Distal tibial tuberosity translation using TTA implants for the treatment of patella alta in large breed dogs. Surgical technique and clinical outcome

Vet Comp Orthop Traumatol. 2015;28(4):274-81. doi: 10.3415/VCOT-14-05-0075. Epub 2015 Apr 22.

Abstract

Introduction: Medial patellar luxation frequently occurs in dogs resulting in lameness with increasing incidence in large breed dogs. Patella alta has been defined as a patellar ligament length to patellar length ratio that is greater than two and may predispose to patellar luxation.

Objective: To describe the surgical technique for stabilization of the distal translation of the tibial tuberosity using tibial tuberosity advancement plates and the clinical outcomes with follow-up for clinical cases of dogs.

Methods: Dogs that were presented with the complaint of patellar luxation and that were concurrently diagnosed with patella alta and were greater than 20 kg in body weight underwent surgery using a tibial tuberosity advancement plate to stabilize the osteotomy. Radiographic assessment of A:PL distance (the ratio of the proximal aspect of the patella to the femoral condyle [A] to the patellar length [PL]), L:P ratio (ratio of the length of the patellar ligament to the diagonal length of the patella), and owner assessment were obtained.

Results: Eleven stifles in nine dogs underwent surgical correction with a mean preoperative L:P ratio of 2.47. There were no complications and the lameness resolved clinically. The mean A:PL ratios preoperatively (2.6 ± 0.22) and postoperatively (2.1 ± 0.25) were significantly different (p = 0.0003). All owners were satisfied with the outcome and all dogs had a resolution of lameness with no recurrence of patellar luxation.

Clinical significance: Stabilization of distal translation of the tibial tuberosity using tibial tuberosity advancement implants to correct patella alta in large breed dogs was feasible and resulted in good clinical outcome.

Keywords: Patellar luxation; TTA; large breed dogs; patella alta; tibial tuberosity advancement.

MeSH terms

  • Animals
  • Bone Plates / veterinary
  • Dogs / injuries
  • Dogs / surgery*
  • Female
  • Male
  • Osteotomy / methods
  • Osteotomy / veterinary
  • Patella / diagnostic imaging
  • Patella / surgery
  • Patellar Dislocation / diagnostic imaging
  • Patellar Dislocation / surgery
  • Patellar Dislocation / veterinary*
  • Radiography
  • Stifle / diagnostic imaging
  • Stifle / surgery
  • Tibia / diagnostic imaging
  • Tibia / surgery*