Tibial Tuberosity Advancement

Tibial Tuberosity Advancement (TTA) is a surgery performed on dogs who have sustained cranial cruciate ligament injury (the “ACL” in people). The cranial cruciate ligament plays a crucial role in making sure the tibia bone does not slip out and forward from the stifle joint. ACL rupture in dogs is one of the most common causes of hindlimb lameness, and it almost always requires surgical correction.

Veterinarians can diagnose ACL rupture in dogs with a physical exam and radiographs (x-rays). Many reasons are reported to be the cause of this injury such as obesity, chronic degenerative joint disease, genetic conformational abnormalities, or excessive athleticism. These injuries are more common in large breed dogs verses small breed dogs.

The goal of the TTA surgery is to limit this tibial thrust, which can be quite painful. The goal is to transfer the load of the joint from the patellar ligament to the quadriceps muscle. To achieve this, the surgeon makes a cut into the tibial tuberosity (bone). The tibial tuberosity is advanced into a position perpendicular to the tibial plateau, thus removing the load from the ruptured cruciate ligament. To keep this newly positioned tibial tuberosity in place, a stainless steel implant is secured to the bone, and a spacer and bone graft material is placed into the cleft between the bones. This helps to stabilize the joint. Physical therapy is required after surgery to help the healing process. Many patients area walking better when they leave the hospital postoperatively.