Hi,

Has anyone else had this procedure done on a large breed (e.g. rottweiler), or any breed for that matter.  I know the usual procedure is a TPLO but I'd really like to hear from anyone with experience of the TTA and the recovery process.

Thanks

tio (bullmastiff) had a cruciate repair where his leg was broken and part plated (no idea which one that was, he wasn;t with us at the time) and he's recovered pretty well, he favours the leg a little tiny bit (it took a vet looking very very closely to spot it).

he was at the young stupid age though at the time and needed to be crated and sometimes sedated to get it healing.

i hope your rotties alright

I only have experience of TPLO for Cruciate Rupture (with a very successful outcome)..................what does TTA involve?

hey, i know some of the orthapedic surgeons have started doing this procedure at Glasgow University Small Animal Hospital, they also do TPLOs. To be honest im not an orthopedic nurse so not sure exactly what the criteria is for choosing which procedure to do, basically involves a different type of plate and different approach surgically. as far as im aware the recovery time etc is similar. Would be best to speak to an expert about the differences.

TIBIAL PLATEAU LEVELING OSTEOTOMY (TPLO)

This procedure uses a fresh approach to the biomechanics of the knee joint and is meant to address the lack of success seen with the above technique long term in larger dogs. With this surgery the tibia is cut and rotated in such a way that the natural weight-bearing of the dog actually stabilizes the knee joint. As before the knee joint still must be opened and damaged meniscus removed. The cruciate ligament remnants may or may not be removed depending on the degree of damage.


The TPLO rotates (as indicated by the arrow) the sloped tibial plateau until it is perpendicular to the line between
the stifle and the hock joint centers


This surgery is complex and involves special training in this specific technique. Many radiographs are necessary to calculate the angle of the osteotomy (the cut in the tibia). At this time the TPLO is felt by many experts to be the best way to repair a cruciate ligament rupture regardless of the size of the dog and is especially appropriate for dogs over 50lbs. This surgery typically costs twice as much as the extracapsular method and requires a specialist.

Typically, most dogs are touching their toes to the ground by 10 days after surgery although it can take up to 3 weeks.
 
As with other techniques, 8 weeks of exercise restriction are needed.
 
Full function is generally achieved 3 to 4 months after surgery and the dog may return to normal activity.
TIBIAL TUBEROSITY ADVANCEMENT (TTA)

The TTA represents another take on how to use the biomechanics of the knee to create stabilization. The idea is that when the cruciate ligament is torn, the tibial plateau (the top of the tibia) and the patellar ligament should be repositioned at 90 degrees to one another to combat the shear force generated as the dog walks. To make this happen, the tibial tuberosity (front of the tibia where the patellar ligament attaches) is separated and anchored in its new position by a titanium or steel "cage," "fork," and plate. Bone grafts are used to assist healing. This procedure was developed in 2002 at the University of Zurich and since then over 20,000 patients worldwide have have had this surgery. Some experts prefer it to the TPLO while others prefer the TPLO. Both procedures require specialized equipment and expertise.

Typically the leg is bandaged for a week after surgery.
 
The patients activity must be restricted and confinement is a must post-operatively with gradually increasing activity over 3-4 months. Most dogs can return to normal activity by 4 months after surgery.
INTRACAPSULAR REPAIR (sometimes called the "over the top" method)

We mention this procedure for its historical significance though it is not one of the "big three." This procedure has fallen out of favor lately as it has been unable to demonstrate results superior to those of the extracapsular technique described above though apparently it is still a popular repair method in the U.K.

Intracapsular repair intuitively seems like it should do better as it uses living tissue (rather than an artificial material) to essentially make a new ligament. This takes more time surgically. As with the extracapsular repair, the knee joint is opened, fragments of the ligament are removed, as is damaged meniscus. After this a strip of connective tissue is dissected locally and passed through the middle of the joint exactly where the cruciate ligament used to be. The "new ligament" is attached at the opposite end to an implant or simply
 sewn into place.

Bandaging for a couple of weeks after surgery is commonly recommended.
 
Again, the dog may not bear weight for a good two weeks after surgery and will likely require 2 months to return to normal function.
 
Again, 8 weeks of exercise restriction will be necessary for healing.
General Rehabilitation after Surgery

Thanks for all the replies :)  My dog has already had the op but I just wondered if anyone had any first hand knowledge of it being done on their own dog as I wondered if my dog is progressing okay as he was weight bearing and now isn't.  He's off to the vet on Thursday, but I thought it might be good to see what others have experienced.

Thanks

wow kenya, good post :)

> TIBIAL TUBEROSITY ADVANCEMENT (TTA)
>
> The TTA represents another take on how to use the biomechanics of the knee to create stabilization. The idea is that when the cruciate ligament is torn, the tibial plateau (the top of the tibia) and the patellar ligament should be repositioned at 90 degrees to one another to combat the shear force generated as the dog walks. To make this happen, the tibial tuberosity (front of the tibia where the patellar ligament attaches) is separated and anchored in its new position by a titanium or steel "cage," "fork," and plate. Bone grafts are used to assist healing. This procedure was developed in 2002 at the University of Zurich and since then over 20,000 patients worldwide have have had this surgery. Some experts prefer it to the TPLO while others prefer the TPLO. Both procedures require specialized equipment and expertise.
>

pretty sure thats what Tio had.

My boy had the op (not sure which one ) At first he seemed to limp a little more than before the op and i started to worry , but he was soon bouncing on the trampoline once he had done his 8 week crate sentence .Also he seemed a little stiff sometimes if he had been led for a while but now he is back to full throttle ...You would not beable to tell which leg it was if his hair was fully grown in ...(poor boy still has a baldyish leg compared to his other)He went for a little hydrotherapy but we found he got too excited and was scared he would damage himself more ...

Hi, Hope everything is going ok.  One of my mastiffs had a tplo done Dec 2007. It is quite long road to recovery.  Just to complicate things she had the plate removed a year and a half later as a secoma kept appearing over the plate site (one of the screws was slightly infected).  Didnt realize they could be removed but apparantely this is becoming more common. The recovery is the main key to the success of this operation (slowly,slowly).  I had a super ortho surgeon (took a while to track down) that had experience of giant breeds so this helped.  The vet school were going to double up a plate, as he put in the "mastiff "plate(that is what it is called), I knew I had made the right descision to go with him.  I did ask him about the tta op, but said it was relatively knew and he was happier with tplo results.  She has full use of her leg. I spent 2 months sleeping in the kitchen with her, it is a lot of work, but worth it in the end. 

my lab had her cruciate ligament repaired with keyhole surgery so it was weight bearing on the same day (important as she only had one back leg) surgery was brilliant recovery very swift she could walk the day after the op, and it never bothered her again  Hers was done at liverpool uni

Interesting to read about all the different procedures people have had done.  My vet can't find anything wrong with the leg, so I think I'm just expecting too much too soon!  Thanks everyone.