TPLO is the abbreviation for tibial plateau leveling osteotomy. TPLO Surgery for dogs is used to treat cranial (or anterior) cruciate ligament rupture in dogs. It involves changing the angle of the top of the shin bone (the tibial plateau) by cutting the bone, rotating it, and stabilizing it in a new position with a plate and screws.

Cranial cruciate ligament (CCL) rupture is the most common cause of hind limb lameness in dogs. As a result TPLO surgery is one of the most common orthopaedic surgical procedures performed in dogs in specialist orthopaedic practices.

Why does the cranial cruciate ligament rupture?
In dogs the cruciate ligament tends to undergo degenerative changes that weaken it prior to rupturing. This is in contrast to people, where rupture is often associated with an injury such as skiing or playing football. This important difference explains why treatment options in dogs are quite different to those in people.

The reason the cruciate ligament degenerates prior to rupturing is not clearly understood. Certain breeds, such as Labradors and Rottweilers, are much more commonly affected than others. This suggests there is an inherited component to the condition, possibly related to conformation or gait.

What are the signs of cranial cruciate ligament rupture?
The signs of CCL rupture can be quite variable as rupture may be sudden and complete or gradual and partial. The key signs are hind limb lameness and stiffness. The latter is generally most evident after rest following exercise. Difficulty rising and jumping are common features in dogs with both knees affected. Occasionally 'clicking' noises may be heard.

TPLO surgery first involves examining the CCL tear using a small arthroscope to document the type of tear and to remove the torn portion. Then the medial and lateral meniscus cartilages are examined for tearing. If a tear of either meniscus is found, the damaged part of the meniscus is removed using small instrumentation while viewing through the arthroscope. Next a curved cut in the top of the tibia bone (osteotomy) to include the tibial plateau is made with a saw. The tibial plateau is then rotated along the curved osteotomy in order to change the slope of the top of the tibia according to a predetermined calculation. Next a plate and screws are inserted to hold the tibial plateau in place so the bone can heal.

TPLO Surgery Procedure

1. The first part of the TPLO surgery requires removing the torn ends of the cruciate ligament and examining the medial and lateral meniscus cartilages. If a tear of either meniscus is found, the damaged part of the meniscus is removed.

2. The tibial plateau leveling osteotomy - TPLO surgery involves making a curved incision in the top of the tibia bone (osteotomy) to include the tibial plateau. The tibial plateau is then rotated along the curved osteotomy in order to level the slope.

3. A plate and screws are used to hold the tibial plateau in place so that the bone can heal well.

TPLO Surgery Recovery for your dog:

1. Unlike healing from other some surgical techniques, a dog's recovery from TPLO surgery frequently is more rapid and complete. In our experience, about 50% of the dogs will start to walk on the limb within 24 hours after surgery. Within 5 days after surgery most dogs will begin weight-bearing on the operated limb.

2. By 2 weeks after TPLO surgery, a moderate amount of weight-bearing can be expected. Dogs with partial tears tend to recover quicker than dogs having complete ligament tears. We have seen some dogs having partial tears recover to near full weight-bearing within 2 weeks after surgery…this is phenomenal, as we have never seen this type of a recovery with any of the other surgical techniques that are used to stabilize the knee.

3. Radiographs taken at 6 to 8 weeks after TPLO surgery should reveal healing of the osteotomy site. At this time most dogs have mild or no lameness; when we evaluated our patients having TPLO, the average time for the lameness to resolve was 10 weeks.

4. At 2 months after TPLO surgery, exercise in the form of leash walks should be gradually increased each week. Increasing the number of walks per day tends to be better than just increasing the duration of each period.

5. At 4 months after TPLO surgery most restrictions of exercise can be lifted. Full working activities (hunting, agility, etc) can begin at 6 months after surgery. Unconstrained activity prior to this time can cause spraining of the soft tissues of the stifle (patellar ligament sprain) resulting in a prolonged recovery.
    

For a complete list of certified TPLO surgeons,, review the Slocum Enterprises website.