A Dog's Cranial Cruciate Ligament
The cranial cruciate ligament is one of the two ligaments in a dog's knee, it's a band of connective tissue that helps connect the femur and tibia (the bones located above and under the knee) allowing the knee to function. This is also the ligament that is most prone to getting injured.
A dog's cranial cruciate ligament (CCL) is similar to the anterior cruciate ligament (ACL) in humans and just like the rupture of the cruciate ligament in dogs, people are often subject to ACL tears.
A dog's cruciate ligament can rupture suddenly (acute rupture) or slowly tear, getting worse until a complete rupture occurs.
Tibial Tuberosity Advancement (TTA) Surgery
Tibial Tuberosity Advancement surgery is a less invasive surgery than other types of surgical procedures used to treat a torn CCL such as TPLO surgery (Tibial Plateau Leveling Osteotomy).
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 in order 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 start by assessing your dog's knee to determine the extent of the injury, its severity, and if Tibial Tuberosity Advancement surgery is the best option for your dog's treatment. Some tests and diagnostics your vet might conduct 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 at a later date.
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. And 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 then are 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 oftentimes patients can go home the day after their TTA procedure.
After Surgery Care
Your dog's rehabilitation after their surgery may take several months and it's imperative to follow the post-operative care instructions your vet gives you carefully. Your vet will prescribe a course of antibiotics and painkillers at the time your dog is sent home after their surgery. If your dog has a habit of licking their wound they may also need to wear an Elizabethan collar while the incision site heals.
You will need to visit your vet during the first couple of weeks following your dog's surgery so they can check in on the recovery process, as well as remove any sutures.
It's imperative to your dog's recovery that you restrict their activity and movements, limiting it to toiletry purposes only. You must keep them on a leash to prevent any running, stair climbing, and jumping. When they are off of their leash you must keep your pup in a small room or pen to prevent these movements. After several weeks have passed you may gradually increase your dog's activity and movement.
After approximately 6 to 8 weeks have gone by since your pooch's procedure you will have a follow-up appointment with your veterinarian. At this visit, your vet will monitor the function of your dog's leg, take X-rays to assess the healing of the cut bone, and provide you with advice about 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 and most dogs go on to make a smooth and complete recovery 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.