The Tibial Tuberosity Advancement (TTA) is a procedure that is currently being used to surgically treat cranial cruciate ligament disease in dogs.  The procedure utilizes an osteotomy (cut in the bone) to change the biomechanics of the joint and neutralize the cranial tibial thrust (instabiltiy) that is found in a cranial cruciate deficient stifle.

In order to neutralize the cranial tibial thrust with the TTA, you have to basically get the patellar ligament perpendicular (90 degrees) to the tibial plateau.  By doing this, it basically balances the hamstrings and quadriceps muscles as they cross the stifle joint and negates the cranial tibial thrust. The procedure provides active stabilization. So, dogs that have had a TTA done will have then benefit of a stable knee joint by way of the muscles when they are active on the leg! The muscles will work together to stabilize the stifle and resist cranial translation of the tibia in relation to the femur.

The TTA advances the patellar ligament forward so that the joint surface and patella tendon are at 90 degrees to each other.  It is held there with a titanium plate, screws and spacer until the bone heals permanently.

I have trained in  performing the TTA  and have been performing the procedure for 7 years. I like this procedure because the complications with the TTA are minimal and tend not to be as devastating as I have seen with other procedures for treating cranial cruciate ligament disease. The procedure also allows dogs do get back to a very high activity level even if they are working dogs.

If you would like more in depth information regarding cranial cruciate ligament disease and treatment options in dogs please follow this link (CCLD in depth).