A Tibial Plateau Leveling Osteotomy (or TPLO) is a biomedical technique used to treat cranial cruciate ligament (CCL) disease(knee joint injuries) in dogs. A TPLO, decreases the slope at the top of the tibia, which greatly reduces or eliminates the force pushing the tibia forward, removing the need for the ligament to be present to prevent that motion.
In 95% of cases, follow-up surgery is not needed to remove these plates and screws, allowing your pet to heal and recover quickly.
The goal of surgery is not to “repair” the cranial cruciate ligament itself – since it is generally a degenerative condition, repairing the ligament would only be a very temporary repair. Instead, surgery seeks to stabilize the joint in other ways.
Our board-certified surgeons perform TPLO surgeries several times per week at our Boundary Bay Veterinary Specialty Hospital in Surrey, BC, and at our sister hospital in Bellingham, Washington.
At Boundary Bay Veterinary Specialty Hospital, we recommend arthroscopy (a minimally invasive surgical technique that employs the use of a small camera called an arthroscope) to visualize inside the knee joint at the time of surgery.
This allows the surgeon to examine the joint structures, including the cruciate ligaments and the meniscus, as well as joint surfaces for abnormalities and injuries. Arthroscopy has been shown to be more sensitive for picking up injuries inside the joint than traditional open approaches.
Our surgeons are certified by the American College of Veterinary Surgeons (ACVS), which means they have completed an additional 4-5 years of specialized training, rigorous board exams, and must have published research in peer reviewed journals. Collectively, our surgeons have over 35 years of board-certified experience.
In dogs, the top of the tibia (shin bone) is sloped, so when dogs stand and the femur (thigh bone) pushes down on the tibia, the tibia tries to slide out from under the femur. The cranial cruciate ligament (analogous to the anterior cruciate ligament, or ACL in people) prevents this motion. The ligament also provides some rotational stability to the knee. There is also a structure inside the knee called the meniscus, that helps the tibia and femur to fit together well, and distributes the forces across the joint.
Cruciate ligament disease (CLD) is one of the most common orthopedic injuries in dogs. Over time, the cruciate ligament can degenerate, often going through multiple cycles of progressive tearing. Eventually, the ligament gets weak enough that it cannot prevent the motion between the tibia and femur, and the resulting abnormal motion causes both substantial discomfort, and potentially damage to the meniscus.
These conditions can affect dogs of any age or breed, causing joint instability (mild to severe) which can lead to arthritis, lameness, muscle atrophy, pain and wasting of the limb.
If your dog has had an acute or progressive hindlimb lameness, or is frequently getting sore on one or both of their back legs following activity, it can be a sign they have a cruciate ligament injury.
Diagnosis of CCL rupture varies from one dog to the next and may occur at the same time as other problems and sources of lameness. It is important that the surgeon evaluate each patient directly with the client present to confirm the diagnosis and determine the appropriate treatment plan.
At BBVSH, the surgeon will perform an examination of your dog, including palpation and manipulation of their knees, and potentially take x-rays of the knee to help determine if they may have a cruciate ligament injury. If your dog has a lameness associated with a cruciate ligament injury, there is a good chance they would benefit from a TPLO, but our board-certified surgeons and your veterinarian can discuss the specifics of your situation with you.
Dogs will typically stay overnight with us and go home the day after a TPLO. This ensures that your pet is fully and safely recovered from anesthesia. Additionally, almost all dogs will get a local anesthetic block – similar to an epidural – to keep them comfortable through surgery and reduce the needed depth of anesthesia. It is important to make sure that your pet will be comfortable on pain medications you can give at home as the anesthetic block wears off. To make this transition, it is normal for your pet to receive narcotic injections in the hospital overnight before going home on medications that you can administer yourself.
During their stay, our patients are under the care and supervision of board-certified critical care specialists and our team of Registered Veterinary Technologists, who have access to any of our other board-certified specialists on an on-call basis.There is at least one veterinarian, and multiple support staff to monitor your pet overnight in hospital.
Recovery is relatively quick; you can expect your dog to be up on their feet and putting weight on their leg within a few days, and after a period of restricted activity defined by your veterinary surgeon, they’ll likely be able to participate in all or most of the activities they enjoyed before their CCLR symptoms first appeared. Most dogs are capable of 10-20 minute walks within four weeks of surgery, and up to 30-45 minutes by two months post-operatively.
Written instructions will be provided at the time of your pet’s discharge. Someone on your pet’s care team will go over these instructions with you.
Due to the Canada-wide TELUS phone outage, our phone lines are functioning intermittently. If you cannot reach us by phone, please contact us at info@bbvsh.com
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