TPLO / Cruciate Ligament Repair
Tibial Plateau Leveling Osteotomy (TPLO) is the most common repair for a ruptured Cranial Cruciate Ligament (CCL)—the dog equivalent of a human ACL tear. It involves reshaping the top of the shin bone (tibia) to stabilize the knee joint without needing the ligament.
This procedure is commonly recommended for dogs with knee instability causing pain, lameness, or decreased activity levels.
Our focus is on restoring comfort, mobility, and long-term joint function through precise surgical technique, thoughtful planning, and a smooth, supported recovery.
How the Procedure Works
Surgical Steps
1
Joint Inspection: The surgeon often performs an arthrotomy to inspect the joint and remove any damaged portions of the meniscus (the knee’s shock absorber).
2
The Cut (Osteotomy): A specialized circular saw makes a curved cut at the top of the tibia.
3
Rotation & Leveling: The cut bone segment is rotated to reduce the slope (typically from 25–30° down to 5–7°).
4
Stabilization: A medical-grade locking plate and screws are secured to the bone to hold it in place while it heals.
The "Wagon on a Hill" Analogy
Imagine a wagon (the femur) tied to a post on a hill (the tibial plateau). If the rope (the CCL) breaks, the wagon rolls down. TPLO levels the hill so the wagon stays put even without the rope.
Recovery Timeline & Milestones
Days 1–7
Most dogs begin “toe-touching” or light weight-bearing within 24–48 hours.
Weeks 1–2
Healing
Strict confinement is required. Owners must use a leash for bathroom breaks to prevent slipping or jumping.
Weeks 3–8
Strengthening
Controlled leash walks begin, starting at 5 minutes and gradually increasing. Physical therapy, such as underwater treadmills, is often introduced here.
Weeks 8
The Milestone
Follow-up X-rays are taken to confirm the bone has fused together. If healing is sufficient, activity restrictions are gradually eased.
3 Months
Expected Outcomes & Success Rates
- High Success: Approximately 90-95% of dogs regain full or near-full pre-injury function.
- Reduced Arthritis: By eliminating the mechanical "thrusting" in the joint, TPLO significantly slows the progression of osteoarthritis compared to non-surgical management.
- Contralateral Risk: Owners should be aware that roughly 30-60% of dogs who tear one CCL will tear the other in their lifetime, often within a year of the first surgery.
Potential Complications
Infection
Often caused by the pet licking the incision; an E-collar is mandatory for the first 14 days.
Implant Failure
Usually occurs if a dog jumps or runs too soon, causing the plate to bend or screws to loosen.
Late Meniscal Tear
If a small tear was missed or a new one occurs post-op, a “click” may be heard when the dog walks.