Distal Tibial Osteotomy for Medial Tibiotarsal Osteoarthritis in Dogs

The distal tibial osteotomy (DTO) procedure is a simple technique to offload the medial compartment of the tibiotarsal joint in dogs that have medial compartment osteoarthritis (OA). Analogous in concept to the high tibial osteotomy (HTO) used in people with knee gonarthrosis and the sliding humeral osteotomy (SHO) developed for use in dogs with elbow disease. The DTO technique involves performing an incomplete opening wedge osteotomy in the distal tibia. DTO presurgical planning involves obtaining accurate caudocranial and lateral radiographs of both tibias as described by Dismukes (5). Surgical planning software is used to establish frontal plan mechanical axis and joint orientation lines. The mechanical medial distal tibia angle (mMDTA) is then determined. Published normals for mMDTA range from 90.59 to 101.39 degrees. The goal of the DTO is to increase the mMDTA by 5 to 7 degrees thus shifting the mechanical axis laterally and off-loading the medial compartment. Osteotomy location in the distal tibial will depend to some degree on the implant system employed but should be as distal as possible while still allowing for appropriate implant placement and avoidance of the joint and/or growth plate in young dogs. The technique is applicable in both acute and chronic conditions related to OCD or other joint trauma. This technique has been employed clinically for 10 years and performed by numerous ACVS surgeons with consistently positive outcomes.

Acknowledgment

None.

 

MissingLinkText

Publication History

Article published online:
15 July 2025