Tibial-plateau-leveling osteotomy

Tibial-plateau-leveling osteotomy (TPLO) is a surgical procedure used to treat cranial cruciate ligament injury in the knee joints of dogs. This condition is analogous to the anterior cruciate ligament (ACL) injuries in humans. TPLO surgery aims to reconfigure the knee joint to prevent the femur from sliding off the tibia and to stabilize the joint without directly repairing the ligament.

Overview

The cranial cruciate ligament is crucial for stabilizing the knee joint in dogs. When this ligament is torn or damaged, it leads to instability, pain, and eventually, osteoarthritis. Traditional surgical methods focused on directly repairing or replacing the ligament. However, TPLO surgery takes a different approach by changing the dynamics of the knee joint to make the function of the cranial cruciate ligament unnecessary for joint stability.

Indications

TPLO is most commonly recommended for active, large breed dogs with a torn cranial cruciate ligament. However, it can be considered for dogs of any size with this condition. The decision to perform TPLO is based on several factors, including the degree of lameness, the size of the dog, the slope of the tibial plateau, and the presence of osteoarthritis.

Procedure

The TPLO procedure involves making a curved cut through the top of the tibia (tibial plateau), rotating it to flatten the slope, and then stabilizing it in its new position with a metal plate and screws. This alteration changes the biomechanics of the knee so that the tibia no longer slides backward when the dog is bearing weight, thus stabilizing the knee without the need for the cranial cruciate ligament.

Recovery

Recovery from TPLO surgery involves several weeks of restricted activity to allow the bone to heal properly around the metal plate and screws. Physical therapy and controlled exercise are crucial components of the recovery process to regain strength and flexibility in the knee joint. Most dogs can return to normal activity levels within three to six months after surgery.

Risks and Complications

As with any surgical procedure, TPLO surgery carries risks, including infection, fracture of the bone around the metal implants, and failure of the bone to heal properly (nonunion). Long-term complications can include development of osteoarthritis in the knee joint.

Conclusion

Tibial-plateau-leveling osteotomy has become a widely accepted and successful method for treating cranial cruciate ligament injuries in dogs. By altering the biomechanics of the knee joint, TPLO provides a solution that allows for a return to normal activity while minimizing the risk of further injury or degeneration of the joint.