# TPLO vs LATERAL SUTURES?



## Kevin Eskam (Mar 2, 2007)

My dog Jake has to have one of the above surgerys!
does anybody have a preference?
Is one better or more reliable then the other?
Thank You... Kevin


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## Furball (Feb 23, 2006)

<<My dog Jake has to have one of the above surgerys!
does anybody have a preference?>>

Yes, TPLO.

<<Is one better or more reliable then the other?>>

Yes, TPLO.

Please consult an orthopedic surgeon. We are two years out on a TPLO on my parent's TWELVE year old flat-coat (his birthday was Valentine's day). No, not exactly a competing retriever, but one very happy customer.
Would not hesitate to do TPLO again, but hopefully won't have to.
--Anney


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## 2Blackdogs! (Apr 6, 2006)

Kevin- Sorry to hear this. TPLO Just went thri this with KC. She was injured just before she ran (you judged) in Ks last fall- Had the TPLO done a week or two after she got her ribbon. Then 4 months of confinement. She was just released to activity and got to run for the 1st time last weekend- You would never know she had the procedure. You want to avoid cartiledge damage-so stop all activity asap and get it done. email me if you like.


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## 30 caliber (Jan 28, 2008)

I am a veterinarian who has done many surgeries to correct ruptured cranial cruciate ligament (CCL) using the lateral suture technique. Years ago, my dog completely ruptured one CCL and had a partial tear in the other. Since TPLO was supposed to be the best option, I had a board-certified surgeon to a TPLO on the side with the complete tear. My dog never was completely sound on that leg again, and still is not. Fast forward about 3 years. She finished off the partial tear, so now I had a complete CCL rupture on the unoperated knee. Not being completely satisfied with the results of the previous TPLO, I operated the new side and repaired it with the lateral suture technique. Guess which side had the better outcome? The lateral suture side. BTW, she had partial tears of the medial meniscus both times with correction for that being the same each time. Also, there are published studies showing no statistical difference in outcome based on the surgical technique used for repair. There are some exceptions to this, such as extreme slope of the tibial plateau. You need to find a surgeon that has a lot of experience doing knee surgeries, but after that the choice about the type of repair is up to you. What happens in the recovery period after surgery is very important (restricted activity followed by carefully and consistently applied physical therapy) and may have more to do with the final outcome than the surgical technique. Hope that helps.


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## pupaloo (Jan 6, 2006)

30 caliber-sorry for your experience...

Kevin,

Get the TPLO. Nothing in life is 100% perfect-but TPLO is the BEST CURRENT PROCEDURE for Jake to have return to full function. Find a surgeon who has done lots of them, and do exactly what you are told to do for the exact amount of time for the physical therapy afterwards-don't decide Jake feels better and skip steps or go faster than they say. Like Steve says, do it asap-the longer you wait, the more damage will be done. Good luck!

Marlana


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## Greg Seddon (Jan 7, 2005)

Kevin, I remember someone here on RTF recently needed to have knee surgery on his dog and was looking at TPLO or this newer procedure TTA. I took a look at it and decided if my dogs ever needed knee surgery I would have this new procedure (TTA) done. 

*Here are a few links below to what TTA is* 
http://www.veterinaryspecialty.com/TTA.aspx

http://www.mvah.us/tibial_tuberosity_advancement_TTA_surgery.nxg

*Here is a video that came up when I was looking for information on TTA*
*TTA Surgery Video*
http://youtube.com/watch?v=vjJu9noUgco


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## pupaloo (Jan 6, 2006)

TTA does look like a good option-only problem is the procedure is too new to know how it will hold up over time. Great info in those links!


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## 2Blackdogs! (Apr 6, 2006)

That is some good info. It will be interesting to see if the specialist change in general over time as to what procedure they prefer. I took notice to the 8 week rest period vrs the 16 week rest period for the tplo. If that is true it implies a 50% shorter recovery period. It is not intuitive to me that this would be the case though-as it seems that there is a realy big gap to fill in with bone growth on the newer procedure.


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## Misty Marsh (Aug 1, 2003)

I think that TTA offers some advantages over TPLO, but the big thing that kept me from going with it was the relatively recent advent of the procedure and lack of long tern research specifically in the hard working HT/FT world and qualified ortho vets framiliar with the procedure. Given enough time and dogs with a successful repair in the HT/FT world it will likely be an real option.


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## Kevin Eskam (Mar 2, 2007)

Misty Marsh said:


> I think that TTA offers some advantages over TPLO, but the big thing that kept me from going with it was the relatively recent advent of the procedure and lack of long tern research specifically in the hard working HT/FT world and qualified ortho vets framiliar with the procedure. Given enough time and dogs with a successful repair in the HT/FT world it will likely be an real option.


I agree, I need to get the best procedure done for jake, he is not a dog for the faint of heart! He is 100% whacko bird dog gives me 150% when we play! Even yesterday (I think he did it last week but I thought he hurt his foot!))!! went out on our 20 minute run (NAGDA) and he found 3 birds real quick, but the last 10 minutes was really struggling and I knew something bad happened ! There was a Vet there who plays the game checked him out and could move his knee back and forth!

So thanks everybody I just want to get the right thing done for him, So me and my buddy can play some more games!! Kevin


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## 2Blackdogs! (Apr 6, 2006)

Prepare a place for him kevin. They will act like they are ready to go barely a week or two after the procedure but nothing can be farther from the truth. Confinement and only allowed out on leash is a must for months-That is the most difficult part after getting over the $3k bill. My specialist did follow up xrays at 6 weeks and then at 16 weeks. At 6 weeks you can see that the cut in the bone was starting to heal but there was still plenty of gap. There is a bone point created by the procedure on the front that is critcal not to break off and that is a big reason why steps are outlawed thru the healing period. I kept KC in a 3.5' x 7' "room' that opened up to the outside thru a siding glass door- so she could see the outside and we did not have to use any steps to go out to potty (walk out basement). Had to line the walls with plywood as she tried to dig thru the wall! She was kept in there 100% of the time for 2.5 months. Then we began bringing her up stairs on the weekend when I was gone with Cletis and Chief hunting. For the last month we let her out in the small back yard to do her biz off leash and also allowed her to go up and down only the carpeted stairs. Those 1st 2 months are especially critical-never off leash and very confined.


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## lablover (Dec 17, 2003)

You need to talk to a board certified orthopedic surgeon for these questions. The surgeon you select for the operation, should have done hundreds of these procedures.

I used Dr John Sherman, at VETHAB in Raleigh, NC. Totally satisfied with Dooey's results!


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## JusticeDog (Jul 3, 2003)

Greg Seddon said:


> Kevin, I remember someone here on RTF recently needed to have knee surgery on his dog and was looking at TPLO or this newer procedure TTA. I took a look at it and decided if my dogs ever needed knee surgery I would have this new procedure (TTA) done.
> 
> *Here are a few links below to what TTA is*
> http://www.veterinaryspecialty.com/TTA.aspx
> ...


I agree with Greg, and my vet has come to the same conclusion. And you just need to get them into the hands of someone who does a LOT of them.


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## Kevin Eskam (Mar 2, 2007)

Well we got into see Jennifer Fick out of Longmont, she was recommended by quite a few people!! She has done alot of TPLO surgerys, She has not seen enough studys on the TTA surgery to know if it is a better surgery than TPLO, As far as the Lateral Sutures, She just flat out told me he is too big of dog and with what I do with him it will not last!! So next Monday is the date!!


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## Dave Kress (Dec 20, 2004)

keskam
All good advice here but if i may offer my 2 cents- It may not be the surgrey however that is important but the rehabilitation after the fact may be more important. 
Suggest to call Doctor John Sherman at VetHab in Raleigh NC for some facts and figures he uses. John does not do the proceedure but he does do the rehab and many of the very best trial dogs go there for the work.
dave kress


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## Misty Marsh (Aug 1, 2003)

Dave is correct you can have the best surgery out there, but if your re-hab is crap your odds will increase quickly of having a prematurely effected arthrittic dog with likely two surgeries on board due to failure of the once good knee taking the brunt of the load!


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## Kevin Eskam (Mar 2, 2007)

We have alot of stuff like a underwater treadmill just waiting for him when he is ready! I am not going to skimp on the rehab!! He means to much to me!! Kevin


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