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TPLO (cruciate ligament surgery)

  • Dog
  • Anaesthesia
  • Anatomy
  • Analgesia
  • Orthopaedics
  • Surgery
  • Physiotherapy

TPLO (= tibia plateau levelling osteotomy) in dogs means a surgical adjustment of the joint surface of the tibia bone. It is a possibility to treat the cruciate ligament rupture in dogs surgically.

Cruciate ligament tear in dogs – a brief explanation

The knee is a very complex joint; apart from the bones that constitute it, there is a number of ligaments, tendons and other connective tissue structures, such as the menisci or cartilages, which are necessary for optimal function. Unlike in humans, whose cruciate ligament usually tears as a result of a (sport) injury, in dogs it is generally a degenerative disease that develops gradually. This culminates in rupture (tearing) of the cruciate ligament, usually the anterior one. This causes varying degrees of lameness, increased swelling of the joint and instability of the limb as the cruciate ligament normally prevents the thigh bone from sliding off the backward and downward sloping joint surface of the tibia (shin bone). You can find out more about cruciate ligament tear in dogs here.

TPLO in dogs: what is that?

The TPLO cruciate ligament operation in dogs is one way of stabilising the torn cruciate ligament. In this operation, the angle of the tibial plateau (the joint surface of the shin bone) is changed from about 25° (it differs individually) to about 5°. To find out the exact figures, special X-rays are taken before the operation on which the plateau angle can be measured. The dog is given a general anaesthetic for the operation. In the procedure, the surgeon cuts off the head of the tibia with a bone saw and changes its alignment so that the joint surface becomes almost horizontal. The bone fragment is reattached in the new position using screws and plates. The result is that the distribution of forces in the joint is now different and its function is stable even without the cruciate ligament so the thigh bone can no longer slide off. The newer generation implants are usually left in place and not removed later.

As for all operations performed under general anaesthetic, the dog must be fasting for cruciate ligament rupture surgery. Your vet will advise you of any other precautions, for example if your dog is given certain medications. After the operation, the animal remains under veterinary supervision until it is fully conscious again.

By the way: the menisci are often crushed and injured by the instability of the knee. Since they would later cause severe pain, the injured parts of the menisci are removed from the knee joint before the TPLO operation in dogs.

TPLO cruciate ligament operation in dogs: possibilities and limitations

If osteoarthritis is already present, which develops due to incorrect joint loading when the cruciate ligament is partially or completely torn, this can unfortunately not be reversed. Nevertheless, severe pain apparent previously is usually reduced markedly after the operation or disappears completely and the progression of the osteoarthritis is slowed.

TPLO in dogs: recovery and postoperative care

Ideally, recovery after TPLO involves stable knitting of the bone within 8-12 weeks. The dogs are given pain relief and products to build up cartilage after the operation. Physiotherapy also assists the healing process. On no account should your dog become overweight as this would greatly increase the stress on the limbs. TPLO aftercare also includes walking the dog only on a leash for the next 6-8 weeks so as to avoid sudden severe stresses on the knee. The bone must be given time to heal again. In principle, the leg can bear weight cautiously directly after the operation. Your vet will give you an exercise plan as light daily exercise that is increased slowly will get the dog moving again. Loading of the operated knee is thus increased gradually. Exercise also promotes maintenance or building up of muscle and stimulates the circulation and therefore healing.

If the dog is free from lameness and pain again after complete bone healing, there is no reason against a return to sport or service.

Advantages of TPLO in dogs

TPLO in dogs has several advantages:

  • Because the bone is fixed using an implant, light weight-bearing is possibly again directly.
  • Dogs with an only partially torn cruciate ligament can also have surgery using this method. In this way, corresponding complications and pain can be avoided.
  • The employed plate hovers just over the bone so it becomes less irritated and heals faster. There are also fewer infections and complications than with compression plates.
  • The TPLO method can be used in principle in all dogs, regardless of their size.

TPLO in dogs: complications

Following TPLO there is sometimes delayed bone healing or implant loosening. Wound infections, inflammation of the patellar tendon or injury of the menisci can also occur and necessitate a further operation. (Unlike with TTA (TTA in dogs) the joint is opened during TPLO, which is associated with an increased infection risk.) These complications occur in up to 14 % of operated dogs.

TPLO in dogs: cost

The cost of TPLO consists of different components: these include the actual veterinary service, dressing and suture material and naturally the postoperative care. In Germany there is also a binding veterinary fee schedule and billing must be in accordance with this. If you have questions about the cost of cruciate ligament tear TPLO in dogs, ask your vet who will be happy to advise you.

Other cruciate ligament operations in dogs

TPLO is not the only possible treatment of cruciate ligament rupture. Other cruciate ligament operations in dogs are the tibial tuberosity advancement procedure (TTA in dogs) and various ligament replacement operations. The latter are intended to replace the torn cruciate ligament or alter the joint capsule of the knee in such a way that it stabilises.

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