What is Tibial Plateau Leveling Osteotomy (TPLO) for Dogs?

What is Tibial Plateau Leveling Osteotomy (TPLO) for Dogs?

The Tibial Plateau Leveling Osteotomy or TPLO is a popular surgical procedure performed on canines with torn cranial cruciate ligament, also known as ‘the dog ACL.’

This procedure was developed by American veterinary surgeon, Dr. Barclay Slocum, and is an extremely effective surgery to address this type of injury.  It has been the standard surgical procedure for torn canine cranial cruciate ligament for almost two decades.

One of the major functions of the cruciate ligament is to prevent the drawer motion, the forward and backward sliding of the femur.  The cranial cruciate ligament is found inside the stifle joint.  It is responsible for a stable joint.

A tear in this ligament will lead to serious lameness, which is an unfortunate common problem that affects dogs of all ages and breeds.  In-fact my dog, Rhea, has had the surgery done.  I will share my own experience and tips at the end of the article.

The surgery is performed to stabilize the stifle joint, which is simply the knee.

The Process

A dog’s cruciate ligament is vulnerable to tearing because of constant tension on the ligament.  If the ligament is torn, every time your pet stands on the affected leg, the femur slides on the tibia bone.  This causes pain and uncomfortable inflammation.  

Cruciate ligament tearing is considered a gradual process, rather than a condition caused by a single injury.  It is usually brought on by age-related degeneration. The early signs of degeneration include mild lameness or stiffness of the leg.  The lameness becomes obvious after the condition advances.  Dogs of large breeds are almost always recommended surgery after consultation.

During the first part of the surgery, the torn ends of the cruciate ligament is removed and the meniscus cartilages are examined.  The surgery completely alters the dynamics of the stifle joint so that the tear in the ligament becomes irrelevant to the normal functioning of the knee.

It involves making a curved cut at the top of the tibia bone, including the tibial plateau.  After the cut and rotation of the tibia plateau, the femur can no longer slide backwards on the plateau when weight is put on the knee.  A plate and screws are placed in the tibial plateau, so the bone can stay in place for recovery.  This stabilizes the knee and the need of the cruciate ligament is eliminated entirely.

It is important that the screws placed do not penetrate through the top of the tibia bone as it will result in serious complications, such as arthritis.

Recovery

Normally, the dog will begin walking on the limb within a day of the surgery and it will be able to bear weight within 2 weeks following surgery.  Partial tears are easier to recover from than complete ligament tears.

The first three months after the TPLO surgery are a critical recovery period.  You can help your canine recover successfully by the help of certain exercises.  Rehabilitation exercises can be crucial in resuming the normal function of the limb quickly.  In addition to the surgery, post-surgical therapy is equally important to help your dog walk normally again.

Normal working activities can be resumed after 6 months, but it is important not to over do it.  Your dog will never be 100% recovered, and it will still be bad for the knee if they have to constantly jump up onto high objects such as a couch or a bed.  I highly recommend getting a very comfortable dog bed for your dog, as lying down on the floor will not be the same as before.

Why is TPLO a Good Choice?

TPLO is perhaps the best way to repair a cranial cruciate ligament tear in dogs. But, it is also important to be aware of the alternatives to this surgery. Although a great surgery, TPLO is not the only choice that you can make.

It is strongly advised that you carefully consult with your veterinarian and choose the right surgical procedure for your dog.
Compared to other surgeries, the TPLO is more effective because:

  • It offers a shorter recovery time.
  • It provides a better range of motion of the joint.
  • It may help minimize the progression of arthritis.
  • It allows the canine to return to its athletic activity.

Alternatives to TPLO

Instead of TPLO, these three surgeries are common alternatives to remedy a torn cranial cruciate ligament.

  • Tightrope Technique
  • Traditional Extracapsular Lateral Suture Technique
  • Tibia Tuberosity Advancement, which is also known as TTA Surgery

Second to TPLO surgery, the TTA surgery is also an effective surgical procedure.  In this surgery, a boney projection, known as the tibial tuberosity, is cut and rotated to prevent the femur from sliding back off the tibial plateau.

There are many factors that should be considered when it comes to choosing the best procedure to help your dog.  Here are a few of them:

  • Age
  • Size and weight
  • Recovery time
  • Degree of joint disease
  • Post-surgery care
  • Availability of rehabilitation facility
  • Finance

Again, it is crucial that you take careful consideration and confer with your veterinarian which surgical procedure is the best option for your dog.

How Much Does TPLO Cost?

The cost of the surgery will vary depending upon the surgeon and the place of the surgery, which is roughly around $2500 – $4500.  The cost depends upon pre-surgery work, the anesthesia used, ACL repair, the plate and screws used, post-surgery hospitalization, and medications.

No matter the choice of surgery, the key to overall success is the post-surgery care.  Physical therapy is crucial in getting back normal leg motion and recover from such a major orthopedic surgery as TPLO.

Complications to TPLO

Unfortunately, as with any other surgery, there can be some complications with TPLO.  One of the most common complications is infection, which is most commonly caused if the owners allow the dogs to lick.  This can be easily avoided by the use of E-collar or the lampshade.

Complications may occur due to over-activity after surgery.  After the surgery, if the dogs are over active, it leads to poor healing of the bone.  The surgery involves cutting bone, so it is essential that the dogs allow their bone to heal, which will take a minimum of 8 weeks.

If your pet is not restricted during this primary healing period, then it is possible that it may strain the patellar ligament.

My Personal TPLO Experience

My dog,  Rhea, is a 4 year old American Pit Bull Terrier.  You can learn a bit more about her here: About Us.  About one year ago, Rhea had TPLO surgery on her left leg, after I noticed her limping on it for a couple of months.  At first I thought she may have just sprained it or something, as we run around and play a-lot… but the limping continued for too long.  After getting an x-ray, it was clear that she needed the surgery.  I wanted the best treatment for my dog so that she could recover as much as possible, so I took her in to see one of only two qualified surgeons in the city to perform the operation.

Rhea on her way to the Vet.  She looks very frightened and I don’t blame her.

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When Rhea and I arrived home after the surgery, she was still very “out-of-it” and sleepy from the anesthesia and medication.  It is important to have a comfortable dog bed ready for your dog when you get them back home.  The floor will be too hard, creating a painful pressure on their knee, and it will hurt them too much to pick them up and place them on a bed.  You want to let the knee be untouched as much as possible.

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Recommended Dog Bed: Best Dog Beds For After Surgery

The first three months are going to have to be taken very easy.  I went outside with my dog whenever she had to go to the bathroom and made sure that she didn’t walk too much.  It is important to assist your dog into getting onto the porch, or small steps if needed.  This is to prevent pressure on the knee and to make sure that the staples remain in place.

Some Tips After TPLO Surgery

Ok, so it is important to say that your dog is never going recover 100%.  It has been roughly over a year since Rhea’s surgery and she will still limp if I over exercise her.  We still play fetch, but I cut the duration and distance dramatically.  So instead, I have been taking my dog swimming, which she really seems to enjoy.  I believe swimming is very therapeutic and feels good on her joints.  

Watch This Video Of Rhea Swimming Here:

I have also noticed that my dog favors one side when she sits down.  This is most likely to put less pressure on her knee.  She refrains from laying on the floor as much as possible now also, especially since I have 2 dog beds around for her.  Aside from having a bed for your dog and not playing or exercising as intense as you used to, your dog will still be your best bud and will be smiling the very next day.

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