Tibial Plateau Leveling Osteotomy (TPLO)

Knee surgery for dogs

Pet surgery

The Anterior Cruciate Ligament (ACL) in humans is known as the Cranial Cruciate Ligament (CrCL) in dogs.  In both the human and canine model, this ligament may tear.  Most owners do not know exactly how the CrCL tear occured, but they notice the gait abnormality in their pet. Often, the ligament tear will need to be repaired in dogs who lead an active life.  The CrCL repairing technique that we usually recommend at Sun Valley Animal Center is the Tibial Plateau Leveling Osteotomy (TPLO) procedure.  In our hands, we have found few procedures with a success rate as high as that of the TPLO.

Dr. Randy Acker began doing the TPLOs in the early 1990′s, after learning the TPLO technique from Dr. Barclay Slocum, who developed this procedure.

Clinical signs of CrCL tear in dogs will vary from intermittent lameness with exercise to complete carrying of the leg. The CrCL tears can be partial, complete, or complete with a damaged meniscus.  A dog with a partial CrCL tear may be intermittently lame, and when sitting, the dog often holds the leg out to the side.  A dog with a complete CrCL tear tends to be 3-legged lame for a few days with some improvement as the inflammation resolves. The last phase of a tearing CrCL involves damaged meniscus, which will cause the dog to bear very little weight on the leg.

Most partial tears will progress to complete tears.  Sometimes other decisions are made when patients are old or have multiple problems that may lead to more conservative treatments. Because dogs have more cranial tibial thrust than humans do, they usually do not heal with rest. They may function well enough to get along, but they will continue to be lame without knee surgery for dogs.

Most dogs return to normal or near normal function within 6 months of surgery. Patients can return to field trial, jogging, or any other work that they performed prior to surgery.

Traumatic injury is the most common cause, however other factors that may contribute to CrCL rupture include immune-mediated disease, narrow intercondylar notch, and infectious disease.

The tibia is cut, rotated, and plated to make the CrCL unnecessary. The medial meniscus is also examined.

All dogs are examined the day of surgery.  Radiographs are taken of the hips, low back, and both knees. With this information, the best treatment for your dog is determined. Because some dogs have multiple problems, we ask that you are present for the decision making process.

The anesthesia gas used during surgery at Sun Valley Animal Center is Isofluorane.  This gas anesthesia is considered very safe, even for long pet surgeries. A thorough physical exam and pre-operative blood work is performed on all patients to determine their general health and to make sure that they are good candidates for anesthesia and surgery. Patient’s vital signs are continually monitored throughout the surgery.  Pain is managed with an epidural and femoral block followed by local anesthetic.  Take home medication often includes Deramaxx, Tramadol, and a Fentanyl patch.

Most patients go home on the day of surgery.  We rarely hospitalize our patients overnight.

The complication rate is very low at less than 5%. Potential problems include future meniscal damage, patellar tendon insertion fracture, infected plates, dislocated kneecaps. In some patients, the CrCL in the other knee also will rupture in time.

Learn more about TPLO surgery on Synthes’ website, tploanswers.com.

Please call Sun Valley Animal Center at 208-726-7777 to schedule a TPLO.