KNEE SURGERY– TPLO SURGERY
One of the procedures we specialize in is TPLO (Tibial Plateau Leveling Osteotomy). Tibial Plateau Leveling Osteotomy (TPLO) is a surgical treatment used to stabilize the stifle joint when the Cranial Cruciate Ligament (CrCL) has ruptured. The CrCL cannot heal on its own once it starts to tear, nor can it be replaced with a graft, so the surgical techniques used on dogs focus on changing the biomechanics of the knee joint itself in order to attain the goal of pain-free, stable movement. Surgery is the only option to permanently “fix” the instability and relieve pain created by the rupture.
The TPLO procedure consists of cutting the top of the tibia (bone below the knee), rotating it, and stabilizing it in a new position with a bone plate and screws. These changes affect the dynamic movement between the bones of the knee and counter the loss of the CrCL. The TPLO procedure has been proven to have consistent positive outcomes even in large, athletic dogs, and dogs that undergo TPLO are highly likely to be capable of a full and active life.
MORE INFORMATION
What is the CrCL?
The cranial cruciate ligament (the CrCL) is one of the most important stabilizers inside the canine knee (stifle) joint, the middle joint in the back leg. In humans the CrCL is called the anterior cruciate ligament (ACL).
During your dog’s lifetime, he or she can develop ‘cranial cruciate ligament disease’ (CrCLD) and rupture the CrCL. Cranial cruciate ligament disease can affect dogs of all sizes, breeds, and ages, but rarely cats. CrCLD is caused by a combination of many factors, including aging of the ligament (degeneration), obesity, poor physical condition, genetics, conformation (skeletal shape and configuration), and breed. With CrCLD, ligament rupture is a result of subtle, slow degeneration that has been taking place over a few months or even years rather than the result of acute (sudden) trauma to an otherwise healthy ligament (which is very rare).
In fact, rupture of the CrCL is one of the most common reasons for hind limb lameness, pain, and subsequent knee arthritis in dogs. The development of this problem in dogs is much more complex than in humans, and they experience different degrees of rupture (partial or complete). While the clinical signs (symptoms) associated with CrCLD vary, the condition invariably causes rear limb dysfunction and pain.
When is TPLO Surgery Necessary?
A torn CrCL is painful! Dogs with this injury cannot walk normally, and the instability caused by the tear damages the surrounding bone and cartilage. Surgery can stabilize the joint, relieve pain, help avoid irreversible joint damage and the onset of osteoarthritis, and allow your dog to live a normal, active, pain-free life.
What are the Symptoms of a Torn CrCL?
- Decrease in activity level and unwillingness to play
- Limping/lameness
- Difficulty rising or jumping
- Pain and stiffness in the hindquarters
- Decreased range of motion
- Muscle atrophy in the affected leg
- Popping noise or swelling on the inside of the shin bone
What are the Risk Factors for CrCLD?
Risk factors for CrCLD include age, obesity, poor conformation (structure), breed, and lack of fitness. While the disease can affect any size, breed, or age of dog, Newfoundlands and Labrador Retrievers have been found to have a genetic component to developing CrCLD. Other breeds that have a higher risk of developing CrCLD include Chesapeake Bay Retrievers, Akitas, Mastiffs, Rottweilers, Saint Bernards, and Staffordshire Terriers. Cats are rarely affected.
What to Expect Before, During and After Surgery?
Before Surgery
Before surgery, we will conduct a thorough examination of your pet, including X-rays and blood work, to ensure they are healthy enough for surgery. The procedure typically takes 2-3 hours and requires general anesthesia. We will then discuss the causes of a cruciate ligament tear, an explanation of the surgical options available to your pet and answer any questions you may have regarding your pet’s diagnosis. At the initial consultation, our staff will provide an estimate for you for pre-operation, the procedure, and post-operative care.
During Surgery
At Howell Animal Hospital and Surgical Center, your pet’s surgery is performed in our new, sterile surgical suites equipped with the latest monitoring and surgical equipment. We will monitor your pet during surgery and recovery and will make sure your pet is as comfortable and pain free throughout the procedure.
After Surgery
Overnight hospitalization is usually required for TPLO surgery. Your pet will be monitored by a veterinarian and will receive necessary antibiotics and pain medication. Additionally, patients are offered a meal when they are alert and will be walked as soon as possible for elimination. Our staff is available for you to call for updates on your pet any time during their stay with us.
Pain Management
The surgery fee includes all the medications (antibiotic, anti-inflammatory, and pain) your pet needs to come home and be comfortable during their recovery.
Recovery
After your dog returns home, he or she will need to be confined to a small rest area for two weeks with limited walks only while on a leash. For two to six weeks, we recommend all patients go on short walks only while on a leash and continue confinement indoors when unattended. These types of measures at home will ensure a successful and speedy recovery.
Follow-up
Post-surgical appointments to check on the status of your pet are recommended. Post-op follow-up appointments include bandage removal at three to five days, suture removal at two weeks, and post-op X-rays.
Choosing the Right Veterinarian for TPLO Surgery
TPLO surgery is a complex procedure that requires a skilled and experienced veterinarian. At our clinic, our veterinary team has extensive experience in orthopedic surgeries, including TPLO. We use the latest techniques and equipment to ensure a successful outcome for your furry friend.
If you believe your dog may be a candidate for TPLO surgery, please contact our clinic to schedule a consultation with one of our veterinarians. We are committed to providing