Tibial Tuberosity Advancement: The Surgery

TTA Surgery Improves Quality of Life The Farley family adopted Lucy from the humane society when she was six months old. After five years, Lucy is truly a member of the family. "Before the TTA surgery, Lucy seemed depressed because she couldn't exercise but after the TTA surgery she is a new girl." says owner Alison Farley. "The surgery has really improved her quality of life. You should see her at home, she's a normal dog." LUCY, a five year old shepherd mix.  Weight bearing on her left rear leg less than 24 hours after surgery.

A Common Ailment Rupture of the cranial cruciate ligament (CCL) is one of the most common causes of rear limb lameness in the dog. Affected dogs typically become suddenly lame on one rear limb to the point that they can hardly bear weight on it. Some of these pets may have a history of milder lameness in the same limb that seemed to come and go before this sudden worsening of symptoms. The CCL is one of 2 ligaments that cross inside the knee (stifle) joint. The cruciate ligaments function to prevent the femur and tibia from sliding back and forth on each other.     The top of the tibia is the tibial plateau.  During weight bearing, the tendency of the femur is to slide down the tibial plateau. The ACL stops this downward slide, and therefore, is under constant tension during weight bearing. This biomechanical stress on the ligament leads it to fray and eventually tear or rupture. Consequences of CCL Rupture   As the ligament deteriorates, a combination of inflammatory factors released from the ligament and increasing instability of the joint from the weakened ligament causes arthritis to develop quickly within the joint. When the ligament is weakened or ruptured, every time the pet bears weight on the affected leg the femur slides down the tibial plateau with nothing to halt its movement. This sliding action damages a cartilage cushion in the joint called the meniscus. Once the meniscus is torn arthritic change accelerates and perceived pain worsens.   Weight bearing studies have shown that dogs with a damaged CCL bear only about 20-30% of the normal amount of weight on the affected leg. As a result, the weight is shifted to the other rear leg placing even more stress on that limb's CCL.

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