In practice, the most common orthopaedic procedure is the surgical management of cranial cruciate disease in the dog.
The choice of surgical techniques is huge, suggesting that none are perfect. They may be divided broadly into two groups: those which attempt to replace the anatomy or function of the original ligament, and those which seek to moderate the effects of a cruciate deficient stifle.
Techniques which replace either the physical ligament or its function include:
- Over the Top technique (OTT)
- DeAngelis lateral suture and derivatives
- TightRope and similar techniques
All of the above attempt to stabilise the stifle by replacing the ligament or its function.
Techniques which moderate the effects of the cruciate deficient stifle by altering the dynamics of the forces acting on it include:
- Tibial Plateau Levelling Osteotomy (TPLO) radial cut
- Tibial Plateau Levelling Osteotomy (TPLO) wedge cut
- Tibial Tubercle Advancement (TTA)
- Triple Tibial Osteotomy (TTO)
- Modified Maquet technique (MMT)
- TTA Rapid
Ultimately it will be a decision for the individual surgeon as to which techniques will be offered to the client. The client will make their choice based on their own circumstances. We have taken the view that until there is evidence to the contrary we will support all the available techniques through the provision of training materials, instrumentation and implants.