Related Experiment Video
Updated: Jul 12, 2026
Anterior Cruciate Ligament Transection and Synovial Fluid Lavage in a Rodent Model to Study Joint Inflammation and Posttraumatic Osteoarthritis
Published on: September 2, 2025
In dogs with ruptured cranial cruciate ligament, is TPLO superior to TTA in reducing postoperative radiographic
Pico Question:
In dogs with a naturally occurring ruptured cranial (anterior) cruciate ligament [P] does surgical treatment using tibial plateau levelling osteotomy (TPLO) [I] compared to a surgical repair using tibial tuberosity advancement (TTA) [C] result in a reduction in the risk of developing postoperative osteoarthritis? [O].
Category Of Research:
Treatment.
Number And Type Of Study Designs Reviewed:
Three papers were reviewed. These were a prospective, randomised, non-controlled clinical trial; a prospective, randomised, controlled clinical trial; and a retrospective, non-controlled, blinded cohort study.
Strength Of Evidence:
Weak.
Outcomes Reported:
The first clinical trial showed that TTA was associated with less osteoarthritis (OA) progression than TPLO at 6-month follow-up. However, the opposite was reported in the second clinical trial, where less OA was recorded following TPLO than TTA surgery. In both the first and second studies, the difference between groups was not significant. The third study reports a significant increase in OA score in TTA over TPLO group at end of follow-up period. Despite the third study claiming a noticeable difference in recorded OA between these two surgeries, evidence is presently scant.
Conclusion:
At the time of writing of this Knowledge Summary there is minimal evidence to conclude either TTA or TPLO reduces the rate of postoperative osteoarthritis progression for dogs treated for naturally occurring cranial cruciate ligament rupture.
Additional Comments And Caveats:
All three studies possess various limitations, such as a lack of controls, absent confidence intervals, lacking blinding, small sample sizes, presence of confounders, bias, and short follow-up, all of which limit the value of their conclusions. How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient's circumstances and owners' values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.