TPLO SURGERY IN THE SAN JOSE AREA
The first part of the surgery involves removing the torn ends of the cruciate ligament and examining the medial and lateral meniscus cartilages. Our veterinarian then determines if a tear of either meniscus is found, the damaged part of the meniscus is removed. Below is an illustration of the top view of the tibia after the femur bone has been removed; it shows the medial meniscus (M), the cruciate ligament © after it has been cut and the lateral meniscus (L); the dashed line shows the typical location of a tear of the medial meniscus; the drawing below on the right shows the torn part of the meniscus that has been pushed forward.
The tibial plateau leveling osteotomy – TPLO involves making a curved cut in the top of the tibia bone (osteotomy) to include the tibial plateau (the dashed line denotes the top of the tibial plateau) is then rotated along the curved osteotomy in order to level the slope. A plate and screws are used to hold the tibial plateau in place so that the bone can heal well at our veterinary hospital located in the San Jose Area.
Healing Phases Following TPLO surgery:
Unlike the convalescence from other extra-articular or intra-articular techniques, recovery from TPLO surgery frequently is more rapid and complete. Our San Jose Area veterinarian explains 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. By 2 weeks after 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. Radiographs taken at 8 weeks postop 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. At 2 months after 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. Complete recovery may take 3 to 5 months. At 4 months after 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.
Yearly radiograph of the stifle should be taken to evaluate the degree of arthritis. The TPLO procedure should minimize the progression of degenerative joint disease. One study demonstrated a four fold reduction in the progression of arthritis following TPLO surgery, versus dogs that received the lateral imbrication technique.
Success with TPLO Surgery
A successful outcome will return your dog to full function on the limb. About 90% of the dogs having TPLO regain normal or near normal function of the limb (full weight-bearing). The remaining 10% of dogs that do not do as well have concurrent arthritis of other joints on the limb or advanced degenerative joint disease; most of these dogs in this group are also helped with the surgery. We have found that many working dogs return back to full function. Only a small percentage of patients do not respond well to this type of surgery. Dogs that have sustained a blowout fracture of the tibial plateau as a complication of falling after surgery tend to not regain as good of function on the limb. Dogs that have been previously operated using another technique frequently are improved with the TPLO surgery, but the outcome may not be as good, versus a virgin knee that has received the TPLO surgery.
TPLO procedure with synthes locking plate available, for more information visit: tploanswers.com