Surgery STAT: TTA vs. TPLO: Recovery time remains an important consideration
EDITOR'S NOTE: SurgerySTAT is a collaborative column between the American College of Veterinary Surgeons (ACVS) and DVM Newsmagazine. In December, Shawn Mattson, DVM, DVSc, BSc , Dipl. ACVS, discusses "Treating Subchondral Bone Cysts in the Fetlock Joint." Dr. Mattson practices at Moore and Co. Veterinary Services, a full-service equine hospital in Calgary, Alberta, Canada. Dr. Mattson, previously at the Ontario Veterinary College in Guelph, Ontario, has published scientific articles in the American Journal of Veterinary Research and Veterinary Surgery related to research on orthopedic infections in horses.
To locate a diplomate, ACVS has an on-line directory, which includes practice setting, species emphasis and research interests (www.acvs.org/VeterinaryProfessionals/FindaSurgeon).
TTA and TPLO both appear to be excellent procedures for the treatment of cranial cruciate ligament injuries in medium and large breed dogs. These procedures also may be considered in smaller, more active patients and those with bilateral disease. They should be considered for those patients in whom other procedures have failed.
Some dogs are not good TTA candidates due to an excessively steep tibial plateau angle, a coexisting patellar luxation or excessive concavity to the tibial crest. In these cases, TPLO is an excellent alternative. We have been performing the TPLO successfully for 11 years now. Our experience with more than 10,000 cases has been positive and similar to the clinical reviews in the veterinary literature. We recommend this procedure for medium- to giant-breed dogs with cranial cruciate ligament disease and for those patients who need to return to an athletic lifestyle.
Many factors enter into the decision-making process that revolves around a recommendation for medical care. Everything from patient compliance to client financial concerns to the availability of surgical equipment and expertise will impact how a case moves forward.
The interpretation of sound scientific data definitely will help us, but it will be only a piece of this complex puzzle.
Drs. Rasmussen (right) and Levine are ACVS board-certified surgeons. Dr. Rasmussen is with the Veterinary Surgical Specialists — a small-animal surgery specialty practice serving the Greater Twin Cities area of Minnesota. Dr. Levine is owner of Veterinary Surgical Specialists.