TTA vs. TPLO Surgery

TTA and TPLO are dynamic repairs for cruciate ligament injuries. Dynamic simply means they stop tibial thrust in the knee that has a ruptured ACL when the limb is weight bearing. If the knee and muscles surrounding the knee are relaxed and not being loaded tibial thrust can be elicited. However, when your dog walks or uses the limb the knee is stabilized. Both of these procedures are effective at dynamically stabilizing the knee. However, our preference is for TTA in most cases.

  1. 1. TTA is proven to counteract tibial thrust in dogs with complete rupture of the ACL.A¹
  2. 2. TTA does not change the natural alignment of the knee as does TPLO.2 This allows the interior of the knee to function in a more normal fashion.
  3. 3. TTA requires less dissection around the tibia than TPLO thereby decreasing surgery time and morbidity.
  4. 4. TTA appears to have an advantage in complication rate as it is easier to perform.2
  5. 5. While both TTA and TPLO eliminate tibial thrust TTA does so with less loading of the caudal cruciate ligament.2 This reduces stress on the other cruciate ligament inside the knee.
  6. 6. The bone rotation required with TPLO pushes the tibia and meniscus upward or closer to the femur. TTA does not do this and therefore does not increase cartilage pressure points. This may reduce osteoarthritis in the knee.
  7. 7. It is our opinion that TPLO is effective in treating cruciate ligament rupture, but TTA has the ability to reduce some of the disadvantages inherent in the TPLO procedure.






1. Kipfer NM, et al: Effect of tibial tuberosity advancement on femorotibial shear in cranial cruciate-deficient stifle. Vet Comp Orthop Traumatol 21, 2008.
2. Buodrieau RJ: Tibial Plateau Leveling Osteotomy or Tibial Tuberosity Advancement?. Vet Surg 38: 1-22, 2009.