Abstract
Tibial Tuberosity Advancement (TTA) is a surgical technique based on a linear osteotomy that determines a cranial advancement of the tibial tuberosity in patients suffering from cranial cruciate ligament rupture (CCL). The aim is to neutralize the cranial tibial thrust (CTT) and to reach a 90° angle between the patellar tendon and the tibial plateau with a physiological knee extension of 135°. In our study, a Ti6AI4V ELI (Titanium Aluminium Vanadium) titanium scaffold for the Porous TTA, with excellent properties of osteointegration and osteoconduction when subjected to cyclic loading has been adopted. Based on the previous scientific work on an ovine model, the use of this type of porous scaffolds has subverted the previous models. Scaffold production technology is based on direct mechanical manufacturing called Electron Beam Melting (EBM). For this study, 41 dogs, different breeds, medium-large size, weighing between 10 and 80 kg, aged between 1 and 13 years, were enrolled. The inclusion criteria were based on clinical evaluations (different gaits), drawer test and tibial compression, LOAD score (Liverpool Osteoarthritis in Dogs questionnaire), radiographic diagnosis in sedation with a 135° positioning of the joint and baropodometric investigations (Stance Analyzer). The results show that Porous TTA is an excellent method for functional recovery of the knee joint following the partial and total rupture of the CCL.
Highlights
Tibial Tuberosity Advancement (TTA) is one of the most frequently used techniques in veterinary orthopaedics to resolve cranial cruciate rupture in dogs
Patients was of ableosteoblastic to properly load the on limbtitanium, moments after awakening; To further evaluate theofphenotype cells early cultures where the same percentage of dogs showed a proper recovery of the correct load 15 days after surgery and triple-labelled with Hoechst 33352 to visualize the nuclei, vital staining (CMFDA) to observe cell last 27% acquired a correct load bearing during further controls
A percentage of 73% of patients was able to properly load the limb moments after awakening; the same percentage of dogs showed a proper recovery of the correct load 15 days after surgery and last 27% acquired a correct load bearing during further controls
Summary
Tibial Tuberosity Advancement (TTA) is one of the most frequently used techniques in veterinary orthopaedics to resolve cranial cruciate rupture in dogs. This technique was introduced in 2002 in veterinary medicine by Montavon, Damur and Tepic [1]. From 2002, many authors described different techniques variations using different kinds of implants to obtain the cranial advancement of the tibial tuberosity [2,3,4,5]. Some variations include the possibility to replace the original cage with other implants of different materials to improve biocompatibility and osteointegration [6].
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