Is it always a perfect substitute for vsync (other than it takes up more vram)?
I read the AT article, and the article gave me the implication that it was, but can anyone confirm whether that's true?
Its not a substitute, its meant to be used in conjunction with.
Its an alternative to double buffering which can have a major draw back of halving your frame rate if performance can't stay above the monitor's refresh rate.
Triple buffering prevents the massive frame rate drops and, in theory, should have far less input lag than double buffering (but either will have some input lag vs. no vsync at all)
HOWEVER, there are still several caveats to triple buffering:
1. there is no way to force it outside of a hack unless its an OpenGL game
2. games that do support it on their own and call it "triple buffering" (for instance, Left 4 Dead gives you the option between double and triple) don't use true triple buffering, they use a render ahead queue, which is similar in the sense that it prevents frame rate halving, but it does not have the reduced input lag benefit.
3. some games / game engines don't cooperate well with triple buffering no matter what
4. true triple buffering with reduced input lag benefit cannot work on AFR modes for multi GPU setups