Don’t let your veterinarian present you with a single option for surgical repair of your dog’s torn cruciate ligament.
It does matter whether your surgeon is comfortable with any particular procedure. However, it is also important to discuss or research all available options. Figuring out how you want to treat your dog injured knee is an important decision. Surgery is invasive and you and your dog will have to live with your choice.
Today, let’s discuss Triple Tibial Osteotomy (TTO).
The first time I came across this information was on a New Zealand Rottweiler forum. It caught my attention, so I did some further research.
This approach to repair a stifle with a ruptured ACL originates in Australia.
It was developed by a New Zealand orthopedic specialist Dr. Warrick Bruce and seems to be quickly gaining popularity in New Zealand, Australia, and England.
It appears to be a good alternative and I am hoping that it will become an option for dogs here also.
Why might TTO be better?
It is less invasive than the commonly used TPLO. It also seems to have fewer problems associated with it than either the TPLO or TTA surgeries.
Triple Tibial Osteotomy is a hybrid of both of the already available Tibial Plateau Leveling Osteotomy (TPLO) and the Tibial Tuberosity Advancement (TTA).
The ultimate goal of all of the knee repair surgeries in dogs is to regain joint stability after an ACL injury. In TPLO, TTA, and TTO this stability is achieved by altering the anatomy of the stifle joint.
What does Triple Tibial Osteotomy stand for?
Triple Tibial Osteotomy is a descriptive name of the procedure. It consists of three straight cuts to the tibia, none of which are all the way through the bone.
Triple Tibial Osteotomy eliminates the need for a circular cut that is needed in the TPLO. This results in better stability during the healing phase. A straight cut also generates less heat. This decreases the risk of burning the cut surfaces of the bone, eliminating delay in healing.
What is different with TTO
Instead of cutting an entire piece of bone as in TPLO, only a small horizontal wedge is removed from the main bone shaft to level the tibial plateau.
Similar to TTA, the front wedge of the bone is pushed forward.
This surgery seems to have a high success rate. Studies show that the joints repaired with this technique are very stable. It is less invasive, easier to do and seems more reliable than the TPLO and TTA surgeries.
I am not a surgeon, but it definitely looks very good to me. I would want to have the TTO as one of my options to consider if I had to make a decision today about knee surgery for my dog.
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TTO – Triple Tibial Osteotomy