Newer repair techniques for larger patients
The tibia is cut and put back together in such a way to change the slope at the top to nearly horizontal. Typically a bone plate is used to secure the tibia. By doing this the dynamics of the stifle joint are changed in such a way that the anterior cruciate ligament is no longer required to stabilize it. The ligament itself is not replaced. This has been a more successful technique in large dogs but is more expensive to perform.
There are four major methods of performing this technique
1.Tibial plateau leveling operation, which remains the gold standard.
2.Tibial crest advancement
3.Tibial wedge osteotomy
4.Triple tibial osteotomy
All techniques seem to have merit.
Typically these procedures require referral. The surgeons at Boronia now commonly perform Triple tibial osteotomies and have performed a number of Tibial wedge osteotomies as well.