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TTO – Triple Tibial Osteotomy

What is a TTO Surgery?

A TTO, or Triple Tibial Osteotomy, combines different aspects of  the TPLO and TTA.  Similar to the TPLO and TTA, the TTO involves cutting the tibial bone to change the angle of the knee joint.  The TTO is not commonly performed in the US at this time.

Basic Overview of How the TTO Surgery is Performed

During a TTO, a veterinary surgeon makes three cuts into the dog’s tibia.  These cuts allow the surgeon to rotate the tibial plateau (as in TPLO), while moving the tibial tuberosity forward slightly (as in TTA).  A metal plate is then screwed into place onto the bone to hold the new joint angle.  These cuts and bone angle changes result in a 90 degree angle within the knee joint when the dog’s leg is extended.

Read More: What is a TTO Surgery?

TTO Recovery Time

You will have a visit with your vet a few days following the procedure.  Odds are your dog may already be toe touching within 48-72 following surgery.  At 1-2 weeks your dog should start using the leg more, and full healing of the bone should take place at about 6 weeks.

Of course, physical therapy and rehabilitation should be integrated slowly to be most effective and not place undue strain on the recovering joint.

Read More: TTO Surgery Recovery

Estimated Cost of TTO Surgery

According to Dog Knee Injury Community Contributors, the cost for TTO surgery is in the $3000-5000 range.

The cost for TTO can vary depending on:

Size of Your Dog – Smaller dogs require less; many of the medications, supplies and even the metal used to hold the joint together are calculated based on weight

Geographic Location – Veterinary hospitals and clinics within major cities tend to be more expensive than smaller veterinary offices

Type of Veterinary Facility – Veterinary universities and smaller clinics typically charge less than orthopedic specialty clinics

What is Included – Are you paying ONLY for the surgery, or are post-operative x-rays, visits and medications included?

Read More: TTO Surgery Cost

Additional Information on TTO Surgery

Rave’s story is a very detailed account of what to expect when going through a TTO surgery – Rave’s TTO Surgery

Read Owner Experiences

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TTO Surgery for Dogs

TTO and MMP Surgery for Dogs – Heidi

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TTO Surgery with Laser

TTO Surgery with Laser – Stetson

Stetson had his TTO surgery today, just 9 weeks after my girl, Rave. His accident is an unfortunate co-incidence. Neither is related to their agility involvement. However both dogs being athletic competitors, we want a great outcome thru both the surgery and the ensuing physical therapy. I have been very well pleased with Rave’s recovery […]


TTO Surgery – Coco the Chocolate Lab

TTO Surgery for Dogs – Coco The Chocolate Lab’s Story Coco is doing fine. She is now putting her foot to the floor for balance although she is not putting her full weight on it. She has just undergone her 2-week review and had the stitches removed. She has a further check up in 2-weeks […]