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Orthopedic Services

Cody B. Johns, DVM

Tibial Tuberosity Advancement (TTA)

The TTA procedure involves making a cut in the front part of the tibia bone (tibial tuberosity) and advancing this portion of bone forward in order to realign the patellar ligament so that the abnormal sliding movement within the knee joint is eliminated. A specialized bone spacer, plate and screws are used to secure the bone in place. A special bone putty is placed in the gap in the bone to stimulate healing. These patients have a quicker recovery time and a more consistent return to full function.

 For young, large breed dogs, the TTA promises better long term joint stability and less chance of secondary osteoarthritis or degenerative joint disease.

Lateral Extracapsular Technique

The lateral extracapsular technique is a better choice for small dogs and cats. During the lateral extracapsular procedure, heavy suture material (monofilament nylon cord) is passed from the lateral fabella to the tibial crest in order to eliminate joint instability (drawer movement). It is this nylon cord that will act as the CCL ligament in the future by holding the joint together and keeping it stable.

Tightrope CCL is an extracapsular technique using the lateral suture stabilization (LSS) procedure in conjunction with a material called FiberTape to provide bone to bone stabilization. The Fiber Tape is placed in the dog's knee through a few small incisions which create tunnels through the bone. The Fiber Tape holds the joint in place while the knee forms scar tissue around the knee to permanently stablize the joint.

Gastrocnemius Tendon Repair ( Achilles Tendon )

The Achilles tendon is actually composed of three tendons with the gastrocnemius tendon being the superficial digital flexor tendon. When this tendon ruptures or is lacerated, the lower leg becomes hyperextended, and the animal may have trouble bearing weight on it's leg. Surgical treatment is preferred over conservative treatment if the entire tendon has ruptured. The most common form of injury to this tendon is laceration, but degeneration of the tendon can develop over time.

Fracture Repairs

Accidents happen and bones often break! While some smaller, less-displaced bone


fractures can heal with the help of a simple splint or cast (known as external fixation), most require a little more hardware (or internal fixation) to get the best healing results and maximum comfort. 

Dr. Silver has over 20 years of experience fixing bone fractures such as :

Long bones (such as the femur, tibia/fibula, radius/ulna, tibial and femoral fractures

Joint bones or small bones (such as metacarpal, carpal, metatarsal or tarsal bones)

Mandibular jaw fractures

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