Summary
Objectives: This in vitro study evaluated three modified techniques of tibial tuberosity advancement (TTA).
Loads to failure were calculated for each technique.
Methods: A 9 mm TTA procedure was performed in the tibiae of dogs weighing between 32 and
38 kg. In group 1 (n = 12), the distal part of the tibial crest was left attached
to the tibia by the cranial cortex, and a figure-of-eight wire was added for stabilisation.
In group 2 (n = 12), the tibial crest was left attached but no additional device was
used for stabilisation. In group 3 (n = 12), the tibial crest was completely separated
from the tibia and fixed by a figure-of-eight wire so that, in this group, only the
wire opposed avulsion of the tibial crest. Unidirectional axial force was applied
via the patella to determine the maximal load to failure of the model.
Results: There was no significant difference between group 1 and group 2. These two groups
both had a significantly stronger construct than that of group 3.
Clinical significance: We described modifications to the TTA procedure without plate fixation that warrant
clinical investigation. When the crest is broken during its advancement, the tension
sustained by the repair is significantly weaker from a biomechanical point of view
and the use of such a repair clinically is not recommended by the authors.
Keywords
Cranial cruciate ligament rupture - dog - mechanical resistance - tibial tuberosity
advancement
