Based on the work of Slocum, Tepic and Montavon, the Triple Tibial Osteotomy has been developed by Dr Warrick Bruce to overcome some of the problems encountered in the Slocum TPLO technique, the Montavon TTA (Tibial Tubercle Advancement) and the closing wedge TPLO technique.
Some of the problems include:
Work by Tepic suggests that the tibial plateau should be perpendicular to the patella ligament to minimise shear strain at the CrCL. The Slocum technique does not always address this issue.
The bi-radial Slocum blade is inefficient and difficult to resharpen resulting in the generation of significant amounts of heat which leads to delayed healing and other complications.
The Montavon TTA technique creates a large defect in the cranial tibia which requires an expensive titanium cage and plate to prevent collapse during the healing phase.
The closing wedge TPLO shortens the tibia and creates a defect in the tibia which has to be protected from the pull of the straight patella ligament by a figure of eight wire.
The TTO technique deals with all of these problems: A long osteotomy is made in the tibial crest to allow the tibial tubercle to move forward. The angle correction is made by making a small wedge osteotomy in the caudal tibia which, when closed creates a small tibial tubercle advancement.
TO SEE MORE INFORMATION ON THE TTO PROCEDURE, INCLUDING A STEP BY STEP GUIDE & VIDEO, PLEASE CLICK HERE