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Review
. 2022 Aug 17;12(16):2114.
doi: 10.3390/ani12162114.

Tibial Tuberosity Advancement Techniques (TTAT): A Systematic Review

Federica Aragosa  1 , Chiara Caterino  1 , Giovanni Della Valle  1 , Gerardo Fatone  1
Affiliations
Review

Tibial Tuberosity Advancement Techniques (TTAT): A Systematic Review

Federica Aragosa et al. Animals (Basel). .

Abstract

(1) Background: Several surgical techniques were described for the treatment of cranial cruciate ligament rupture in dogs. This report aims to critically review the available literature focused on preoperative planning, surgical procedure, follow-up, and complications of cranial cruciate ligament rupture treated by tibial tuberosity advancement techniques; (2) Methods: three bibliographic databases: PubMed, Google Scholar, and Scopus were used for a board search of TTAT (canine OR dog). Five GRADE recommendations according to Grading of Recommendations Assessment, Development and Evaluation and Joanna Briggs Institute Critical Appraisal Checklists were applied to the studies included. Data regarding preoperative planning (a measure of advancement), meniscal disease (meniscectomy, meniscal release, and late meniscal tears), and postoperative patellar tendon angle were recorded. Time frame, outcome, and complications were classified according to Cook’s guidelines; (3) Results: from 471 reports yielded, only 30 met the inclusion criteria. The common tangent method was the most commonly reported measurement technique for preoperative planning. The 40.21% of stifles presented meniscal tears at surgery, while 4.28% suffered late meniscal tears. In short-, mid-and long-term follow-ups examined showed a full/acceptable function was shown in >90% of cases. Among all new generation techniques, minor complications were reported in 33.5% of cases and major complications in 10.67%; (4) Conclusions: Compared to traditional TTA, new generation TTAT resulted effective in the treatment of cranial cruciate ligament failure, showing a lower rate of late meniscal injury but a higher rate of minor complications.

Keywords: MMP; MMT; TTA rapid; TTA-CF; TTAT; cranial cruciate ligament rupture; mTTA; porous TTA; traditional TTA.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Graphic illustrations of TTAT included: (A) modified Maquet technique (MMT), (B) TTA rapid, (C) modified Maquet procedure (MMP), (D) modified Maquet tibial tuberosity advancement (mTTA), (E) tibial tuberosity advancement with cranial fixation (TTA-CF) and (F) porous TTA (designed by Claudio Palumbo).
Figure 2
Figure 2
PRISMA 2020 flow diagram for new systematic reviews included searches of databases, registers, and other sources.
See this image and copyright information in PMC

References

    1. Lampman T.J., Lund E.M., Lipowitz A.J. Cranial cruciate disease: Current status of diagnosis, surgery, and risk for disease. Vet. Comp. Orthop. Traumatol. 2003;16:122–126.
    1. Witsberger T.H., Villamil J.A., Schultz L.G., Hahn A.W., Cook J.L. Prevalence of and risk factors for hip dysplasia and cranial cruciate ligament deficiency in dogs. J. Am. Vet. Med. Assoc. 2008;232:1818–1824. doi: 10.2460/javma.232.12.1818. - DOI - PubMed
    1. Livet V., Baldinger A., Viguier É., Taroni M., Harel M., Carozzo C., Cachon T. Comparison of outcomes associated with tibial plateau levelling osteotomy and a modified technique for tibial tuberosity advancement for the treatment of cranial cruciate ligament disease in dogs: A randomized clinical study. Vet. Comp. Orthop. Traumatol. 2019;32:314–323. doi: 10.1055/s-0039-1684050. - DOI - PubMed
    1. Moore E.V., Weeren R., Paek M. Extended long-term radiographic and functional comparison of tibial plateau leveling osteotomy vs tibial tuberosity advancement for cranial cruciate ligament rupture in the dog. Vet. Surg. 2020;49:146–154. doi: 10.1111/vsu.13277. - DOI - PubMed
    1. Slocum B., Slocum T.D. Tibial plateau leveling osteotomy for repair of cranial cruciate ligament rupture in the canine. Vet. Clin. North Am. Small Anim. Pract. 1993;23:777–795. doi: 10.1016/S0195-5616(93)50082-7. - DOI - PubMed

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