Kuan S, Smith B, Black A. University Veterinary Teaching Hospital Sydney, University of Sydney, New South Wales, Australia. sooyuin@yahoo.com.au Aust Vet J 2009 Nov 87 11 438-44 BACKGROUND: Tibial wedge ostectomy (TWO) is a surgical procedure that aims to give functional stability during weight-bearing in a hindlimb with cranial cruciate ligament deficiency, by reducing the slope of the tibial plateau angle. PROCEDURE: Advantages of the TWO surgery are that it does not require dedicated equipment and can be performed in young dogs prior to closure of the physis. However, it is a technically demanding procedure and the potential for complications is high. RESULTS: In this retrospective review of 249 dogs that had unilateral and 51 that had bilateral TWO surgery, the overall complication rate was 31.7% (95/300) and the rate of revision surgery was considerable (37 cases or 12.33%). CONCLUSIONS: The most important clinical complications were postoperative medial meniscal tears, tibial fractures and implant failures, necessitating repeat surgery.