Canine Stifle Biomechanics Associated With Tibial Tuberosity Advancement Predicted Using a Computer Model

Abstract

Model-predicted stifle ligament loads improved following TTA compared to the CrCL-deficient stifle, but TTA did not restore CrCL-intact stifle biomechanics. The TTA effectively reduced tibial translation, but tibial rotation was not stabilized.

Major complications of tibial tuberosity advancement in 1613 dogs

“…Implant failure can be caused by surgical error, damage to the fork during insertion, cycling of the hardware, poor bone quality, or poor owner compliance with postoperative exercise restriction. Since its introduction in small animals, research on postoperative complications, implant biomechanics, and advancement of software technology have led to refinement in preoperative planning and implant selection for TTAs . The authors now use lateral stifle radiographs with the limb in full extension, rather than at 135 degrees of flexion for preoperative measurements.…”

“…Since its introduction in small animals, research on postoperative complications, implant biome-chanics, and advancement of software technology have led to refinement in preoperative planning and implant selection for TTAs. 6,9,24 The authors now use lateral stifle radiographs with the limb in full extension, rather than at 135 degrees of flexion for preoperative measurements. Similarly, transparent common tangent overlay 24 or software (Orthoplan, Sound-Eklin, Carlsbad, California) are used to select cage and plate size.…”

“…Tibial tuberosity advancement (TTA) is designed to align the patellar tendon perpendicularly relative to the tibial plateau, by displacing the tibial tuberosity cranially. This advancement neutralizes tibiofemoral shear forces and allows return to function despite deterioration of the cranial cruciate ligament (CrCL) in the dog stifle . TTA is an accepted surgical procedure to manage lameness associated with cruciate ligament disease in dogs .…”

“…This advancement neutralizes tibiofemoral shear forces and allows return to function despite deterioration of the cranial cruciate ligament (CrCL) in the dog stifle. [1][2][3][4][5][6] TTA is an accepted surgical procedure to manage lameness associated with cruciate ligament disease in dogs. 2,[7][8][9][10][11][12][13][14][15] Postoperative complications associated with the TTA procedure include bone fracture (1-5.1%), 2,10,11,[16][17][18] implant failure (0.8-2%), 2,7-9 patellar luxation (0.8-1%), 2,7,17 postliminary meniscal tear (3.1-25.4%), 2,[7][8][9][10][11][12] and infection (0.5-5.3%).…”

A modified Maquet‐tibial tuberosity advancement technique for treatment of canine cranial cruciate ligament disease: Short term outcome and complications

“…9,15,19,23,24 After stifle exploration via arthroscopy or a caudo-medial arthrotomy, the partial frontal osteotomy extended from the tubercle of Gerdy to the tibial crest cut-back zone. An X-Gen stainless steel TTA plate (Securos, Fiskdale, Massachusetts) was precontoured (before advancement based on anticipated final contour of the advanced tibial crest) and placed on the tibial crest with 2.4 mm self-tapping cortical screws.…”