Tibial Tuberosity Advancement Techniques (TTAT): A Systematic Review

Aragosa, Federica; Caterino, Chiara; Valle, Giovanni Della; Fatone, Gerardo

doi:10.3390/ani12162114

Cited by 6 publications

(2 citation statements)

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“…11,12,[19][20][21] Treatment outcome in dogs with CCLD has been evaluated in several ways, for example, by using force plate gait analysis, visual gait observation, orthopaedic and physiotherapeutic examination, radiography for evaluation of OA progression and owner questionnaires. 8,17,[22][23][24][25][26][27][28][29] Owner questionnaires based on behaviour are considered one of the most reliable tools for assessment of chronic pain in dogs. [30][31][32] There are several questionnaires available, such as the canine orthopaedic index (COI), the Helsinki chronic pain index (HCPI), the Liverpool osteoarthritis in dogs, the canine brief pain inventory (CBPI) and the Bologna healing stifle injury index (BHSII).…”

Section: Introductionmentioning

confidence: 99%

“…Treatment outcome in dogs with CCLD has been evaluated in several ways, for example, by using force plate gait analysis, visual gait observation, orthopaedic and physiotherapeutic examination, radiography for evaluation of OA progression and owner questionnaires 8,17,22–29 . Owner questionnaires based on behaviour are considered one of the most reliable tools for assessment of chronic pain in dogs 30–32 .…”

Section: Introductionmentioning

confidence: 99%

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Long‐term outcome in dogs with cranial cruciate ligament disease evaluated using the canine orthopaedic index

et al. 2023

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BackgroundCranial cruciate ligament disease (CCLD) is common in dogs, but studies on the long‐term treatment outcome are scarce.MethodsThe long‐term outcome in a cohort of 71 dogs with CCLD treated with tibial plateau levelling osteotomy (TPLO, n = 18), tibial tuberosity advancement (TTA, n = 23) or lateral fabellotibial suture (LFS, n = 30) was evaluated using the canine orthopaedic index.ResultsThe risk of stiffness and lameness was increased in dogs treated with TPLO (stiffness: incidence rate ratio [IRR] 1.33, p = 0.015; lameness: IRR 1.34, p = 0.020) or TTA (stiffness: IRR 1.26, p = 0.035; lameness: IRR 1.31, p = 0.026) when compared to LFS at a median follow‐up time of 4.6 years.LimitationsNo follow‐up veterinary examination was performed. Data were collected from only two university animal hospitals, and thus, a referral bias towards more complicated cases is possible, which may limit the generalisability of the results.ConclusionClinicians can use the results to inform dog owners about the expected long‐term outcome in dogs with CCLD.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long‐term outcome in dogs with cranial cruciate ligament disease evaluated using the canine orthopaedic index

et al. 2023

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Comparison and interobserver reliability of three different methods for measuring the amount of the tibial tuberosity advancement in the preoperative planning of TTAT

Della Valle,

Aragosa,

Caterino

et al. 2023

PLoS ONE

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Introduction The goal of preoperative planning techniques for advancement of the tibial tuberosity is to determine the amount of advancement required to achieve a postoperative patellar tendon angle of 90° and to select the optimal wedge size to achieve this target. Material and methods Three radiographic methods for determining the advancement distance for the tibial tuberosity were evaluated for comparability and interobserver reliability. Among the methods developed, we decided to include the common tangent method, the tibial anatomy-based method, and the Bielecki method. For all techniques, radiographs were taken in mediolateral projection with the knee joint flexed at 135°. Three observers with different levels of experience independently evaluated and scored the degree of osteoarthritis for each stifle, as previously described, and performed measurements of the amount of advancement of the tibial tuberosity on 33 stifles using common tangent method, tibial anatomy-based method, and Bielecki method. Results According to the results, the overall score for osteoarthritis in the mediolateral view was influenced by the experience of the observers, which contradicts the results from a previous study. Regarding the measurement methods used to assess advancement, poor interobserver reliability was found for common tangent method and Bielecki method, while only a slightly moderate interobserver agreement was found for tibial anatomy-based method. Discussion These results are inconsistent with data collected by Bielecki and colleagues. Moreover, measurements from common tangent method and tibial anatomy-based method were overlapping, as confirmed previously. Conversely, Bielecki method showed no agreement with the other methods included in the present study, with a significantly higher mean rank, probably due to its correction formula. Based on the results of the present study, tibial anatomy-based method has better interobserver reliability and is easier to perform according to the observers.

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Comparison of the short-term complications of TTA-rapid and modified cTTA procedures

Zólyomi

Ipolyi

Molnár

et al. 2022

AVet

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The objective of this retrospective study was to determine the complications of the first 30 tibial tuberosity advancement rapid (TTA-rapid) and 30 modified circular tibial tuberosity advancement (mcTTA) procedures performed by our team, and to compare the results with the findings reported in the literature. Our research was based on 30 procedures in each group. All dogs were client-owned. Data were collected only for the study of cases that had a minimum follow-up period of 3 months. Intraoperative (IO) and postoperative (PO) complications were assessed, with the latter divided into two subgroups: major and minor. Results obtained for the TTA-rapid group: IO complications 23.3% (7/30), major PO complications 13.3% (4/30), minor PO complications 16.7% (5/30). Results of the mcTTA group: IO complications 0% (0/30), major PO complications 3.3% (1/30), minor PO complications 20% (6/30). Comparing the complication rates, we found that there was a significant difference between the two groups in the occurrence of IO complications (P = 0.01054); however, there was no significant difference in the incidence of major (P = 0.3533) and minor (P > 0.9999) PO complications between groups. Our results are consistent with the findings reported in the literature and suggest that both techniques are efficient and carry a relatively low complication rate.

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Tibial Tuberosity Advancement Techniques (TTAT): A Systematic Review

Cited by 6 publications

References 57 publications

Long‐term outcome in dogs with cranial cruciate ligament disease evaluated using the canine orthopaedic index

Long‐term outcome in dogs with cranial cruciate ligament disease evaluated using the canine orthopaedic index

Comparison and interobserver reliability of three different methods for measuring the amount of the tibial tuberosity advancement in the preoperative planning of TTAT

Comparison of the short-term complications of TTA-rapid and modified cTTA procedures

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