What is TPLO Surgery?
The TPLO surgery stands for Tibial Plateua Leveling Osteotomy Surgery. It is provided to dogs who have torn the cranial cruciate ligament (crCL ligament), often referred to as a torn ACL.
The top of the tibia in dogs is not flat like that of humans; instead, it is sloped backward. This change in position causes undue, consistent stress on the CrCL. The purpose of the crCL is to prevent backward movement of the femur in relation to the tibia. Continuous stress on the crCL eventually causes it to tear, leading to an unstable joint and chronic pain.
TPLO surgery aims to ultimately remedy this condition by preventing this torn CrCL ligament from impacting the dog’s stance.
What are the mechanics of TPLO Surgery?
During the operation, the surgeon will cut and rotate the tibial plateau portion to alter its slope. This change in slope will prevent the femur from sliding down the slope of the tibial plateau when a dog places any weight on its knee, effectively creating a condition in which the crCL ligament is no longer required for the dog to maintain its stance.
- The Initial Appointment
- During this appointment, Dr. Natt will perform a physical examination on your pet to analyze the movement and overall stability of the knee. Additionally, x-rays of the joint are also taken to determine if additional factors are contributing to the joint pain or for signs that the ligament has torn (the presence of osteoarthritis and the overall angle of the tibial plateau)
- These x-rays also ensure proper planning and the determination of key factors essential to the success of the surgery such as the size and blade required, the position of the cut, and the level of rotation required for the bone.
- The Surgery
- During the surgery, antibiotics, anesthesia and painkillers are administered on the dog. The slope of the tibial plateau is altered by cutting the tibia and rotating the tibial plateau and applying a plate which is further locked into place with locking screws in order to stabilize the joint.
- Post-Surgery Care
- Post-operative x-rays are taken to assess whether the repair in sufficient. In particular, the overall slope of the tibial plate and the placement of the bone plate and screws is assessed.
- Upon discharge (typically the day after surgery), painkillers and antibiotics are provided. If the dog is likely to scratch or lick the area of the incision, an Elizabethan collar may also be provided to prevent irritation of the area. We also recommend to all clients to download the TPLO Step-by-Step Home Rehabilitation Guide.
- During this rehabilitation process, exercise and stress on the joint must be prevented for the first few weeks after the surgery to ensure that the cut bone heal sufficiently.
- At 2 weeks, 4 weeks and 8 weeks after surgery, Dr. Natt will also administer a post-surgery examination. At the 8-week stage, Dr. Natt will obtain an additional set of x-rays to ensure that the bone has healed appropriately (the cost of these x-rays are included in the overall cost of the surgery).
Other surgeries offered for ACL Rupture:
- The MMP (Modified Maquet Procedure) TTA (Tibial Tuberosity Advancement) is another alternative for TPLO Surgery. The goal of the surgery is to make the patella ligament at 90 degrees to the tibial plateau—thus, making the knee stable dynamically. In this procedure, a titanium foam implant is utilized to advance the tibial crest further and place the femur head. The implant has a porous structure which permits the growth of bone for added stability to the joint. For more information, please visit the following link.
- At Serra Veterinary Hospital, Dr. Natt performs this surgery on dogs smaller than 30 pounds and bigger dogs who are old and at risk of slower bone healing.
- CBLO (Cora Based Leveling Osteotomy) is another alternative for TPLO Surgery and is based on cutting the Center Rotation of Angulation of the tibia (the CORA). It is reserved for dogs with excessive slopes as well as young dogs with open growth plates. It has been available for only a few years and is not as prevalent as TPLO. While it may not be as commonly performed as TPLO, this is another surgery that Dr. Natt has performed if needed.
- Extra-Capsular Repair
- This procedure is typically performed on smaller dogs. In this procedure, a micro-filament structure material is passed through the fabella (a small bone attached to the femur), passed through a bone tunnel located in the front of the tibia, and then looped back to attach to itself. This procedure may also be referred to as a “lateral suture stabilization” or the “fishing line technique.” At Serra Veterinary Hospital, Dr. Natt uses a metallic anchor and braided synthetic material called FASTAK/Swivel-lock Anchor system by Arthrex. Please find more information about the surgery at the following link.
Questions? Call us at (408)739-3545.