TTTT

TTTT
(Tibial Tuberosity Transposition Technique)

The TTTT-MTTT- tibial tuberosity transposition technique involves moving the tibial tuberosity without separating it from the tibia, and allows for proper function of the patellofemoral joint.

To do this, we perform an osteotomy using an oscillating saw, guiding the cut proximally from the plane of the tibial plateau along the axis of the bone to the area below the curvature of the tibial tuberosity.
In order to spare the tissues surrounding the joint, the last section of the cut is made with a scalpel.
With the help of a thin wide chisel inserted proximally in the line of the cut, we try to gently release and then, using the principle of the so-called greenstick, bring about the displacement of part of the bone along with the attachment of the ligament to the lateral side. In the case of a young animal, this is a fairly easy procedure and the extent of transfer needed is achieved fairly quickly. In the case of an older patient with heavily calcified bone this technique requires patience as too much compression can lead to bone separation.