Today at the Peninsula Pet Hospital was surgery day. The first surgery I observed was an ACL repair for a fourteen year old, poodle named Jenna. The specific surgical technique that Dr. Harish was using is called tibial tuberosity advancement, an orthopedic procedure to fix a torn anterior cruciate ligament and a torn meniscus. There are three popular ways to fix an ACL: extracapsular stabilization, tibial plateau leveling osteotomy (TPLO) or as Dr. Harish used, TTA. The first, extracapsular stabilization, entails the surgeon placing a nylon suture around the knee and into a drilled tunnel in the proximal tibial crest. This is the oldest and cheapest method; but the prosthetic suture may wear down and break. The TPLO method calls for a cut to be made in the tibia bone (an osteotomy) so that the slope of the tibial plateau can be leveled, all of which is held together by a plate and screws. This method is rather invasive, so Dr. Harish decided to do a TTA on Jenna. TTA entails correcting the angle between the tibial plateau and the patellar tendon to 90 degrees by placing a titanium implant on the knee. The result is that the ACL is no longer needed because the normal unstabilizing forces were offset by the 9o degree angle.

Actually seeing the TTA surgery was amazing. I could not believe I was seeing actual bone and tendon in front of me. Dr. Harish was careful to point out what everything was to me, and even showed me Jenna's torn ACL. The vet tech jokingly said I should be proud I didn't pass out, although the smell of the little saw that Dr. Harish used on Jenna's tendons was starting to get to me.

The next surgery of the morning was for Molly, an adorable six month old Coton de Tulear. She was being spayed laparoscopically, which is much less invasive (yet $250 more expesive) than a regular spay.