title: Distal tibial tuberosity translation using TTA implants for the treatment of patella alta in large breed dogs. Surgical technique and clinical outcome.
abstract: BACKGROUND
  Medial patellar luxation frequently occurs in dogs resulting in lameness with increasing incidence in large breed dogs. Patella alta has been defined as a patellar ligament length to patellar length ratio that is greater than two and may predispose to patellar luxation.
  
  
  OBJECTIVE
  To describe the surgical technique for stabilization of the distal translation of the tibial tuberosity using tibial tuberosity advancement plates and the clinical outcomes with follow-up for clinical cases of dogs.
  
  
  METHODS
  Dogs that were presented with the complaint of patellar luxation and that were concurrently diagnosed with patella alta and were greater than 20 kg in body weight underwent surgery using a tibial tuberosity advancement plate to stabilize the osteotomy. Radiographic assessment of A:PL distance (the ratio of the proximal aspect of the patella to the femoral condyle [A] to the patellar length [PL]), L:P ratio (ratio of the length of the patellar ligament to the diagonal length of the patella), and owner assessment were obtained.
  
  
  RESULTS
  Eleven stifles in nine dogs underwent surgical correction with a mean preoperative L:P ratio of 2.47. There were no complications and the lameness resolved clinically. The mean A:PL ratios preoperatively (2.6 ± 0.22) and postoperatively (2.1 ± 0.25) were significantly different (p = 0.0003). All owners were satisfied with the outcome and all dogs had a resolution of lameness with no recurrence of patellar luxation.
  
  
  CONCLUSIONS
  Stabilization of distal translation of the tibial tuberosity using tibial tuberosity advancement implants to correct patella alta in large breed dogs was feasible and resulted in good clinical outcome.
authors.affiliation: Lauren C. Pugliese, DVM, The Ohio State University, College of Veterinary Medicine, 601 Vernon L Tharp Street, Columbus, OH 43210, United States, Phone: +1 614 292 3551, Fax: +1 614 292 1454, E-mail: lpugliesedvm@gmail.com.
authors.forename: L C
authors.initials: LC
authors.lastname: Pugliese
authors.forename: F S
authors.initials: FS
authors.lastname: Pike
authors.forename: S W
authors.initials: SW
authors.lastname: Aiken
mesh_terms: D000818:Animals; D001860:Bone Plates / Q000662:veterinary; D004285:Dogs / Q000293:injuries / Q000601:surgery*; D005260:Female; D008297:Male; D010027:Osteotomy / Q000379:methods / Q000662:veterinary; D010329:Patella / Q000000981:diagnostic imaging / Q000601:surgery; D031222:Patellar Dislocation / Q000000981:diagnostic imaging / Q000601:surgery / Q000662:veterinary*; D011859:Radiography; D013264:Stifle / Q000000981:diagnostic imaging / Q000601:surgery; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Patellar luxation; TTA; large breed dogs; patella alta; tibial tuberosity advancement