Retrospective Clinical and Radiographic Outcomes of a Cageless Tibial Tuberosity Advancement Technique in Small-Breed Dogs

Cranial cruciate ligament rupture is a common orthopedic condition in dogs, and tibial tuberosity advancement is a well-established surgical treatment. The aim of this retrospective study was to evaluate the short-term clinical and radiographic outcomes of a cageless tibial tuberosity advancement technique in small-breed dogs. Medical records of 63 dogs (77 stifles) treated using this technique were reviewed. Fixation was achieved using three construct types: a screw-pin construct (the majority of cases), a screw-only construct, or a screw combined with two pins. Due to small subgroup sizes, fixation-type outcomes were primarily analyzed descriptively. Clinical and radiographic evaluations were performed immediately after surgery and at eight weeks postoperatively. Clinical outcomes were graded based on limb function, and radiographic bone healing was scored using a standardized scale. Postoperative complications were recorded and analyzed in relation to patient and procedural variables. No intraoperative complications were observed, while postoperative complications occurred in 27% of dogs and were predominantly minor and implant-related. Lameness scores improved significantly over the follow-up period. All treated stifles demonstrated stable implants, maintained advancement, and satisfactory bone healing. The use of bone graft material appeared to be associated with fewer complications and more favorable clinical outcomes; however, this observation should be interpreted with caution given the retrospective and non-randomized design of the study. In this retrospective case series, cageless tibial tuberosity advancement using screw-based fixation (predominantly screw-pin constructs) was associated with favorable short-term clinical and radiographic outcomes. These findings should be considered preliminary and limited to short-term evaluation, given the retrospective design, absence of a control group, and relatively short follow-up period. Further prospective studies with larger populations, standardized outcome measures, and longer follow-up are warranted to confirm these findings.