Tibial Plateau Leveling Osteotomy
Thank you for your interest in Brinker Veterinary Hospital’s TPLO procedure.
TPLO, Tibial Plateau Leveling Osteotomy, is an advanced orthopedic surgical technique for repairing the canine stifle (knee) joint. Rupture or tear of the anterior cruciate ligament is the most common orthopedic injury in the dog and the TPLO procedure has become the mainstay for reparation in dog’s who weigh 30 pounds and more.
The dog’s knee is a joint which separates the femur (thigh) bone and tibia (shin bone). The patella (knee cap), tendons and ligaments all play a role in the rear leg’s function and support. The cranial and caudal cruciate ligaments play a very important role in joint stability. The cranial cruciate ligament is responsible for preventing forward motion, or cranial tibial thrust. When this ligament is torn or injured, the tibia slides forward in front of the femur and causes pain, swelling, inflammation, cartilage erosion and arthritis formation. A cruciate ligament injury is painful.
Past surgical correction techniques attempted to replace the cranial cruciate ligament with a monofilament suture secured around the joint (MRIT procedure). The TPLO does not replace the cranial cruciate ligament, it replaces the need for it by leveling the angle of the joint itself.
Before surgery, one of our two certified TPLO doctors, Dr. Jack Brinker or Dr. Corey (Hermoyian) Gut will meet with you and your pet. We will examine your dog and discuss the surgical procedure and post-operative recovery period. We may take radiographs or schedule a sedation/palpation session for your pet. In most cases, a diagnosis can be made on physical exam and palpation alone and radiographs are often taken the morning of your pet’s TPLO surgery.
The surgery consists of several steps. The first is exploration of the joint. The cranial cruciate ligament remnants are cleaned out (if any) and the caudal cruciate ligament is examined to ensure that it is still intact. The medial and lateral menisci (cartilage pads that cushion the joint) are examined and removed if torn/injured. Any arthritis that has formed along the joint is cleaned up and the joint is closed.
The second part of the surgery is making a semi-circular cut into the bone and rotating the bone to reduce the angle of the joint to an optimal 4-6 degrees. A jig is placed on the bone before the cut is made to maintain alignment. Once the bone is rotated, a bone plate is secured onto the bone with six to eight bone screws. The plate will serve to stabilize the bone and joint for 8-12 weeks while healing. The plate and screws will remain in your pet’s leg for the remainder of his/her life.
Patients will spend the night in our hospital and will go home the following day with pain medications and antibiotics. Your dog will be on a strict enforced rest regime for 12-16 weeks. The first time we need to see your pet back is in 14 days for skin staple removal. (If we are not your regular vet, this can be done at your regular veterinarian’s office). We will need to see you for the first set of post-op radiographs at 8-10 weeks to assess bone healing.
An estimated 90-92% of dogs who have the TPLO procedure done after injuring their cranial cruciate ligament will regain completely normal or near normal pain-free function of that leg. Studies have shown that this procedure reduced the amount of arthritis formation in the joint four times that of the preceding (MRIT) techniques. This procedure also yields a more rapid recovery and dogs post-operatively will have better range of motion of that joint.
For more information regarding this procedure, please call our office at 248-693-1677.