OssAbility Guided TTA Surgical Instrument Set Instructions
- June 12, 2024
- OssAbility
Table of Contents
OssAbility Guided TTA Surgical Instrument Set
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**Product Information
The Guided TTA system by OssAbility is designed for the treatment of cranial cruciate ligament (CCL) disease by tibial tuberosity advancement. It consists of several components including an Osteotomy Guide, Advancement Lever, Wedge Implant, and tension band plate wit cortical screws. The Osteotomy Guide is configurable for each patient to control the position and orientation of the osteotomy. The Advancement Lever is used to advance the tibial crest for easy implant placement. The Wedge Implant, made of a proprietary porous biocompatible titanium alloy, facilitates rapid bone healing without the need for bone graft. The crest is stabilized using a tension band plate with cortical screws.
Instructions **
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Step 1:
- Configure the TTA Guide according to the pre-op plan.
- Match the orientation of the Guide (left or right marking) to the patient’s limb.
- Insert each offset pin into the dovetail. Align each pin with the predetermined position Secure each pin in place by tightening the thumbscrew.
Step 2:
- Apply the TTA Guide to the patient according to the pre-op plan
- Identify the patellar tendon insertion.
- Measure and mark the predetermined location of the proximal offset pin on the bone
- Align the proximal offset pin to the mark Ensure both offset pins are in contact with the bone
- Rest the Guide on the bone or medial buttress if present
Step 3:
- Insert the proximal locating pin Insert a 2.5 mm single-trocar pin into the proximal locating pin hole
- Extend the pin over the proximal tibial surface, under the fat pad, and caudal to the patellar tendon
- Check that the pin is perpendicular to the plane of stifle motion.
Step 4:
- The hole Identify the hole position on the Guide according to the pre-op plan using a 2.5 mm bit.
- Leave the bit in place.
Step 5:
- Check that the offset pins are in contact with the bone.
- Apply gentle pressure to the Guide and offset pins to maintain contact.
- Identify the oblique locking hole directed away from the stifle
- Insert a 2.0 mm bit into the oblique locking hole and Leave the bit in place.
Step 6
- Perform the osteotomy Incise the periosteum through the Guide using a scalpel.
- Perform the osteotomy using a sagittal saw Use copious saline lavage.
- Maintain blade alignment with the Guide Please note that these instructions provide a genera lover view of the Guided TTA Surgical Technique
- It is essential to carefully plan and execute each step for successful treatment assistance . provides Decision Support at support .
- It is important to remember that all clinical actions are the sole responsibility of the veterinarian providing treatment for the patient.
Step 7
- Remove the TTA Guide Remove the oblique locking bit, Marquette bit, and proximal locating pin.
- Remove the Guide
Step 8
- Introduce the Advancement Lever Compress the bone hinge immediately distal to the Marquette hole with pointed reduction forceps.
- Open the osteotomy with a periosteal elevator. Release lateral tissue if required.
- Introduce the Advancement Lever corresponding to the selected Wedge Implant. Position the Advancement Lever 3 mm distal to the proximal aspect of the osteotomy, engaging the far cortex.
- Remove the periosteal elevator.
Step 9
- Advance the tibial tuberosity Slowly rotate the Advancement Lever to open the osteotomy
- Ensure the Advancement Lever is flush with the proximal aspect of the osteotomy.
Step 10
- Insert the Wedge Implant Lavage the surgical site with saline.
- Handle the Wedge Implant using forceps.
- Insert the Wedge Implant into the osteotomy immediately distal to the Advancement Lever.
Step 11
- Check the Wedge Implant position Remove the Advancement Lever
- If treating MPL, lateralize the tibial tuberosity to achieve alignment of the patellar tendon.
- The final position of the Wedge Implant should be 3 mm distal to the proximal aspect of the osteotomy and flush with the medial bone surface.
- Adjust the Wedge Implant position if required.
- Remove pointed reduction forceps from the bone hinge. Reapply across the osteotomy to compress the construct.
Step 12
- Contour the plate
- Contour the plate using the plate-bending recesses of the Advancement Levers.
- If treating MPL, match the contour to the lateralized tibial tuberosity.
Step 13
- Place the plate according to the pre-op plan
- Position the plate on the tibia according to the pre-op plan.
- Check the proximal screws are centered on the crest and distal to the patellar tendon insertion.
- Check the distal screws are centered on the diaphysis.
- Drill and place the screws in the following order: most proximal screw, most distal screw, and then the remaining screws.
- Remove the pointed reduction forceps.
Step 14
- Compare the completed construct to the pre-op plan
- Check the Wedge Implant placement. Check the plate placement.
- If treating MPL, check patellar tendon alignment.
- Perform post-op radiographs.
TTA wedge implant selection guide
You can use the Breed Guide below to select an appropriate Wedge Implant size for your patient, based on their standing height.
- For example, if a short Mastiff is presented with a standing height of a Labrador, use the implant size for a Labrador.
Guided TTA Catalogue
- 2.4 mm Hex-head Titanium Self-tapping Cortical Screws:
2.4 mm Hex-head Titanium Self-tapping Cortical Screws:
Total Length Product Code
- 10 mm OSS.003.024-10
- 12 mm OSS.003.024-12
- 14 mm OSS.003.024-14
- 16 mm OSS.003.024
Total Length Product Code
- 18 mm OSS.003.024-18
- 20 mm OSS.003.024-20
- 22 mm OSS.003.024-22
- 24 mm OSS.003.024-24
2.7 mm Hey-head Titanium Self-tapping Cortical Screws:
Total Length Product Code
- 16 mm OSS.003.027-16
- 18 mm OSS.003.027-18
- 20 mm OSS.003.027-20
Total Length Product Code
- 22 mm OSS.003.027-22
- 24 mm OSS.003.027-24
- 26 mm OSS.003.027-26
Titanium TTA Plates:
- Plate Product Code
- Extra Small OSS.002.XS
- Small OSS.002.S
- Medium OSS.002.M
- Large OSS.002.L
Guided TTA Catalogue
Wedge Implants:
- Wedge Size Product Code3.5 mm OSS.001.035
- 4.5 mm OSS.001.045
- 6 mm OSS.001.060
Wedge Size Product Code
- 9 mm OSS.001.090
- 12 mm OSS.001.120
- 15 mm OSS.001.15
Guided TTA Instrument Set:
Product
- 6/9 mm Advancement Lever
- 12/15 mm Advancement Lever
TTA Guide
Contact information
Usability Limited
Website: www.ossability.com
Email:info@ossability.com
Decision Support: support.ossability.com
Guided TTA Instructions for Use
Version 2.1
Products described in this document are covered by granted or pending patents.
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