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Anterior Cruciate Ligament Slide 2 -GENETIC -ENVIRONMENT -OTHER Slide 3 GENETIC Conformation Stifle angle >135 deg Valgus /Vargus Medial Patella Luxation(MPL) Sloping Posterior Tibial Plateau Small Bone Structure/Muscle Mass Slide 4 -USE/ACTIVITIES =Field Trial =Agility =Frisbee =squirrel chaser Slide 5 -DIET/CONDITIONING -OTHER -injury -tumor Slide 6 -Anterior Drawer Sign -Tibial Thrust -Radiography -Anesthesia Slide 7 -Extracapsular -Non-Absorbable Suture -Artifical Ligament Implant -Geometric Altering Procedures -Aronosky Over the Top Slide 8 -Tibia Plateau Leveling Operation- TPLO Licensed by Slocum Enterprises Eugene, OR Slide 9 Slide 10 -First Break-Through for RCCL Repair, esp. Active and Obese Patients -Allows for the Correction of Vargus/Valgus in one operation -Increases Pressure in the Posterior joint space and on the menisci -Most Invasive and Traumatic of current procedures -Most likely to require Rehabilitation - Corrects the sloping posterior tibia -Can be used when other procedures have been performed -Implants made of SS, are quite massive, limited industry standards Slide 11 Immediate Post-op TPLO Slide 12 4-week Post-op TPLO Slide 13 Tibial Tuberosity Advancement Developed by Slobodan Tepic and Pierre Montavon University of Zurich, Switzerland KYON-Zurich, Switzerland and KyonPharma, Boston Slide 14 TTA Slide 15 Restores stability by adjusting joint force vectors Maintains congruency of joint Allows unimpeded full range of motion Preserves primary loading axis of tibia Increases lever arm of quadriceps force and thus reduces all internal joint reactions Implants are made specifically for TTA and are Titanium for reduced body reactivity Implants and instruments made in Switzerland and Germany and of highest quality and standards Slide 16 Requires a bone graft Less Allowance for Technical Errors More difficult to correct Valgus/Vargus Potential for Non-Union is greater Patients will weight-bear immediately upon recovery from anesthesia which lessens requirement for rehab Unkown if Osteoarthritis is reduced but is expected to do so with current case experience Over 40,000 cases world-wide have been performed Slide 17 Both require surgeon with training and experience Both require strict aseptic techniques Both require extensive inventory of implants Both require Orthopedic Power Equipment Both require extensive array of Orthopedic Instrumentation Both require extensive Follow-Up Slide 18 Common Tangent of Femur Condyles and Tibial Plateau German Method Elimination of Tibial Thrust Weight and Plate Size Slide 19 Slide 20 Slide 21 Slide 22 Slide 23 Slide 24 Field-Trail Lab 7m0 PostSurgery TTA Slide 25 KYON.CH (Swiss website) KYONPHARMA.COM(Boston) SLOCUM ENTERPRISES.COM JEFFMAYO.COM Slide 26 R-9-17-08 L-11-20-09 Dates of surgery, TTA, both legs Slide 27 Slide 28 Two Days Post Op Cocker Male-5yr Slide 29 Thanks for fixing my leg, Griffen Slide 30 STAGE ROAD ANIMAL HOSPITAL,PC James Ritchie Pearce, BS,DVM,DABVP