TPLO (Tibial Plateau Leveling Osteotomy)
Our skilled team of veterinary professionals specializes in performing TPLO (Tibial Plateau Leveling Osteotomy) procedures to effectively treat cranial cruciate ligament injuries, restoring mobility and improving your pet’s quality of life
Pet TPLO
The cranial cruciate ligament (CCL) in dogs, similar to the ACL in humans, is a vital structure that stabilizes the knee joint (stifle). Together with the caudal cruciate ligament, it forms a crisscross pattern inside the knee, preventing abnormal movement. When the CCL is torn or injured, it leads to significant pain, joint instability, and long-term damage.
How the Injury Affects the Knee:
- Positive Drawer Sign: A telltale sign of CCL rupture is the tibia sliding forward relative to the femur, which can be felt during a physical examination.
- Pain and Mobility Issues: Most dogs with a CCL tear have trouble walking or bearing weight on the affected leg. They often limp or avoid using the leg entirely.
- Joint Damage: The instability from a torn CCL causes wear and tear on the cartilage and bones, accelerating the development of osteoarthritis and worsening joint health over time.
Causes of CCL Rupture:
- Acute Injury: A sudden trauma, like a slip, twist, or high-impact activity, can cause the ligament to tear.
- Chronic Degeneration: In some dogs, the ligament gradually weakens due to age, repetitive stress, or genetic predisposition, leading to a partial or complete rupture.
Treatment Options:
Treatment depends on the size, age, and activity level of the dog, as well as the severity of the injury. Options include:
- Surgical Correction: Procedures like TPLO, TTA (Tibial Tuberosity Advancement), or Lateral Suture Stabilization are commonly performed to restore stability and prevent further damage.
- Conservative Management: For small or less active dogs, a combination of pain management, physical therapy, and restricted activity may be considered, although surgery typically yields better long-term outcomes.
The development of Tibial Plateau Leveling Osteotomy (TPLO) revolutionized the management of cranial cruciate ligament (CCL) ruptures in dogs. This surgical procedure alters the mechanics of the knee joint (stifle) by changing the angle of the tibial plateau, thereby stabilizing the joint even in the absence of a functional CCL.
How TPLO Works:
- Reducing Tibial Thrust: During movement, a ruptured CCL allows the tibia to shift forward relative to the femur, creating instability. TPLO minimizes this forward movement by changing the slope of the tibial plateau to a nearly level position.
- The Surgical Process:
- A semicircular cut is made through the proximal (top) part of the tibia.
- The cut portion of the tibia is rotated to achieve the desired slope.
- A bone plate and screws secure the rotated segment, allowing the bone to heal in its new position.
- Stability and Healing: By leveling the tibial plateau, the surgery eliminates the need for the CCL to prevent forward tibial thrust, providing stability during weight-bearing and movement. This reduces the risk of further joint damage, inflammation, and osteoarthritis.
The Wagon Analogy:
To better understand the biomechanics:
- Before TPLO: The tibial plateau is sloped, like a hill. The femur’s weight exerts force down the slope, causing the tibia to “slide” forward unless restrained by a functional CCL (like a rope holding a wagon on a hill).
- After TPLO: By leveling the tibial plateau, the “hill” becomes flat, and the tibia no longer slides forward under weight, even if the “rope” (CCL) is absent.
This procedure has become a gold standard in veterinary orthopedic surgery, offering dogs a reliable path to regain mobility and comfort.
Recovery from TPLO surgery typically takes 8 to 16 weeks, depending on your dog’s age, size, overall health, and how closely you follow post-operative care instructions. Here’s a general timeline to help you understand what to expect:
1-2 Weeks Post-Surgery (Acute Recovery Phase):
- Activity: Strict rest is crucial. Your dog should only go outside for potty breaks and be kept on a leash at all times.
- Wound Care: Monitor the incision site for signs of infection (redness, swelling, discharge). A cone or Elizabethan collar may be needed to prevent licking.
- Pain Management: Your veterinarian will prescribe pain medications and possibly antibiotics. Follow the medication schedule carefully.
2-6 Weeks Post-Surgery (Initial Healing Phase):
- Activity: Gradually increase controlled activity, such as short leash walks. Avoid running, jumping, or climbing stairs.
- Rehabilitation: Depending on your vet’s advice, you may begin gentle range-of-motion exercises or physical therapy to maintain flexibility and muscle strength.
- Follow-Up X-Rays: At around 6 weeks, your vet will likely take X-rays to assess bone healing and ensure the plate and screws are stable.
6-12 Weeks Post-Surgery (Strengthening Phase):
- Activity: As healing progresses, leash walks can become slightly longer, but high-impact activities are still restricted.
- Physical Therapy: Hydrotherapy or other low-impact exercises may be introduced to rebuild strength and mobility.
12-16 Weeks Post-Surgery (Full Recovery):
- Activity: Most dogs can return to regular activities, including running and playing, by this time. However, some larger or older dogs may take longer.
- Final X-Rays: Your vet may recommend a final set of X-rays to confirm complete healing of the tibia.
Long-Term Considerations:
- Arthritis Management: Even with TPLO, some dogs may develop osteoarthritis in the joint over time. Maintaining a healthy weight and possibly using joint supplements (e.g., glucosamine, chondroitin) can help.
- Ongoing Monitoring: Continue regular check-ups with your veterinarian to ensure long-term joint health.
Always follow your veterinarian’s specific recovery plan, as they’ll tailor it to your dog’s needs. Strict adherence to rest and rehabilitation is essential for optimal healing.
Veterinary Services
Below are all of the veterinary services we offer at Ithaca Animal Hospital. If you have any questions regarding our services, please feel free to call us.