Tibial Tuberosity Advancement – 2 in clinical development

The TTA (Tibial Tuberosity Advancement) is entering the second decade of clinical use. Kyon has sold over 100,000 TTA implant sets to about 1,000 surgeons worldwide and almost all veterinary orthopedic companies have either copied or modified the TTA system.  We believe the TTA-2 has the potential to:


  • –  reduce the risk of infections;
  • –  reduce iatrogenic damage to the tuberosity;
  • –  accelerate incorporation of the implant into the bone; and
  • –  shorten the surgery time.

We are frequently asked why we do not perform Tibial Plateau Leveling Osteotomies (TPLO) for cruciate failure. A recent VCOT (Veterinary and Comparative Orthopaedics and Traumatology) article presented the infection rates when using  the TPLO system for cruciate repair. Out of 668 cases in which the TPLO system was used, there were 57 infections, or 8.5%. During the same time period, surgeons using the TTA system experienced a much lower infection rate; between 0.5% and 1%.

One of the most important benefits of the TTA-2 is that the tuberosity won’t be touched once the partial osteotomy is performed.

In the original TTA, the grade 2 titanium cage is designed to minimize the volume of the metal and to allow the bone to infiltrate the cage. The much stronger grade 4 titanium TTA-2 cage has been redesigned for “through-growth” of the bone. This new design will allow the bone to move through the void inside the cage and fill it with fully perfused bone and without the risk of mechanical failure. The TTA-2 cage is coated with Biocer® which improves the ability of cells attach to the surface. This should allow faster mechanical soundness with the TTA-2 over the original procedure.

All of these factors should contribute to a shorter period of consolidation and reduced risk of infection.

An additional benefit may be shorter surgery time –by as much as 10 to 15 minutes – which will further reduce the risk of infection. The TTA-2 cage is longer and fills the gap with a scaffold for bone through-growth, which should eliminate the need for gone graft material as well.

Dr. Dew is one of a handful of veterinary surgeons selected by Kyon to use the TTA-2 procedure. During your pet’s exam and consultation, he will determine whether the TTA-2 is right for your dog.