1.TTA - TIBIAL TUBEROSITY ADVANCEMENT or 2.TR - TIGHTROPE PROCEDURE
The most common knee injury in the dog is rupture of the Cranial Cruciate Ligament (CCL), also frequently called the Anterior Cruciate Ligament (ACL). This injury can occur at any age and in any breed, but most frequently occurs in middle-aged, overweight, medium to large breed dogs. This ligament can suffer a partial tear, leading to slight instability of the knee. If this damage goes untreated, it most commonly leads to complete rupture and possibly damage to the medial meniscus of the knee. The meniscus acts as a cushion in the knee. Complete rupture results in front-to-back instability, commonly called Tibial Thrust, and internal rotation of the lower leg, commonly called Pivot Shift. Untreated legs usually become very arthritic and painful from the instability.
An injured Cruciate Ligament can only be corrected by surgery. There are numerous surgical corrections currently being performed. Dr. Aluas is trained and certified in TTA, Tightrope CCL, and Lateral Suture, performing these procedures on a regular basis. He also proficiently manages medial patellar luxations & fractures using external fixation systems.
Tibial Tuberosity Advancement (TTA)
The TTA or Tibial Tuberosity Advancement Procedure is based on research indicating that the Patellar Ligament can stabilize the joint if it is at a 90 degree angle to the Tibial Plateau. The Patellar Ligament is one of the toughest ligaments in the body and it is completely controlled by one of the biggest muscles in the body, the Quadriceps muscle on the front of the leg. By advancing the Tibial Tuberosity, we can overcome the abnormal front to back motion called Tibial Thrust, and also tend to overcome the tendency for Pivot Shift. Current thought is that this procedure leads to less arthritic change in the joint. This procedure can be successfully done on any size dog, and is currently the treatment of choice of many surgeons.
Tightrope CCL (TRCCL)
The TRCCL was developed to provide a minimally invasive method for extracapsular (outside the joint) stabilization of the cranial cruciate ligament (CCL/ACL) deficient canine knee. TRCCL seeks to optimize the lateral suture stabilization technique by employing bone to bone fixation and a more anatomical implant placement. TRCCL is a more refined alternative to classical methods of ACL repairs involving sutures.