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TDK conference 2014

CTTA: a new treatment method for cranial cruciate ligament rupture in dogs – preoperative palanning and surgical technique
Zólyomi Dorottya - year 6
SZIU Faculty of Veterinary Science, Department of Surgery and Ophthalmology
Supervisor: dr. Tamás Ipolyi


The most common orthopedic problem in dogs is cranial cruciate ligament rupture (CCLR) of the stifle joint. The CCLR is an absolute indication for surgery. There are several surgical techniques for the treatment of CCLR. The subject of this study is one of these, called cTTA (circular tibial tuberosity advancement). This method was presented in 2010 by an Italian veterinarian Massimo Petazzoni. To date, there are only two scientific reports available of this method.

CTTA could be preferred to other corrective osteotomy techniques like TPLO (tibia plateau leveling osteotomy) and TTA (tibial tuberosity advancement) for many reasons. It is less invasive than TPLO, and in contrast with TTA, there is no gap in the line of osteotomy. The implant can thus be readily removed in case of an unexpected complication. This method can also be used for the correction patellar luxation.

One of the key points to the success of the surgery is precise calculation of the degree of correction. There are two methods we can use (the Common Tangent method; and the distance between tuberositas tibiae and the line that is perpendicular to the tibial plateau and crosses the patellar tendon insertion point). We have done comparative analysis of the two methods in all sixty (60) radiographs, as in our experience, the two results often differ.

After the preoperative planning we have performed cTTA surgery on 16 dogs. Complications were classified as acute or chronic (by analogously) and major or minor. The dogs were examined before surgery, at suture removal and 8 out of 16 dogs at the time of implant removal (in the rest of the cases, the implants have not been removed to date).

According to our results, there is a correlation between the two methods. If the base value of the patellar tendon angle (the angle between the tibial plateau and the line of patellar tendon) is 100 degrees, the two calculation methods result in almost the same results in every case. If the base value is bigger, the difference is also bigger. Of the 16 clinical cases that we have had, some sort of complication occurred in five cases.

In summary, we can state, that despite the method is new and we only have a few reports of it, cTTA is well applicable in practice. However, there are some unanswered questions about preoperative planning. The standardization of the technique is under investigation.

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