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Early post-operative outcomes in unilateral cranial cruciate ligament deficient dogs treated with tibial tuberosity advancement or tibial plateau levelling osteotomy

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Peter K Shires, Otto Lanz, Robert A Martin, Jonathon Miller, Dean Filipowicz.
Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia, United States

ACVS Abstract 2007 

We hypothesized that 6-month TTA outcomes would be similar to TPLO. Twenty large dogs with unilateral CCL deficient stifles were trained to walk across the force plate. Surgical planning, results, and mid-patella thickness were measured from radiographs. Force plate and static load data was collected prior to, and 10, 56 and 180 days after, surgery. Lameness, pain, crepitation, stifle range of motion and mid-thigh circumference was measured.

All had arthrotomy and meniscal release or partial meniscectomy. Half were randomly assigned to each surgery and assessors were blinded to treatments. In 10 days lameness improved in both groups, markedly by 8 weeks, and was minimal at 6 months. Owner and initial clinician assessments were marginally better for TTA. Surgery was 15%quicker for TTA. TPLO caused 95% more ligament thickening than TTA. At 10 days TPLO caused slightly less static loading than TTA.

Both groups increased static loading with time, lateralized load distribution improved towards 50:50. At 10 days, peak vertical force was slightly reduced for TPLO, unchanged for TTA. With time, both groups increased peak force and became similar. Lateralization was closer to 50:50 for TPLO. Probability of soundness improved by 10 days – TPLO slightly less than TTA, by 8 weeks both were the same. There were no obvious loading differences by 6 months using the designated rehabilitation protocol. 

Minor, early, differences were noted. Surgery is quicker for TTA and patella ligament thickening is more marked after TPLO. Both procedures produce clinically successful outcomes, and high owner satisfaction. 

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