252 Surgical Treatment
Conclusions
TTO represents another approach to modifying
the forces around the stifle in order to achieve
functional stability following cruciate ligament
rupture. About two-thirds of the adjustment
is achieved by leveling of the tibial plateau,
and one-third by advancing the tibial tuberos-
ity. Because of this combined approach, the
overall morphology of the tibia is altered less
than with a CCWO. Also, because the tibial
tuberosity is separated from the plateau frag-
ment, there is much less force acting on the
osteotomy, and complications of fixation are
therefore much reduced. The specialized instru-
mentation facilitates accurate wedge cutting.
For surgeons unfamiliar with TPLO and who
are unable to purchase a radial cut saw, the TTO
procedure is a viable alternative.
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