunches, got kids geared up to go, and loaded everything into the van. I even did the rehab swimming at $75 a session, because I hoped this dog could get back into it and finish Senior. Healing from TTA surgery is generally rapid and dogs resume normal activities quickly. Conversely, the prominent tibial tuberosity following TTA is, on occasion, objectionable to pet owners. In contrast, with TPLO, the tibial crest is attached to the remainder of the tibia such that it cannot be medially or laterally transposed independent of the sagittal plane of the tibia unless an additional osteotomy were made. Make an appointment today. As the Modified Maquet Procedure is relatively new, there is limited evidence thus far. Long-term outcomes that were better after TPLO compared with TTA included average pain in the last 7 days (P = .007), interference with walking (P = .010), morning stiffness (P = .004), jumping (P = .003) and climbing (P = .040), limping during mild activities (P = .001), and overall quality of life (P = .045). TTA is a fairly new procedure and it is unknown as of now The dimensions of the TTA cage spacer (maximum 12mm width and XX mm overall length) may limit its application in giant breeds of dogs. But the knee never stabilized completely. Oops! This blog post addresses the top questions we get asked from dog owners about TPLO. They can be divided into static-constraint or dynamic-constraint (geometry-altering) methods. 2009 Jan;38(1):1-22. doi: 10.1111/j.1532-950X.2008.00439.x. TPLO requires considerably more soft tissue elevation around the proximal tibia than does TTA. Objective: In a few cases, it has an advantage over the TTA because some angular limb deformities might be corrected with the TPLO. 2018 May;47(4):566-571. doi: 10.1111/vsu.12790. Ninety-four dogs treated with TPLO (133 stifles) and 24 dogs treated with TTA (33 stifles) met the inclusion criteria. Veterinary Pet Insurance (VPI). Hope this helps you. Like TPLO it requires plates and screws to stay in place initially, and although they are not required after healing they are rarely removed. It is biomechanically comparable to TTA but easier and faster to perform and may provide more stability. The results of a single comparative study suggest that dogs with TPLO reach a slightly better overall outcome than dogs with MMP. While both techniques are advanced procedures requiring strict attention to detail, surgeons experienced with each method tend to regard TTA a simpler technique to master. Clinical significance: :) But your concern about the other leg is valid. Further studies needs to evaluate if in vivo dynamic stability can be achieved with TPLO or TTA. There is, however, a trend amongst experienced TPLO surgeons toward reduced or no elevation of soft tissues lateral and caudal to the tibia in recent years. Option one is conservative treatment- try to get the dog to heal on its own without surgery. Moore KW, Read RA. Vet Med (Auckl). Conclusion: 1995;72(8):281-285. There are quite a few options. Ninety‐four dogs treated with TPLO (133 stifles) and 24 dogs treated with TTA (33 stifles) met the inclusion criteria. He is having a TTA, per his veterinarian expert. That is the root of the problem. Rayward R, Thomson D, Davies J, Innes J, Whitelock R. Progression of osteoarthritis following TPLO surgery: a prospective radiographic study of 40 dogs. This ligament can suffer a partial rupture, leading to instability of the knee. While both TPLO and TTA reduce strain on the CrCL, the advisability of leaving remaining CrCL fibers intact is debated. The wise choice is the one that gives the best results … This topic was covered a couple of weeks ago and the concencous was that TTA is a releatively new procedure with no long term results on active/ hard working FT/HT type dogs. Ober CA 1, Factor G 2, Meiner Y 2, Segev G 2, Shipov A 2, Milgram J 2. Why?, I asked him. Please enable it to take advantage of the complete set of features! I have a dog 9 months post TPLO and doinig great! Recent in vitro mechanical studies conducted at the University of Florida have shown that cranial tibial subluxation and internal tibial rotation associated with CrCL transection causes a caudal shift in femoro-tibial contact, reduced femoro-tibial contact area and associated increased peak contact pressures. Dogs treated with TPLO subjectively seemed to have less pain and fewer mobility issues. 2008 Feb;37(2):111-25. doi: 10.1111/j.1532-950X.2007.00361.x. Tibial osteotomies for cranial cruciate ligament insufficiency in dogs. Methods to augment the TTA procedure in these situations have been described, but add considerable complexity to the procedure. Tibial plateau leveling osteotomy or tibial tuberosity advancement? 2005 Mar-Apr;34(2):133-41. doi: 10.1111/j.1532-950X.2005.00021.x. The article also discusses TPLO, TTA and extra-cap procedures and concludes that, “The decision of whether TPLO or TTA is most appropriate is made based on the anatomy of the individual. In cases where there is some combination of excessive tibial plateau slope and/or hypoplastic tibial tuberosity, it may not be feasible to accomplish a 90° patellar tendon-tibial plateau angle with currently available instrumentation that is limited to a 12mm wide spacer cage. Dogs with unilateral ruptured CCL treated with TTA (n = 14), TPLO (n = 15), and ECR (n = 23), and normal adult dogs (control, n = 80). Measures of outcomes included a radiographic osteoarthritis score (preoperative, 8 weeks postoperative, and ≥3 years postoperative), the Canine Brief Pain Inventory, and the Canine Orthopedic Index. Pick up Wednesday, April 23, afternoon. Ross H. Palmer, DVM, MS, DACVS Bethesda, MD 20894, Copyright Several surgical techniques are currently used to correct CCL rupture. A high (proximal) insertion point may favor TTA as it allows the use of a larger TTA plate and provides bony support for the cage spacer, but with TPLO would risk rotation of the tibial plateau to a point below the patellar tendon insertion (putting the tibial tuberosity at risk of fracture due to loss of bony buttress support). Patellar Luxation Requiring Tibial Tuberosity Transposition. CLINICAL IMPACT: Tibial plateau leveling osteotomy and TTA provide passive stability to the stifle. 1997;27(4):699-723. Careers. TTA does not have a quicker recovery time than TPLO. This injury can happen at any age or breed, but most lately occurs in middle aged, overweight, large breed dogs. Tibial plateau leveling osteotomy provides a better long-term radiographic and functional outcome than TTA. TPLO & TTA provide a very high profit for the surgeon. The TTA implants are typically made of titanium and have a slender profile in comparison to the more bulky TPLO implants most often made of stainless steel. National Library of Medicine It increases the pressure that is exerted by the patella (knee cap) on the femur, which increases the risk of cartilage erosion and arthritis at this location. Would you like email updates of new search results? While each method has inherent advantages and disadvantages, case selection for each method is often dictated by surgeon preference and anecdotal observations. A similar situation can arise following TPLO and with either technique the surgeon must be prepared to supplement with a static-constraint technique when deemed necessary. Records from June 2012 to May 2015 were reviewed. In addition, dogs with tibial plateau angle in excess of 35° have a conformational deformity of the stifle joint that place it in a relative angle of hyperextension despite the limb itself not being in the extended position. Pet osteoarthritis. Failure to adequately advance the tibial tuberosity could risk residual lameness associated with persistent postoperative stifle instability. Long-term radiographic comparison of tibial plateau leveling osteotomy versus extracapsular stabilization for cranial cruciate ligament rupture in the dog. https://www.petinsurance.com/healthzone/pet-articles/pet-health/Pet-Oste... NCI CPTC Antibody Characterization Program. Cranial cruciate ligament rupture in the dog-a retrospective study comparing surgical techniques. Objectives: This study aimed to compare outcomes between the tibial plateau levelling osteotomy (TPLO) procedure and a modified tibial tuberosity advancement (TTA Rapid) in dogs with cranial cruciate ligament rupture. Client-owned dogs with ≥3 years follow-up (118 dogs, 166 stifles). Tibial Tuberosity Advancement (TTA) Tibial Tuberosity Advancement (TTA) is similar in approach to TPLO. The primary benefit of the TTA is 2017 Jan 1;250(1):68-74. doi: 10.2460/javma.250.1.68. The debate of which technique is superior has not been, and likely, never will be resolved. In … TTA VS TPLO The most often knee injury in the dog is tear of the Cranial Cruciate Ligament (CCL), also called the Anterior Cruciate Ligament (ACL). This also means it is significantly less expensive than the TPLO (mentioned below). My Dog Tore Her ACL (CCL)! In many cases, either surgery would constitute a suitable and appropriate choice.” When CrCLD is complicated by concurrent patellar luxation requiring tibial tuberosity transposition, TTA permits medial or lateral transposition of the isolated tibial crest at the same time that advancement is performed. This usually involves confining the dog in a crate for a period of time. This study used cadaver limbs and a TPLO or TTA … Vet Surg. This info helps dog owners understand the difference between newer types of procedures such as CBLO or MMP versus TPLO, Tightrope, Lateral Suture or TTA. Tibial Plateau Leveling Osteotomy for Cranial Cruciate Ligament Rupture in Canines: Patient Selection and Reported Outcomes. Vet Clin North Am Small Anim Pract. This may explain the tendency for TTA-treated dogs to regain limb use slightly sooner than TPLO-treated dogs. Osteoarthritis score progressed more after TTA (P = .003) and in dogs with bilateral surgery (P = .022). Hundreds of thousands of dogs have been treated by TPLO and TTA surgery for cranial cruciate rupture.
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