TTA is where instead of cutting the top of the bone in a curve and rotating it to a 90 degree angle, they slice down the part of the bone that is non-weight bearing and put in a spacer to make the bones meet correctly. They still install a plate and screws, only because it's on a non weight bearing part of the bone as opposed to the TPLO that cuts into the weight bearing part of the bone, that the dogs seem to heal better and faster. The recovery is still about the same, no running jumping etc. but they are able to put weight on the leg within a shorter amount of time. It also seems that with the TPLO, the tendon doesn't have much to 'hang onto', but with the TTA, the tendon stays in place. TTA also is not as difficult surgery as TPLO becuase there is less 'manipulation' in the surgery. The results seem to be the same, but the TTA is relatively new procedure (since 2003) whereas the TPLO is around a little longer. (although still relatively new itself) I have researched doctors who do both, and it seems they are doing more TTA than TPLO even though they can do both. We want to do the best for him, but with so many conflicting opinions it's hard to know what that is. If I go to a vet that does only TPLO he says that's the best. If I go to a vet that does TTA he says that's the best. There are no vets around here that do both, so I relied on research to see that vets that do both do more TTA. I know the regular 'ligament repair' surgery is not recommended for dogs over 30 lbs. so we have eliminated that from our decision. Any thoughts would be greatly appreciated. Thanks.