Tibial Plateau Leveling Osteotomy (TPLO)
The TPLO is one of the original osteotomy techniques. It aims at achieving a reduction of the tibial plateau slope
or the tibial plateau angle (TPA). By changing the TPA, when a dog bears weight the forces acting on the joint are neutralized. In a dog with CCL injury, neutralizing the forces eliminates forward thrust of the tibia in relation to the femur. In essence, these osteotomy procedures alter the biomechanics of the joint and eliminate the need for the CCL.
TPLO surgery involves making a cut in the bone, called an osteotomy, and rotating the cut piece of bone to reduce the TPA. The cut bone is then stabilized with a bone plate and screws. Once the bone has healed (~8 weeks), the plate and screws are no longer necessary. They are typically left in place unless there is a problem associated with the plate such as infection or irritation. A small percentage of patients that have the TPLO may, at some point in the fut
ure, need the plate removed.
Dogs are usually comfortable fairly quickly after successful TPLO surgery and may begin putting weight on the affected limb within days.
Complications can include (but are not limited to):
General anesthetic risks
Life-threatening cardiorespiratory arrest
Incisional breakdown and separation
Incisional swelling (seroma)
Specific TPLO complications and risks:
Delayed bone healing or non-healing bone
Malunion bone healing (mal-alignment)
Implant failure (pin migration, screw pullout, plate breakage/failure)
Implant or bone infection (osteomyelitis)
Subsequent meniscal injury
Patellar ligament desmitis (inflammation)
Risk contralateral cranial cruciate ligament rupture within 1-2 years
With the TPLO procedure, there is a reported 90-95% good to excellent outcome especially in larger breed, active dogs. This means your pet can run, jump and play AFTER his/her full recovery (at least 8 weeks postoperatively). For one reason or another, 5-10% of patients will not return to a level of function that we expect. It is important to note that just because your pet suffers a complication such as an infection or a meniscal injury, they can still have a good to excellent outcome – there just may be some hiccups along the way.