The standard TTA procedure assumes that there is no co-existing patella issues. The tibial tubercle is simply advanced. In cases where there is patella luxation in addition to cranial cruciate rupture, it is possible to move the tibial tubercle either laterally or medially to help re-align the quadriceps mechanism. this is achieved by adding washers to either the cranial screw or the caudal cage screw. The washers are placed between the cage and the tibia to effectively push the tibial tubercle laterally (cranial screw) or push the tibial tubercle medially (caudal screw). It is sugested that the tibial tubercle is moved a maximum of 50% of its width.
Each washer adds 1.0mm of translation.
TTA Washer Titanium.