What is Tibial Plateau Leveling Osteotomy (TPLO) Surgery?
Tibial plateau leveling osteotomy (TPLO) stabilizes the knee after a cranial cruciate ligament (CCL) tear has occurred. During this procedure, the joint is explored through a small incision to confirm the CCL tear and check the health of the meniscal cartilages. Meniscal tears can occur secondary to CCL tears in dogs. If there is a meniscal tear, it is treated by removing the affected cartilage.
After the joint assessment, the TPLO is performed by making a semi-circular cut at the top of the tibia bone. The top is rotated 5-10 millimeters so that the angle of the tibial plateau is reduced from approximately 25 degrees to 5 degrees. A bone plate and bone screws are placed across the cut (osteotomy) so that the bone heals in that new shape. The joint is immediately stabilized by this adjustment so the CCL is no longer required for comfort and limb function.
This procedure yields far better results than attempts to replace the ligament. While no guarantees can be made about any procedure, owner satisfaction rates are very high with TPLO and dogs typically return to excellent limb function.
Frequently Asked Questions
What complications can occur?
The most common complication following TPLO (at any clinic or hospital) is infection. It is important to ensure that your pet ‘or any other pets’ in the home cannot lick, chew or sniff the incision as that significantly increases the risk. Implant removal may be necessary once the bone is healed if infection occurs.
It is possible that a meniscal tear can occur following TPLO surgery. This is uncommon (< 5% risk) but surgery to remove the torn cartilage is indicated if it occurs. Patellar tendinitis can occur in some cases and responds to rest and anti-inflammatory medication typically. Major complications, such as bone fracture and implant failure, are uncommon as long as the discharge instructions are followed closely.
What else can I do to maintain my dog’s joint health?
Besides weight management, there are several things such as a prescription joint diet with omega-3 fatty acids, glucosamine chondroitin, Adequan injections, and ongoing rehabilitation.
Please refer to the Management of osteoarthritis page for more information.
My dog has CCL tears in both knees. Will you do surgery on both sides at the same time?
In many cases, we will perform bilateral TPLO to avoid putting the patient through two separate procedures and recovery periods. It is also more financially feasible for many owners to do both knees at the same time.
It is important to recognize that these patients will typically take 24-72 hours before they start becoming mobile. They require more nursing care and support (walking with sling or carrying) than a patient having surgery on one leg.