Cruciate Disease

The Cranial Cruciate Ligament (CCL) maintains the stability of the Tibia relative to the Femur when the foot is in contact with the ground. It stops the Tibia from sliding forward when weight is put on the limb. When the CCL is weak or completely ruptured, it is unable to maintain this stable relationship. As a result the knee gives way under the patient when they transfer weight onto the affected limb. This is an unusual experience and causes pain by stretching the joint capsule. The patient responds by reducing load through the leg and this results in the appearance of the lameness. In man this is usually caused by an injury, whilst in most dogs this happens because the ligament weakens prematurely. This process can begin as early as seven months of age. Unfortunately in many breeds such as Labradors, Rottweilers, Retrievers, Boxers and Springer Spaniels; this will occur in both stifles simultaneously. This can result in severe poverty of action in the hindquarters, making it difficult for them to stand up and they may need help to get up from rest. This can also be seen in Hip Dysplasia which has a similar breed predisposition and is often present in dogs with CCLR. This can result is some confusion from time to time regarding the diagnosis. Cranial Cruciate Ligament Rupture requires surgical management for a successful outcome.



Tibial Tuberosity Advancement


There are many techniques to stabilise the Cranial Cruciate Deficient stifle. Tibial Tuberosity Advancement (TTA) is our favoured method management for the reasons discussed below. TTA was devised by Slobodan Tepic (Kyon) and Pierre Montavon (University of Zurich) and is used worldwide to restore stability instantaneously to the Cruciate Deficient Stifle.


Torrington Orthopaedics and Tibial Tuberosity Advancement


Why TTA?

TTA is a procedure that has a repeatedly excellent outcome in our hands. Patients are using the limb within a few days of surgery and require very little Rehab input to achieve excellent outcomes. The implant quality and design from Kyon is second to none and this makes us comfortable to use this technique in the entire spectrum of sizes of and lifestyles of our patients. Recent work by Kim and Pozzi has shown that TTA is the only technique that normalises the stresses in the stifle post surgery. TPLO has many of the benefits in terms of early limb use and so forth, but research from the same group shows that TPLO increases the stresses in the medial (inner) compartment of the stifle. We do not want to provide a stable stifle that will result in increased wear of the medial compartment over time.


Many practices do TTA why should we choose Torrington Orthopaedics

  • We have performed over 650 TTAs.
  • All of our surgeons have been trained directly by Kyon at one of their approved courses and two of the surgeons here (Andy Torrington and Turlough O’Neill) are instructors for the Kyon course.
  • Torrington Orthopaedics is the only UK venue for Kyon TTA training courses.
  • Our close association with the originating company means that we are at the forefront of developing and enhancing the technique.
  • We only use Kyon implants and not the cheaper and often poorly manufactured “Me too” products on the market.
  • Our implant failure rate was zero in this set of 650 patients.
  • Our complication rate was less than 1%.
  • Read More about this procedure and aftercare here.

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