Triple Tibial Osteotomy: My Two Cents on TTO Cruciate Repair

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.

Triple Tibial Osteotomy: My Two Cents on TTO Cruciate Repair

Today, let’s discuss Triple Tibial Osteotomy (TTO).

I first came across this information 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 quickly gained popularity in New Zealand, Australia, and England.

It appears to be a good alternative, and I hope it will also become an option for dogs here.

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 the already available Tibial Plateau Leveling Osteotomy (TPLO) and the Tibial Tuberosity Advancement (TTA).

The ultimate goal of all 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 delays 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. In addition, 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.

Related articles:
Talk to Me about ACL Injuries

Further reading:
TTO – Triple Tibial Osteotomy

Categories: CCL injuries • Joint issues • Knee issues

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Jana Rade

I am a graphic designer, dog health advocate, writer, and author. Jasmine, the Rottweiler of my life, was the largest female from her litter. We thought we were getting a healthy dog. Getting a puppy from a backyard breeder was our first mistake. Countless veterinary visits without a diagnosis or useful treatment later, I realized that I had to take Jasmine's health care in my own hands. I learned the hard way that merely seeing a vet is not always enough. There is more to finding a good vet than finding the closest clinic down the street. And, sadly, there is more to advocating for your dog's health than visiting a veterinarian. It should be enough, but it often is not. With Jasmine, it took five years to get a diagnosis. Unfortunately, other problems had snowballed for that in the meantime. Jasmine's health challenges became a crash course in understanding dog health issues and how to go about getting a proper diagnosis and treatment. I had to learn, and I had to learn fast. Helping others through my challenges and experience has become my mission and Jasmine's legacy. I now try to help people how to recognize and understand signs of illness in their dogs, how to work with their veterinarian, and when to seek a second opinion. My goal is to save others the steep curve of having to learn things the hard way as I did. That is the mission behind my blog and behind my writing. That is why I wrote Symptoms to Watch for in Your Dog, which has turned out being an award-winning guide to dog owners. What I'm trying to share encompasses 20 years of experience.

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