Tibial tuberosity advancement for stabilization of the canine cranial cruciate ligament-deficient stifle joint: surgical technique, early results, and complications in 101 dogs

Vet Surg. 2007 Aug;36(6):573-86. doi: 10.1111/j.1532-950X.2007.00307.x.


Objective: To describe the surgical technique, early results and complications of tibial tuberosity advancement (TTA) for treatment for cranial cruciate ligament (CrCL)-deficient stifle joints in dogs.

Study design: Retrospective clinical study.

Animals: Dogs (n=101) with CrCL-deficient stifles (114).

Methods: Medical records of 101 dogs that had TTA were reviewed. Complications were recorded and separated into either major or minor complications based on the need for additional surgery. In-hospital re-evaluation of limb function and time to radiographic healing were reviewed. Further follow-up was obtained by telephone interview of owners.

Results: Complications occurred in 31.5% of the dogs (12.3% major, 19.3% minor). Major complications included subsequent meniscal tear, tibial fracture, implant failure, infection, lick granuloma, incisional trauma, and medial patellar luxation; all major complications were treated with successful outcomes. All but 2 minor complications resolved. The mean time to documented radiographic healing was 11.3 weeks. Final in-hospital re-evaluation of limb function (mean, 13.5 weeks), was recorded for 93 dogs with lameness categorized as none (74.5%), mild (23.5%), moderate (2%), and severe (1%). All but 2 owners interviewed were satisfied with outcome and 83.1% reported a marked improvement or a return to pre-injury status.

Conclusions: TTA is a procedure comparable with alternate methods of CrCL repair with expected good to excellent functional outcome.

Clinical relevance: TTA procedure can be successfully used to obtain the dynamic stability of a CrCL-deficient stifle joint in dogs.

MeSH terms

  • Animals
  • Anterior Cruciate Ligament / pathology
  • Anterior Cruciate Ligament / surgery*
  • Anterior Cruciate Ligament Injuries
  • Biomechanical Phenomena
  • Dogs / surgery*
  • Female
  • Injury Severity Score
  • Joint Instability / pathology
  • Joint Instability / surgery
  • Joint Instability / veterinary
  • Lameness, Animal / epidemiology
  • Male
  • Postoperative Complications / epidemiology
  • Postoperative Complications / veterinary*
  • Reoperation / veterinary
  • Retrospective Studies
  • Rupture / pathology
  • Rupture / surgery
  • Rupture / veterinary
  • Stifle / injuries
  • Stifle / pathology
  • Stifle / surgery*
  • Tibia / injuries
  • Tibia / pathology
  • Tibia / surgery*
  • Time Factors
  • Treatment Outcome