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Cruciate surgery For Large Dogs – The TTA

Specialist level cruciate surgery

Tibial Tuberosity Advancement

Radiograph of a completed TTA procedure

The TTA is one of the most popular treatments for Canine Cruciate Ligament Rupture.

Dr Adrian Fleay BVMS – Is your “go to” dog cruciate surgeon.

The Tibial Tuberosity Advancement (TTA) surgery is one of the most commonly performed surgical procedures for the repair of Cranial Cruciate Ligament damage in dogs. It is the most common knee injury in the dog and it can occur at any age and in any breed, but most frequently occurs in middle aged, overweight, medium to large breed dogs.

3D printed titanium ossability wedge

What is the TTA Cruciate Ligament Surgery?

The TTA is widely considered the preferred way to repair cruciate ligament injuries in large dogs (over 20kg).

Unfortunately, most regular Perth veterinary hospitals are only able to offer the traditional repair with a nylon ligament which is not an ideal solution for large dogs. Referral to a specialist for TPLO is often necessary.

Dr Adrian Fleay has been performing TTA’s in Perth now since 2011 and has been performing cruciate surgeries on dog’s since 2003. So if your dog requires a cruciate repair without the specialist price tag, congratulations you have found him!

I Just saw a specialist vet and was recommended the TPLO?


TTA vs TPLO Cruciate Ligament Surgery

The Tibial Plateau Levelling Osteotomy (TPLO) surgery was the first of the tibial plateau levelling surgeries. For many years, most large dogs were implanted with an artificial ligament of some type. These artificial ligaments came with a variety of different problems and complications making them really only beneficial for smaller dogs.

The TPLO a “patented” procedure, relied on highly specialised training and equipment which added considerably to the cost and reduced it’s availability to most veterinary surgeons. As a result, the TPLO procedure was only available from specialist veterinary orthopaedic surgeons located in specialist surgical referral centres and university veterinary teaching hospitals, making it very costly and inaccessible for many pet owners.

The main proposed benefit of the TPLO over the TTA is anecdotal evidence of reduced post operative meniscal tears. The diagnosis of a torn meniscus during surgery is very common and fortunately is corrected during any cruciate repair. 

A number of veterinary orthopaedic surgeons developed similar procedures which used some of the theory behind the TPLO to improve stifle joint stability without the difficulty and proprietary limitations of the original TPLO.
Hence, the TTA was developed and has rapidly become one of the most popular of the new tibial plateau levelling procedures. It is attractive to vets because it is simpler, faster, easier and more reliable than more complex procedures such as the TPLO.

Dr Adrian performing one of his early TTA's way back in 2013

If you are interested in actually watching the procedure being performed check out the video below. The procedure has changed a little over time using more advanced equipment, implants and newer techniques but it gives you get a great insight into how technically demanding this procedure is.

It contains graphic images so is not for the squeamish