Anterior Cruciate Ligament -GENETIC -ENVIRONMENT -OTHER GENETIC Conformation ▪ ▪ ▪ ▪ ▪ Stifle angle >135 deg Valgus /Vargus Medial Patella Luxation(MPL) Sloping Posterior Tibial Plateau Small Bone Structure/Muscle Mass -USE/ACTIVITIES =Field Trial =Agility =Frisbee =squirrel chaser -DIET/CONDITIONING -OTHER -injury -tumor -Anterior Drawer Sign -Tibial Thrust -Radiography -Anesthesia -Extracapsular -Non-Absorbable Suture -Artifical Ligament Implant -Aronosky “Over the Top” -Geometric Altering Procedures -Tibia Plateau Leveling Operation-TPLO Licensed by Slocum Enterprises –Eugene, OR -First “Break-Through” for RCCL Repair, esp. Active and Obese Patients -Corrects the sloping posterior tibia -Allows for the Correction of Vargus/Valgus in one operation -Most Invasive and Traumatic of current procedures -Most likely to require Rehabilitation -Increases Pressure in the Posterior joint space and on the menisci -Can be used when other procedures have been performed -Implants made of SS, are quite massive, limited industry standards Immediate Post-op TPLO 4-week Post-op TPLO Tibial Tuberosity Advancement Developed by Slobodan Tepic and Pierre Montavon University of Zurich, Switzerland KYON-Zurich, Switzerland and KyonPharma, Boston TTA Restores stability by adjusting joint force vectors Maintains congruency of joint Allows unimpeded full range of motion Preserves primary loading axis of tibia Increases lever arm of quadriceps force and thus reduces all internal joint reactions Implants are made specifically for TTA and are Titanium for reduced body reactivity Implants and instruments made in Switzerland and Germany and of highest quality and standards Requires a bone graft Less Allowance for Technical Errors More difficult to correct Valgus/Vargus Potential for Non-Union is greater Patients will weight-bear immediately upon recovery from anesthesia which lessens requirement for rehab Unkown if Osteoarthritis is reduced but is expected to do so with current case experience Over 40,000 cases world-wide have been performed Both require surgeon with training and experience Both require strict aseptic techniques Both require extensive inventory of implants Both require Orthopedic Power Equipment Both require extensive array of Orthopedic Instrumentation Both require extensive Follow-Up Common Tangent of Femur Condyles and Tibial Plateau German Method Elimination of TibialThrust Weight and Plate Size Field-Trail Lab 7m0 PostSurgery TTA KYON.CH (Swiss website) KYONPHARMA.COM(Boston) SLOCUM ENTERPRISES.COM JEFFMAYO.COM R-9-17-08 L-11-20-09 Dates of surgery, TTA, both legs Two Days Post Op Cocker Male-5yr Thanks for fixing my leg, Griffen STAGE ROAD ANIMAL HOSPITAL,PC James Ritchie Pearce, BS,DVM,DABVP