Relationship between Tibial conformation, cage size and advancement achieved in TTA procedure

Meeson, Richard; Corah, Louise; Conroy, Megan; Calvo, Ignacio

doi:10.1186/s12917-018-1433-0

Cited by 9 publications

(21 citation statements)

References 21 publications

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“…The 6‐mm cage resulted in a median tTTA of 4.3 mm, but it was not significantly different from 4.5 mm. The underadvancement measured in this study was greater in magnitude compared with previous studies …”

Section: Discussioncontrasting

confidence: 83%

“…This study was designed to measure tTTA and to calculate underadvancement for the most commonly used TTA cages. On the basis of the previously described mathematical model and a recent retrospective study, it is not surprising to find the tTTA less than the TTA cage sizes . In our study, the discrepancy was substantially greater in magnitude compared with the mathematical predictions or radiographic measurements.…”

Section: Discussionsupporting

confidence: 53%

“…From our data, a cage size of 9 mm should lead to tTTA of 7 mm, whereas the calculated model showed an advancement of 8.2 mm when the desired advancement was 9 mm with a TPA of 24° . The percentage underadvancement measured by Meeson et al was approximately 15.5% when 4 cages sizes were classified into 2 groups. The percentage underadvancement calculated in this study ranged from 21% to 28%.…”

Section: Discussionmentioning

confidence: 84%

“…Numerous theories have been proposed for underadvancement during the TTA. Variations in tibial anatomy contribute to the degree of underadvancement due to the shape of the commercially available TTA cages . The cages are designed in a trapezoid shape to accommodate the tibial tuberosity's traveling pattern, pivoting at the distal end of the osteotomy.…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that there is a severe underestimation of the required distance for TTA when the TPA is larger than 31° . More recently, it has been suggested that the tibial conformation has a greater influence on the underadvancement of tibial tuberosity compared with TPA . Meeson et al also stated that the current TTA implant design and cage positioning recommendation leads to underadvancement compared with the cage size selected.…”

Section: Introductionmentioning

confidence: 99%

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Discrepancy between true distance of tibial tuberosity advancement and cage size: An ex vivo study

et al. 2018

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Objective: To determine the discrepancy between true distance of tibial tuberosity advancement (tTTA) and the most commonly used cages. The null hypothesis was that tTTA would be within 1.5 mm difference of the cage size. Study design: Ex vivo study. Sample population: Eight foam cortical shell specimens modeled from canine tibias. Methods: Modified tibial tuberosity advancement (TTA) was performed to allow repeated measurement of the tTTA. The Pearson correlation test was used to evaluate the relationships of tTTA and cage sizes (P < .05). The difference between tTTA and cage size was calculated to establish the degree of underadvancement during the TTA. Results: Two hundred forty tTTA measurements were recorded. The tTTA was less than each corresponding cage size (P < .001). Four cage sizes resulted in a difference greater than 1.5 mm (P < .001-.04). The 6-mm cage resulted in median tTTA of 4.3 mm, which did not differ significantly from 4.5 mm (range, 3.2-6.65). The median underadvancement ranged from 1.7 to 2.5 mm for the tested cage sizes. The percentage underadvancement ranged from 21% to 28% for the tested cage sizes. Conclusion: The tTTA was less than the corresponding cage sizes by at least 1.5 mm in all except the 6-mm cage. Clinical significance: Selection of a larger cage size during the TTA may be advantageous to compensate for underadvancement and to minimize the risk of residual cranial tibial translation.

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Section: Discussioncontrasting

confidence: 83%

Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Discrepancy between true distance of tibial tuberosity advancement and cage size: An ex vivo study

et al. 2018

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A retrospective evaluation of complications associated with forkless tibial tuberosity advancement performed in primary care practice

Matchwick¹,

Bridges

Scrimgeour

et al. 2020

Veterinary Surgery

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Objective: To report postoperative complications associated with forkless tibial tuberosity advancement (TTA) performed in primary care veterinary practice and to compare results with previous publications. Study design: Retrospective study. Sample population: Three hundred seventy-four forkless TTAs in 329 dogs performed by six nonspecialist veterinarians. Methods: Medical records of dogs treated with a standard forkless TTA (2013-2016) and with at least 12 months of postoperative follow-up were reviewed. Complications recorded by the referring practice or the operating veterinarian were classified as minor (medically treated) or major (surgically treated). Results: Complications occurred in 57 of 374 (15.2%) TTAs; 28 (7.5%) complications were major, and 29 (7.7%) complications were minor. Postliminary meniscal injuries were documented in 12 of 374 (3.2%) TTAs (12/57 major complications) and were more common when the ratio of cage size to bodyweight was ≤0.25 (P = .019). Mean TTA (cage size) was greater in this population than what has been previously reported for a lower median bodyweight. Conclusion: The incidence of major complications was low and within the range previously reported for TTA in referral practice after adjusting for study design. The magnitude of advancement was greater, and the incidence of postliminary meniscal injury was lower than what has been previously reported, after accounting for dogs that had a preliminary meniscal injury or medial meniscal release. Clinical significance: Forkless TTA may be successfully performed by experienced veterinarians in primary care practice with a low rate of complications. The incidence of postliminary meniscal injury may be reduced by a greater degree of advancement of the tibial tuberosity.

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Short-term outcomes and complications of 65 cases of porous TTA with flange: a prospective clinical study in dogs

Bernardi-Villavicencio

Jimenez-Socorro

Rojo-Salvador

et al. 2020

BMC Vet Res

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Background: Cranial cruciate ligament rupture (CrCLR) is the most common orthopaedic cause of lameness in the hind limb in dogs. Many surgical treatments have been described, but tibial tuberosity advancement (TTA) is one of the most commonly used today. Since it was first described, TTA has evolved to reduce major complications and to arrest the progression of osteoarthrosis. The aim of this study was to assess a surgical technique called Porous TTA with flange prospectively. This study was performed in 61 dogs that underwent 65 Porous TTA with flange procedures, to validate it as an alternative CrCLR treatment. Complications and clinical outcomes (pain, lameness, weight bearing, flexion, extension, crepitation and atrophy) were reported over 3 months, i.e. at 3, 6 and 12 weeks postoperatively. Results: The results showed a positive clinical outcome, a minor complication rate of 47.69% at the first review 3 weeks postoperatively, 10.77% at the second one (6 weeks after the surgery) and 4% at the third one (at 12 weeks). Major complications were observed only at the last review, with one case that had an infection requiring implant removal; this represented 1.5% of cases. Variables evaluated for a relationship with complication scores and improvement were body condition score, sex, age, breed, body weight, breed size, side of the affected limb, traumatic anamnesis and time of lameness before surgery. No relationship was detected. Conclusions: Clinical outcomes and complications show that Porous TTA with flange is an efficient alternative for surgical treatment of CrCLR in dogs.

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Relationship between Tibial conformation, cage size and advancement achieved in TTA procedure

Cited by 9 publications

References 21 publications

Discrepancy between true distance of tibial tuberosity advancement and cage size: An ex vivo study

Discrepancy between true distance of tibial tuberosity advancement and cage size: An ex vivo study

A retrospective evaluation of complications associated with forkless tibial tuberosity advancement performed in primary care practice

Short-term outcomes and complications of 65 cases of porous TTA with flange: a prospective clinical study in dogs

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