Abstract
<strong>PICO question</strong><br /><p>In dogs with cruciate disease, is the use of TTA Rapid (TTAR) compared to traditional TTA (tTTA) associated with a higher risk of tibial diaphyseal fractures?</p><strong>Clinical bottom line</strong><br /><p>Based on studies published between January 2013 and January 2018, the rate of tibial diaphyseal fractures as a complication of Tibial Tuberosity Advancement Rapid (TTAR) surgery is within the published limits of traditional Tibial Tuberosity Advancement (tTTA). In this period, seven studies were related to tTTA, comprising of four; one case series, two retrospective case-control studies, and one retrospective cohort study. Five case series were related to TTAR. All evidence within this period has been observational (Level 3 and 4 evidence). No direct head-to-head comparison between the techniques has been studied. </p><br /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access" /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed" />
Highlights
No bone grafts were placed on osteotomy site
Outcome studied: Incidence of major and minor complication rates associated with tTTA in Boxers vs. non-Boxers
Since the advent of tTTA in 2002 (Montavon et al, 2002), various second generation TTA procedures have been invented. These techniques (TTAR, Orthofoam-MMP, MMT, TTA–2) utilise custom saw guides to aid the surgeon in producing an incomplete osteotomy of the tibial tuberosity
Summary
Intervention details: All dogs received perioperative Cephazolin 22 mg/kg. Meniscal release or meniscectomy was performed based on preference. Outcome studied: Major complication rates in dogs receiving tibial tuberosity advancement surgery and the effects of medial meniscal release on postoperative meniscal tear. Main findings: (relevant to PICO question): Major complication rate – 13.4% Minor complications – not included Medial meniscal tear 40.5% had medial meniscal injury and were treated with partial meniscectomy 59.4% had normal meniscus. 72.4% of these dogs had meniscal release. 0.5% of these dogs developed postliminary meniscal injury. 27.6% of dogs with normal meniscus did not receive meniscal release. 0.7% (11 dogs) developed fracture; 3/11 tibial diaphyseal fractures and 8/11 tibial tuberosity fracture. PICO – three (0.18%) tibial diaphyseal fractures were reported
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