Cranial cruciate ligament (CCL) rupture is one of the most common orthopedic problems in dogs. A damaged cruciate ligament causes knee joint instability, pain, limping, and leads to arthritis if left untreated. TTA, or tibial tuberosity advancement, is a modern surgical method that corrects knee joint biomechanics without replacing the ligament.
How Does TTA Work?
In TTA surgery, the tibial tuberosity is advanced forward and secured with a titanium plate, screws and spacer. This changes the angle of the patellar tendon relative to the tibial plateau to approximately 90 degrees, neutralizing the shear forces (cranial tibial thrust) acting on the knee joint. The dog's knee is functionally stabilized without an artificial ligament.
TTA or Lateral Suture?
At our clinic we use two methods for cruciate ligament repair. The lateral suture technique stabilizes the knee joint with synthetic support material that mimics the function of the ligament. TTA, on the other hand, permanently alters knee biomechanics. Lateral suture is suitable for small dogs and cats, while TTA is a good option especially for active and larger dogs.
Recovery
After TTA surgery, dogs typically begin bearing weight within a few days. Bone healing takes about 8 weeks, and by around 16 weeks most dogs have returned to full activity. Movement is restricted during recovery and follow-up visits are scheduled at 2 and 8 weeks. Studies show that over 90% of dogs achieve a good or excellent outcome.
Risks and Complications
As with all surgeries, TTA carries a risk of complications: infection, implant loosening, slower bone healing, or meniscal injury (approximately 9–10% of cases). Complication risk decreases with surgeon experience. At our clinic we closely monitor anesthesia and provide comprehensive pain management for all orthopedic procedures.
When Should You Contact Us?
If your dog is limping on a hind leg, avoiding exertion, or stiff after rest, a cruciate ligament injury is a common cause. Early diagnosis and treatment significantly improve the prognosis. Book an orthopedic examination — we will assess the situation and recommend the most suitable surgical method for your dog.