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This study evaluates the impact of Kirschner wire (K-wire) insertion direction on the biomechanical properties of combined tibial plateau leveling osteotomy (TPLO) and tibial tuberosity transposition (TTT) procedures in small-breed dogs with cranial cruciate ligament rupture and medial patella luxation. Twenty-one cadaveric tibiae were divided into two groups; the specimens were divided into two groups; one underwent TPLO-TTT with a proximal pin placement (Group TTP), and the other received TPLO-TTT with a distal pin placement (Group TTD). For both pin placements, two additional subgroups were formed: one with a 0.56 mm tension band (Groups TTP0.56 and TTD0.56) and the other with a 0.76 mm tension band (Groups TTP0.76 and TTD0.76). The tensile force was applied, and failure load and mode were recorded. The distal pin direction in Group TTD0.56 exhibited a significantly higher mean failure load (380.1 N) compared to the proximal pin direction in Group TTP0.56 (302.2 N,
Nam et al. (Sat,) studied this question.