FAQ
These FAQ's are some of the many questions I receive on this website everyday about TTA and TPLO.
Q. What is the HEAVIEST dog Dr Mayo has ever performed a TTA on?
A. 198 pounds (normal body weight, a Mastiff)
Q. What is the smallest dog Dr Mayo has ever performed the TTA on?
A. 10 pounds, a Yorkshire Terrier
Q. Why is my doctor NOT recommending a TTA over the TPLO?
A. TPLO is only indicated over TTA if your dog has a steep tibial plateau angle (the top of the tibia) or if your dog has crooked legs (walks like a "bull rider"). There are no other reasons to perform TPLO over TTA except for comfort in performing (or recommending) one procedure over the other for the doctor. Many doctors do not understand the TTA yet.
Q.My dog recently had a TTA done, and now the leg is swollen a lot. What should I do?
A. The swelling is usually located just past the surgery site. This is usually due to extensive bleeding from the bone grafting site in the tibia to fill the grafted area. This can be avoided by using a bone graft from somewhere else in the body, or by using a synthetic product such as Velocity(R). If you see this swelling, make sure your pet stays off of the leg as much as possible for a few days, and that you ice the leg 3-4 times a day for the next week. The swelling will go away. If it gets to be too much, it could cause the incision to swell.
Q. My vet told me my pet has a "torn ACL" and that it should have a TPLO done. What are my options?
A. Not all dogs require TPLO to restore knee function. Dogs weighing less than 40 pounds may have a different technique, often referred to as a "lateral suture technique", that will work equally well. This technique is not for overweight dogs. The recovery is slower but most dogs acheive almost normal function in the limb. This procedure does not work as well in larger dogs. It is important that if you are going to pursue the lateral suture technique that these sutures be placed in an isometric position, and ideally, attached through the use of bone tunnels.
Q. When would you pick TPLO over TTA?
A. Dogs with excessive tibial plateau angles over 30 degrees, or angular limb deformities should have TPLO performed instead of TTA. These are rarely seen.
Q. What are the advantages of TTA over TPLO?
A. TTA is quicker, easier to perform, and in the right hands there are very few complications. TTA can treat chondromalacia, a common sequalae in dogs with a torn cruciate, makes the knee extend easier, and does not inflame the patellar tendon postoperatively. TPLO causes increases in the forces within the knee, permanent loss of some range of motion, and the knee is more difficult to extend for the patient after surgery.
Q. My dog recently had knee surgery and is not using the leg. What should I do?
A. Most dogs start using the leg again around 2 weeks postoperative. Some of the simple exercises you should start doing include: "Sit to stand", hip balancing, 60-90 flexion & extension, and cavelleti work. Under no circumstances, should you allow your dog to run fee on a leash until your doctor tells you it is ok. See the rehab-section on the TTA website for more details. Consider having the leg x-rayed to look for potential problems.
Q. My dog had TTA/TPLO surgery 10-12 weeks ago and is still limping. What could be wrong?
A. The first thing to ask is, is there something else wrong? Have your veterinarian re-x-ray the leg. If the x-ray and exam show nothing obvious, then the next thing to suspect is that the medial meniscus is torn. This should be addressed by either: re-operating on the leg, through an open incision or arthroscopy, or giving the pet some more time.
Q. How can I tell if my vet has any experience with TTA or TPLO?
A. Check the website for the hospital, search the internet, ask for references, find out how and when your doctor learned the procedure. Ask your doctor how many times he/she has performed the procedure.
Q. My dog has bad hips and a torn ACL. Should I proceed with surgery?
A. Absolutely. The hips are rarely the cause of acute limping. If the ACLs are torn, your pet is only going to get worse.
Q. My dog has a torn ACL, and I was told he could tear the other one any time. What should I do?
A. First of all, get the knee fixed. Secondly, be prepared that at any time, the other leg could tear. Lastly, to avoid any confusion, mark the leg to be operated on when you drop your pet off. Most dogs have a 50% chance of tearing the other ACL within 5 months. To avoid this, restrict exercise during recovery, work on the rehabilitation, and reduce your pet's weight.