Simultaneous Bilateral Modified Tibial Tuberosity Advancement in Fifteen Overweight Dogs

Tibial tuberosity advancement (TTA) is one of the surgical techniques used to stabilize the cranial cruciate ligament deficient (CCL) canine stifle joint. However, tibial tuberosity fractures have been reported to occur as one of the possible complications associated with TTA. Tension band wiring (TBW) is the gold standard to repair avulsion fractures. This is based on a previous in vitro study confirming that TBW increases resistance of the TTA fixation failure. Simultaneous bilateral procedure in 15 large-breed and overweigh dogs >48 kg was carried out prospectively. In this clinical case series, 93% of dogs recovered with only minor issues after the bilateral CCL rupture repair, showing only some infrequent or intermittent lameness. One dog required cage removal. This study has shown that the use of a tension band wire technique for TTA is an effective technique for bilateral simultaneous repair on large obese dogs. This novel configuration has the advantage of allowing removal the cage more easily later if needed and avoids any possibility of fracturing the dorsal tip of the tibial tuberosity under the patella ligament. The results of this preliminary clinical study are encouraging and warrant further investigation.