Based on the work of Slocum, Tepic and Montavon the triple tibial osteotomy has been developed by Dr Warrick Bruce in Australia to overcome some of the problems encountered in the Slocum TPLO technique, the Montavon TTA (Tibial Tubercle Advancement) and the closing wedge TPLO technique. Work by Tepic suggests that the tibial plateau should be perpendicular to the patella ligament to minimize shear strain at the CrCL. The Slocum technique does not always address this.
Additionally, the technique uses flat semi disposable blades for ease of use and cutting efficiency.
Advantages over Slocum Procedure
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Does not require expensive and inefficient bi radial saw and blade.
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Flat blades creates less heat and fewer complications.
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Procedure ensures that tibial plateau is brought square to the patella ligament.
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TTO instrument allow minimal errors Slocum technique requires much more guesswork.
Advantages over Wedge Osteotomy
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Tibia is not shortened.
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Osteotomy is not exposed to stress of the pull of the patella ligament as the tibial crest remains intact.
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Does not require figure of 8 wire to neutralize this.
Advantages over Tibial Tubercle Advancement (TTA)
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Does not leave large defect in tibial crest which requires expensive Titanium implants to protect.