TTA2 another challenge

TTA -TPLO
Slobodan Tepic

versus

Barclay Slocum

TTA
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TTA: advancement of tibial tuberosity to neutralise shearing

forces in stifle
Presented in 2000 by Slobodan Tepic as a novel procedure to
treat ACL
Not patented procedure
Based on Maquets experiment in humans
Since then lots of alternative procedures on the market

Forces in TTA

Alternative procedures
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Maquets procedure in huModified Maquet procedure in humans

(1963)
TTA
TTA with screws
Rapid TTA
Porous TTA
Insorvet cages
TTA2 (2014)

MMP ( Modifed Maquet Procedure)

Orthomed- Malcom Ness

Porous tta

TTA with screw

TTA rapid

TTA 2

Why TTA 2
reduce the risk of infections
reduce iatrogenic damage to the tuberosity
accelerate incorporation of the implant into
the bone
shorten the surgery time
less implants minimize stock of implants
cost?

TTA2 procedure
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Medial approach tibia

Use of saw guide
Osteotomy in saggital plane
Secure distal part with PDS
Use of spacer to open the gap ( slowly..)

TTA2 procedure

TTA2 procedure

Normal outcome

Normal outcome

Normal outcome

Normal outcome

Normal outcome

Complications:
Spanish waterhound 6 y

Complications:
Spanish waterhound control 4 w

Complications:
Spanish waterhound control 2 mo

Complications:
Braque 4 y
postop

Complications:
Braque 4y control 4 weeks

Complications:
Braque 4y control 2 months

Complications:
Leonberger 75 kg bilateral problem
3 months

Complications:
Leonberger 75 kg bilateral problem

Left stifle classic TTA 2013

Right stifle cruciate

rupture 2014

Complications:
Leonberger 75 kg bilateral problem

Complications:
Leonberger 75 kg bilateral problem

Complications:
Leonberger 75 kg bilateral problem
2 months

Complications:
Leonberger 75 kg bilateral problem
3 months

Complications:
Leonberger 75 kg bilateral problem
3 months

Complications:
Beagle 22 kg 4y

Complications:
Beagle 22 kg 4y

Complications:
Beagle 22 kg 4y

Complications:
Beagle 22 kg 4y

Complications:
Beagle 22 kg 4y

Complications:
Golden retriever 35kg 9y

Complications:
Golden retriever 35kg 9y
Fracture + infection

Complications:
Beagle 22 kg 4y

AbstractSend to:
Vet Comp Orthop Traumatol. 2014;27(2):148-54. doi: 10.3415/VCOT-13-06-0071. Epub 2014 Jan
20.
Tibial tuberosity fracture as a complication of tibial tuberosity advancement.
Calvo I1, Aisa J, Chase D, Garcia-Fernandez P, San Roman F, Bennett D.
Author information
Abstract
OBJECTIVES:
To retrospectively compare two clinical subsets of dogs suffering tibial tuberosity (TT) fracture
(incidental finding or sudden onset severe lameness) as a complication of tibial tuberosity
advancement (TTA) and to report the surgical management and outcome of TT fracture as a
complication of TTA.
MATERIAL AND METHODS:
The medical records of 10 dogs with eleven TT fractures or crest fractures after TTA were reviewed.
The outcome and complications were determined from clinical and radiographic follow-up
examinations. Limb function was evaluated between six and 12 weeks postoperatively. Owners
were contacted by phone for long-term follow-up at least six months after the last examination.
RESULTS:
Four dogs required surgical stabilization and six dogs had conservative management. In the
surgical group, every case experienced a sudden non-weight-bearing lameness after the initial TTA