TTA, MMP

Question 1

MMP

Terreros VCOT 2021
prospective
bioaabsorbable citrate-based implant

Answer 1

20% major comp - cortical hinge fractures most common
73% good outcome
complete absorption not confirmed 6m postop rads

Question 2

Jin VS 2019

ex vivo study
True TT advancement in commonly used cages

Answer 2

true TT advancement was less than each cage size by at least 1.5mm

20-30% underadvancement

Question 3

Measuring angles TTA

Answer 3

1) Homer VS 2019
retrospective
influence of OA on measuring patellar tendon angle

2) Aragosa Animals 2023
cadaveric study
tibial anatomy based method vs common tangent - postop TPA similar for both and within suggested range
common tangent mean value postop TPA 90deg

Question 4

clinical studies TTA

-Modifications to Tepic’s original:
-mod macquet technique
-TTA rapid
-modified macquet procedure
-modified macquet TTA
-TTA with cranial fixation
-porous TTA

Answer 4

1) Aragosa Animals 2022 (REVIEW)
-30 studies new gen TTA
-common tangent method
-40% presented with meniscal injuries, 4% late meniscal tears
->90% full fx
-10% major comp, 30% minor comp

2) Miller Frontier 2023
-novel mini plate in 26 small dog
-92% good outcome
-20% postop comp: TT #, MPL, persistent lameness

3) Matchwick VS 2021
-Forkless TTA 329dogs
-8% major comp
-3% postlim meniscal tears (incidence may be reduced with greater advancement)

4) Ferriera JSAP 2019
-35 stifles small dogs <15k
-6% comp

5) Ferrell VS 2019
-1768 stifles
-5% SSI (of which 30% implant removal)
-no benefit to postop a/b (increases risk of oxacillin-resistant infection)

Question 5

Meniscal load after TTA

Answer 5

Schmutterer VCOT 2023
TTA reduced contact force ratio in both menisci significantly
no changes in peak pressure or peak pressure location
increased stifle extension (145deg) may increase stability