Tibial-plateau-leveling osteotomy

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Dog's titanium TPLO implant (50843542778)

Tibial Plateau Leveling Osteotomy (TPLO) is a surgical procedure commonly performed on dogs to stabilize the stifle joint after a rupture of the cranial cruciate ligament (CCL). This procedure is designed to alter the biomechanics of the knee joint to prevent the tibia from moving forward during weight-bearing, thereby stabilizing the joint.

Indications

TPLO is primarily indicated for dogs suffering from a ruptured cranial cruciate ligament, which is a common injury in canines. This condition can lead to pain, lameness, and arthritis if left untreated. The procedure is often recommended for active dogs and those with a steep tibial plateau angle.

Procedure

The TPLO surgery involves making a curved cut in the top of the tibia (shin bone) and rotating the tibial plateau to a more level position. This rotation changes the angle of the tibial plateau, reducing the need for the cranial cruciate ligament to stabilize the joint. The bone is then stabilized with a metal plate and screws.

Steps

1. Preoperative Planning: Radiographs (X-rays) are taken to measure the tibial plateau angle and plan the surgery. 2. Anesthesia: The dog is placed under general anesthesia. 3. Surgical Approach: An incision is made over the stifle joint to expose the tibia. 4. Osteotomy: A curved cut is made in the tibia. 5. Rotation: The tibial plateau is rotated to the desired angle. 6. Fixation: The bone is stabilized with a metal plate and screws. 7. Closure: The incision is closed with sutures or staples.

Recovery

Postoperative care is crucial for a successful recovery. The dog will need to rest and avoid strenuous activity for several weeks. Physical therapy may be recommended to help regain strength and mobility. Follow-up radiographs are typically taken to ensure proper healing of the bone.

Complications

As with any surgical procedure, there are potential complications associated with TPLO, including infection, implant failure, and delayed bone healing. However, the success rate of TPLO is generally high, and most dogs return to normal activity levels.

Alternatives

Other surgical options for CCL rupture include the lateral suture technique, tightrope CCL, and tibial tuberosity advancement (TTA). The choice of procedure depends on various factors, including the dog's size, activity level, and the surgeon's preference.

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Contributors: Prab R. Tumpati, MD