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PICO questionIn dogs with cruciate disease, is the use of TTA Rapid (TTAR) compared to traditional TTA (tTTA) associated with a higher risk of tibial diaphyseal fractures?Clinical bottom lineBased on studies published between January 2013 and January 2018, the rate of tibial diaphyseal fractures as a complication of Tibial Tuberosity Advancement Rapid (TTAR) surgery is within the published limits of traditional Tibial Tuberosity Advancement (tTTA). In this period, seven studies were related to tTTA, comprising of four; one case series, two retrospective case-control studies, and one retrospective cohort study. Five case series were related to TTAR. All evidence within this period has been observational (Level 3 and 4 evidence). No direct head-to-head comparison between the techniques has been studied.