Both TPLO and TTA surgeries address stifle instability by leveling the plateau angle. With dog physical therapy, dogs can achieve the best possible outcomes of TPLO or TTA procedures. TTA and TPLO both appear to be excellent procedures for the treatment of cranial cruciate ligament injuries in medium and large breed dogs. We found out yesterday that Rukus (our 6 yo black lab) ruptured the CCL in his right leg. The mean age of the dogs was 5.5 years (range 10 months to 11 years) for TPLO and 4.2 years (range 10 months to 12 years) for TTA. During the procedure, the surgeon uses a specially curved saw to make a cut (osteotomy) on the top surface of the tibia. The TTA is surgically less invasive than the TPLO. Quality of life should be a consideration, most dogs with an experienced surgeon with something like a TPLO or TTA typically return to full function after they are fully recovered, fetch included. Materials and Methods. TTA does not have a quicker recovery time than TPLO. TPLO vs TTA In Dogs. Following a TTA or a TPLO surgery, our patients need to have strict crate restriction for a few weeks. TTA or TPLO? Outcomes-Based Patient Care in Veterinary Surgery:What Is An Outcome Measure? Take into consideration that your pet will be wearing an e-collar the first 2 weeks after surgery. dogcollarsharnessesandleashes. Key Points: CBLO and TPLO surgery both use a radial cut osteotomy to level the tibial plateau. Feb 7, 2012. TTA vs TPLO - Similar until there are complications By: Kate Fitzwater, DVM, MS, DACVS Cranial cruciate ligament rupture is the most common orthopedic injury in dogs. October 31, 2008. 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. At the last minute, we decided to take our American mastiff Freyja with us on the trip. The surgical techniques contributing to its success include a significantly less invasive osteotomy and the lack of compromise to the weight bearing axis of the tibia. The surgeon will place a stainless-steel bone plate, which holds the two pieces of tibia together, until the osteotomy site heals after about eight to twelve weeks of recovery. Again subjectively, some surgeons believe that TPLO is better for more active or athletic dogs. The TTA, which is the newest procedure, and probably the best repair for most dogs. She is pointed a bit outward. What’s the difference? TPLO vs TTA vs Extracapsular Suture Repair All three of these surgeries may produce excellent outcomes, and have situations where one may be preferred over the other. Conventional surgical procedures are much less invasive and less expensive than TPLO or TTA. CBLO and TPLO surgery. In our experience, the patient experience in the immediate post-operative period appears to be improved over other active and passive stabilization techniques such as TPLO and extracapsular lateral suture imbrication. Several surgical techniques for the condition have been developed including: The two most commonly recommend corrective surgeries are the TPLO and TTA procedures. Mar 14, 2011. my vet was telling me about a new procedure tta has anyone had this done in stead of tplo? The surgical procedure involves a radial (semi-circular) osteotomy of the proximal tibia, rotation of this proximal tibial segment and internal fixation with a bone plate and screws (Figures 3 & 4). The TTA advances the tuberosity and is kept in place by inserting a titanium cage that bone grows through. Dogs appear to be more comfortable in the first few post-operative days, as evidenced by early, strong weight-bearing. 12° or 20°? No surgery comes without risks. Unfortunately, dogs can’t tell us how they feel following a surgery. The primary reason we opted against TTA is that the surgeon in our area recommended TLPO for our pup. CL Aragon, SC Budsberg. Removal of implants from a TTA surgery can be much more difficult and have a higher risk of bone fracture, compared to the relatively easy removal of a TPLO plate. We had planned to go on a hike as a family, to Sedona Arizona on the West Fork Trail. Vet Surg (2007) 36:573–586. The long-term outcome appears to be equivalent to the TPLO procedure, based on our experience and indirect comparison of published evidence. A dog’s outcome, much like complications, is largely determined by the experience of the surgeon, the quality of post-operative care, and adherence to recommended rehabilitation (dog physical therapy) protocols. There are less data on the TTA than the TPLO, but results are similar. Percent of function >1 year after surgery was 93.1% + 10.0% for TPLO, 92.7% + 19.3% for TR, and 89.2% + 11.6% for TTA. explains how to do measurements for TTA and TPLO properly. Thank you for submitting your request for an In-clinic Referral Surgery with Direct Veterinary Surgery/Dr. A good size is a crate in which your pet can stand up and turn around comfortably. I have a dog that I did a tplo on at 4yrs and a tightrope on the other leg at 7yrs. Full-weight bearing, however, has been shown to be better with a TPLO at six months of age. 4600 sounds high to me for a TPLO but it will vary depending on area, locally (west US) they go for 3k to 3500 at our teaching hospital. Intracapsular reconstructive techniques, using fascia lata or other natural substitutes, due to documentation of decreased weight-bearing at objective recheck evaluations compared with normal dogs, and better results with other procedures1 2. We don't know how they came to this conclusion. Currently, most veterinary surgeons consider TPLO and TTA to be the preferred treatments for larger, more active dogs. We have been performing the TTA successfully for four years now. Zlig (vormals: VetLig) ist eine schonende, die natürliche Physik nachbildende Methode des Kreuzbandersatzes für mittelschwere und schwere Hunde. Proceedings of the 1st World Orthopaedic Veterinary Congress; Munich Germany, September 2002, p. 152. Dr. Roger Welton is a practicing veterinarian and highly regarded media personality through a number of topics and platforms. But the knee never stabilized completely. The bottom line is this, if money is absolutely no concern, then a TPLO or TTA (according to the America College of Orthopedic Surgeons) would be the best choice for a young, active dog over 20kg. In our experience, patients recover with better long-term results than traditional passive stabilization techniques, such as extracapsular lateral suture imbrication. Everything from patient compliance to client financial concerns to the availability of surgical equipment and expertise will impact how a case moves forward. Dr. Slocum noticed that some dogs had an abnormal slope of the knee (tibia), which put added pressure on the ligament and predisposed dogs to developing CrCLD. Determining Factors: When Is Surgery Needed for a Cruciate Tear in a Dog. The surgeon then rotates the cut portion of bone to create a more desirable angle. Surgical repair of the cranial cruciate ligament in the dog and cat using Tibial Tuberosity Advancement (TTA). Lazarveterinarysurgery.com 4. The procedure involves a cranial tibial crest osteotomy, advancement of the tibial crest with an advancement cage (acting as a stabilizing wedge) and internal fixation of the crest with a thin, tensionband plate held in place with bone screws (Figures 1 & 2). Two recently published literature reviews 3,4 were unable to clearly identify a superior surgical procedure due to variation in study-design and commonly subjective data comparisons. TTA vs TPLO Surgery | KYON. A slower return to limb use after surgery often means more muscle loss due to disuse. Until that conclusive moment arrives, decision-making must continue with available evidence. It generally believed, however, that the more active and larger the pet, the better they will do, in both the short and long term, with a TPLO or TTA. Final Words. During surgery, the surgeon performs an osteotomy, a cut in the bone. 129919871. There are multiple surgical procedures that can be done to treat this disease, but two of the most popular “osteotomy” (cut in the bone) procedures are the TPLO (tibial plateau leveling osteotomy) and TTA (tibial tuberosity advancement). How much correction do we need? Tibial Osteotomies for Cranial Cruciate Ligament Insufficiency in Dogs. This effectively neutralizes the tibial thrust, which occurs when a dog with cranial cruciate ligament disease bears weight on an affected joint. By: Kate Fitzwater, DVM, MS, DACVS Cranial cruciate ligament rupture is the most common orthopedic injury in dogs. Here’s what they found: What's new Vimeo Record: video messaging for teams Vimeo Create: quick and easy video-maker Get started for free Dies wird jedoch den Besonderheiten der Biomechanik des Hundeknies nicht gerecht. 1) first surgery on his left knee: decided do to a TTA a few years ago, thought it was more advanced than a TPLO. Patient selection is similar to the TPLO; specific indications in our hospital are dogs that have concurrent ACL injury with a luxating patella. We packed up, prepared lunch, got ready for the children, and loaded everything into the van. – Why TTA requires less rotation than TPLO. These procedures may also be considered in smaller, more active patients and those patients with bilateral disease. Conventional stabilization surgery, done by an experienced and skilled vet, is the best choice for most dogs when surgery is needed. TPLO vs TTA. TTA uses biomechanical principles to adjust the angle of the patellar tendon. Canine Brief Pain Inventory, goniometry, and thigh circumference results indicated dogs in both groups improved after surgery, but significant differences between groups were not detected. Das vordere Kreuzband verhindert normalerweise eine Vorwärtsbewegung der Unterschenkelknochen in Relation zum Oberschenkel. Our experience with over 10,000 cases has been positive and similar to the clinical reviews in the veterinary literature6,7. – Sehr hoher Anteil guter und hervorragender OP-Ergebnisse in der Literatur! TTA implants have a slender profile and are generally made of titanium whereas TPLO implants are frequently made of stainless steel and tend to be bulky. Comparison of lateral fabellar suture and tibial plateau leveling osteotomy techniques for treatment of dogs with cranial cruciate ligament disease J Am Vet Med Assoc. Web resource for a brief TPLO explanation by the original developers: http://www.slocumenterprises.com/Articles/cranial_cruciate_ligament.htm Cranial Cruciate. He patented his technique and the instruments he developed for the surgery, and veterinary surgeons all over the world use his technique today. Postoperatively there are weekly visits for … TPLO is more common than TTA but TTA was only released into clinical practice in 2005 while TPLO … 12° or 20°? Prior to surgery, pre-operative measurements will be taken, using stifle radiographs (x-rays of the knee). So far, this TPLO has the leg straighter than the TTA , which is twisted a bit after 5 years. Beim Riss des vorderen Kreuzbandes verschieben sich Unter- und Oberschenkelknochen gegeneinander, wenn das Tier den Fuß auf den Boden setzt. Early on in the course of the disease, many clinical signs are minor or not noticed at all. TPLO und TTA werden bei Hunden mit einem vorderen Kreuzbandriss angewandt. Cost is variable by clinic but comparable between TTA and TPLO. Full-weight bearing, however, has been shown to be better with a TPLO at six months of age. Over the past 50 years, surgical treatment of CrCLR has evolved through a number of procedures, many now obsolete. J Cook. The standard TTA and TPLO remain good procedures especially in the hands of an experienced veterinary surgeon, but in my view, MMP is currently the best CCL repair procedure for dogs over 38 pounds that have suffered CCL tears. S LaFaver et al. Some potential complications of TPLO and TTA surgery include the following: Infection of the implant is one of the more common complications associated with these procedures, although implant infection risk is low at 7.4%. TPLO and TTA offer some benefits over older procedures such as extracapsular repairs (ECLS), especially for larger or athletic dogs. https://www.pethealthhospital.com/wp-content/uploads/2019/11/tta-or-tplo-header.png, https://www.pethealthhospital.com/wp-content/uploads/2017/08/footer-logo.png. J Am Vet Med Assoc (2003) 222:1726–1732. The gender distribution was 38 males and 36 females for TPLO and 36 males and 36 females for TTA. TTA vs TPLO The Tibial Tuberosity Advancement (TTA) is a procedure developed in Zurich, Switzerland in the early 2000s (1). Jan 12, 2021 - Comparison of TPLO and TTA ccl repair surgery for cranial cruciate ligament injuries in dogs. While the vast major of Board Certified Surgeons will tell you that the TPLO is the gold standard, research (and their own certifying body) shows no difference between the efficacy of the TPLO and TTA procedures, so the choice will be made based the anatomy of your dog and the experience and comfort level and experience with each procedure of your veterinarian. CrCLD eventually leads to a cruciate tear in a dog, and 50% of dogs with a ruptured ligament will tear the other ligament within the following six to twelve months. Dogs that receive the TTA procedure get back to using their operated limb approximately 2 weeks faster than dogs that receive a TPLO. TPLO, TTA or lateral suture? TPLO vs TTA. The TPLO keeps the rotated bone segment in place using a plate. The difference is that TPLO cuts a weight bearing bone, TTA cuts a … The Tibial Plateau Leveling Osteotomy (TPLO) is a procedure developed in Eugene, Oregon in the early 1990s(2). Cranial cruciate ligament rupture is the most common orthopedic injury in dogs. Hi all, It's been a looooong time since I've posted anything here, and am hoping for some advice. The greatest number of complications with a lateral suture stabilization occur in younger, more athletic dogs. TPLO / TTA -- Not Good Choices for Most Dogs with Ligament Injury. This procedure was developed in Zurich, Switzerland in the early 2000s. Which Surgical Method Is Best for My Dog’s Cruciate Ligament Rupture? Vet Surg (2007) 36:187–189. The TTA and TPLO share similar advantages and disadvantages. The principles of evidence-based medicine decision-making will undoubtedly be useful for answering this question as we collect more data in a prospective and standardized manner3. This lameness usually worsens with exercise and seems to improve with rest. Consequently, more physical therapy is often required to regain the lost muscle mass in dogs that have the TPLO procedure. The TTA is a geometry-altering technique similar to the TPLO. Vet Surg (2005) 34:93–98. The biomechanics behind its success for correcting cranial cruciate ligament-deficient stifles is a change in the patellar tendon angle that effectively neutralizes the tibiofemoral shear (tibial thrust) that occurs during weight bearing. Applications of Evidence-Based Medicine: Cranial Cruciate Ligament Injury Repair in the Dog. Minor complications include: incisional infection/inflammation, seroma, and wound dehiscence. Web-based PDF document for a brief TTA explanation by the original developers: Force plate gait analysis was performed at 1 time point for the normal control group and preoperatively, and at 2 and 8 weeks and 6 and 12 months postoperatively for the treatment groups. TTA can have a potential advantage over TPLO in the immediate post-operative period, as dogs subjectively sometimes appear to be more comfortable and bear more weight because the TTA involves a less invasive osteotomy or cutting of the bone. he was able to swing his knee inside his cone (long legs) and chew on his knee after that, he opened it up 8 more times in 8 weeks. Inaugural-Dissertation zur Erlangung der tiermedizinischen Doktorwürde der Tierärztlichen Fakultät der Ludwig-Maximilians-Universität München von Monika Höpfl aus Landshut München 2011 ); – kürzere OP Dauer mit geringerem Narkoserisiko; – deutliche geringeres Infektionsrisiko des Gelenks (unter 2 % gegenüber 10 bis 12 % bei TPLO). Surgery went great, but he opened up the entire incision after the stitches came out WITH his cone on, not kidding…. As an example of how we facilitate this decision for clients and patients who present to our practice, we recommend TTA as our procedure of choice for most of these cases due to the more rapid ability to bear weight, a lower complication rate, a less painful convalescence, and high owner satisfaction. Advancement of the tibial tuberosity for the treatment of cranial cruciate deficient canine stifle. The goal of a TPLO surgery is to reduce the angle of the tibia’s slope. Peak vertical force of affected hind limbs at a walk and trot was 5% to 11% higher for dogs in the TPLO group versus those in the LFS group during the 12 months after surgery. The decision between TPLO and TTA is based purely on the opinion of your surgeon and their personal technical experience. Slobodan Tepic, sr.sci. Vet Surg (2008) 37:111–125. Most websites about TPLO and TTA are the sites of surgeons who are selling these high-profit surgical procedures. The Tibial Tuberosity Advancement (TTA) is a procedure developed in Zurich, Switzerland in the early 2000s (1).
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