History of TTA Techniques

History of TTA-Techniques

In the following article you can see a historical timeline about techniques to heal a canine cruciate ligament rupture. We begin with the latest technique – TTA RAPID.

TTA RAPID by Rita Leibinger Medical (Tuttlingen | Germany)

TTA RAPID is actually the most promising tibial tuberosity advancement. While older techniques like TTA standard or TPLO can be quite difficult and take a long surgerytime a surgery with TTA RAPID goes very fast and is easy to learn. As a major difference to other techniques TTA RAPID does not saw the tibia into two single parts. This brings the advantage of reducing the number of needed instruments and auxiliary implants, which makes this technique much more stable and quicker.

TTA RAPID implants are a combination of a plate and a cage with an open sponge construction. This combination enables a high stability and a fast bonegrowth “through” the sponge construction. The implant is manufactured with titanium class 1 which minimizes the risk of infections.

Another advantage is the high flexibility of TTA RAPID. In the past surgeons had to switch their techniques depending on the weight and the size of a dog. While TTA standard worked better with dogs under 30kg TPLO worked better with dogs over 20kg. But the new TTA RAPID implants work with a 5kg-dog as well as with a 90kg-dog. RITA LEIBINGER even provides “super-size” cages for heavier dogs.

Here is a short video explaining TTA RAPID:

TTA Standard by KYON – Slobodan Tepic (Zurich | Switzerland)

The first real tibial tuberosity advancement was invented by Dr. Slobodan Tepic from KYON and Professor Pierre Montavon. The technique, which Slobodan Tepic and Pierre Montavon created at the School of Veterinary Medicine (Zurich University, Switzerland) in the late 1990s, was a combination of different implants: in the focus of the whole construction was the TTA cage. In contrast to the TTA RAPID cage the TTA standard cage had just two ears for two screws which holded the cage in the upper end of the osteotomy. An additional plate was fixed by an auxiliary “fork”. This fork was hammered through the plate into the bone.

OrthoFoam MMP by Orthomed Technology GmbH (Langenfeld | Germany)

As a transient technology between the first TTA by Slobodan Tepic, KYON, and the latest TTA (RAPID) by RITA LEIBINGER, there was a technique called MMP OrthoFoam by Orthomed. MMP OrthoFoam is rightly called a transient technology because it already used the Maquet Hole-technique like TTA RAPID does today. The difference between MMP OrthoFoam and TTA RAPID is, that the “wedge” of RITA LEIBINGER is not a foam but a titanium scaffold “open” sponge construction which enables the bone to grow “through”. Furthermore the TTA RAPID implant is a combination of a wedge and a bone plate.

TPLO – Tibial-plateau-leveling osteotomy

The tibial-plateau-leveling osteotomy, short TPLO, is the technique which was developed by Dr. Slocum – before the tibial tuberosity advancement was invented by Slobodan Tepic, KYON. In this technique the surgeon cut the tibial plateau. After this cut it was rotatet with the intention to change the slope to about 5° to the horizontal plane. This has the result that the dog can put weight on its tibia – but the femur does not slide down the slope of the tibial plateau anymore. Even if all later tibial tuberosity advancements have improved the old TPLO procedure: this theory would be the fundament of all later inventions of tibial tuberosity advancements.

And of course, we also have found a video about TPLO: