Tibial tuberosity advancement

There's a couple of big studies.

There was this prospective out of Cornell, like Crocek, comparing TPLO, TTA lateral suture.

And these couple of key articles were definitely, I think, reinforcing of clinical impressions.

Mm-hmm.

And when I was a resident, we did a lot of TTAs and we noticed that they did not appear to be stabilizing the joiners well on the rechase.

Were owners happy? Sure.

Did the lameness improve? Yes.

I don't know if you guys are familiar with this one.

And I remember probably 10, 15 years ago, it was like partial tear, complete tear, let's just do surgery.

I think as this evolved and we realized this wasn't just these acute traumatic tears that even with stabilizing surgery, whether you're doing a lateral suture or a TPLO or a TTA, yeah, you're addressing that cranial tibial thrust, but none of the operations are addressing the synovitis.

None of them are addressing the inflammation, that underlying inflammatory cause.

And so I think with the progression of physical therapy and rehab and the sports medicine board that was created, there are lots of other options.

And that helps.

A recent paper that just came out showed that, hey, do we even have to deal with the meniscus at all at surgery? Let's not even open the joint and look.

We'll just go ahead and do the TPLO or the TTA, which, again, is a little controversial.

But I know a lot of surgeons that are doing that.