TPLO (Tibial Plateau Leveling Osteotomy) and TTA (Tibial Tuberosity Advancement)

For those who taught the TPLO (Tibial Plateau Leveling Osteotomy) surgery and rehab regimine are frightening. Here are information to help those pet owners whose dogs are diagnosed with torn ACL in the leg.

Another surgery for CCL (Cranial Cruciate ligament) issues called a TTA (Tibial Tuberosity Advancement). The TTA is a newer surgery that some vets are doing versus the TPLO. Ortho specialist only does TTA's unless the dogs bone structure won't allow.

The TTA is made of titanium instead of surgical steel, which is better. The TTA is less invasive (cuts less bone) than TPLO. There seem to fewer problems with the TTA than TPLO. However, the LSS (lateral suture stabilization)/traditional repair is probably the best repair. It has fewer complications, fewer infections and is less invasive. You dont' have to go to a specialist to get it done. It's a lot less expensive.

The TPLO is the favorite of most ortho vets, because only they can do it, as oppesed to the traditional repair which is done by general vets. The TPLO has been around longer, so most vets already know how to do it and are comfortable with it. The TPLO was developed for a large dog with a certain angle to the knee. Now they do it for all size dogs and with all kinds of angles. Someone posted on Orthodogs a few months back that their 15 lb. dog had had a TPLO. That's insanity. It would probably have healed with CM in the first place and it definitely would not require a TPLO. The TTA takes new training. so it's not done by as many vets. It also requires a specialist and is not done by a general vet.

Another thing the specialist will tell you - that you have less arthritis with TPLO than with a traditional repair. Research does not bear this out. A previous study had seemed to indicate that would be the outcome, but said more data was needed to come to a good conclusion. They didn't have enough dogs in the study to verify that conclusion. Neither did they have a baseline, in other words, they didn't know how much arthritis each dog had before the knee repair. The study was regularly quoted anyway.

In a study released earlier this year, they found that there was no statistical difference in the severity of arthritis in dogs with TTA, TPLO and the traditional repair. The dogs were looked at before surgery, at 6 months, 12 months, 18 months 24 months.

Unfortunately, I've lost a lot of respect for ortho surgeons over the last two years. If they aren't intentionally misleading people, then they aren't reading the studies that been published and are quoting what they have heard. What they say is not what the published studies say.

I know studies are not perfect. There are problems with all of them. However, If it comes to what the vet thinks is true or has heard and what the controlled studies have found, I'll believe the study.

Posted in Cranial cruciate ligament , Dog Health , lateral suture stabilization , ortho surgeons , surgery , TPLO , TTA