🧠 What Is the Cranial Cruciate Ligament?

The cranial cruciate ligament (CCL) is a critical stabilizer inside your dog’s knee (stifle) joint. When this ligament ruptures, the tibia slides forward out of alignment with the femur, causing pain and instability. You may recognize this as the canine equivalent of the human ACL. 🦴

💥 What Causes a CCL Rupture?

Most cases aren’t from trauma, but rather slow, degenerative weakening over time. This condition—called cruciate disease—leads to complete rupture and significant pain. Large and active dogs are most commonly affected, though it can occur in any breed or age.

🔍 Diagnosing a CCL Tear

Diagnosis is based on physical examination and confirmed with imaging:

• 🐾 Lameness, pain, or muscle loss
• 🩺 “Drawer sign” or “tibial compression test” on exam
• 📸 X-rays to assess joint swelling and rule out other issues

🛠️ What Is TTA Surgery?

Tibial Tuberosity Advancement (TTA) is one of the most advanced surgical methods used to treat CCL ruptures. Unlike traditional techniques that replace the ligament, TTA changes the geometry of the knee so that the ligament is no longer needed. Here's how it works:

• 🦴 The front part of the tibia (tibial tuberosity) is cut and shifted forward
• ⚙️ A spacer and implant are used to fix the bone in its new position
• 📐 This shifts the patellar ligament angle to create natural stability during weight-bearing

TTA is particularly well-suited for medium to large, athletic dogs with active lifestyles.

🔎 Meniscal Inspection

During surgery, the vet will examine the menisci (shock-absorbing cartilage in the knee). About 60% of dogs with a CCL tear also have meniscal damage. If damaged, the affected meniscus may be removed or trimmed.

⏱️ Recovery Timeline

• 🛌 Days 1–14: Rest, pain control, and suture removal around day 10–14
• 🚶 Weeks 2–8: Short leash walks only, no stairs or jumping
• 💧 Week 3+: Hydrotherapy (water treadmill) or light physiotherapy may begin
• 📸 Week 8–12: Follow-up X-rays to confirm bone healing
• 🏃‍♂️ Month 3–4: Gradual return to full activity

💊 Post-Surgical Care

• 💉 Pain meds and NSAIDs
• 🧊 Ice therapy during the first 5–7 days
• 🧘 Passive range of motion exercises under guidance
• 💪 Rehab exercises like sit-to-stands and leash walking

📋 TTA Surgery Summary

⚠️ Risks and Complications

• 🦠 Infection at incision or implant site
• 🔩 Implant shifting or loosening
• 💥 Bone fracture near surgical site (rare)
• 🚨 Limping that doesn’t improve—may require re-check

Complications are uncommon but serious. Always follow all post-op instructions and return for checkups as scheduled. 📆

📈 Long-Term Outcomes

TTA surgery offers excellent long-term results, especially when paired with proper rehabilitation. Most dogs regain full use of the leg and return to athletic function. Ongoing joint support and maintaining a healthy weight will improve your pet’s joint health for years to come. 🐾

🔧 Ask A Vet Can Help

Wondering if TTA is right for your dog? Use the Ask A Vet app for expert orthopedic guidance, recovery tracking, and personalized rehab plans. 🐶💬

🐾 Final Thoughts from Dr Duncan Houston

CCL injuries are painful and life-limiting—but with timely surgery and thoughtful recovery, your dog can get back to what they love. If TTA is your vet’s recommendation, rest assured: it’s a powerful option for a strong, stable future. 💙🦴