ACL/ Cruciate Ligament Repair- TPLO

Rupture of the CrCL is the most common reason for hind limb lameness, pain, and subsequent knee arthritis.

Most ACL tears in dogs are not due to trauma, but to deterioration and an angle at the top of the shin bone that is too steep.

 The TPLO procedure changes the angle at the top of the shin bone to eliminate lameness, reduce pain, and greatly reduce the progression of osteoarthritis in the knee joint of dogs. 

The tibial plateau leveling osteotomy (TPLO) is  the "gold standard" procedure to address lameness due to cranial cruciate ligament disease in canine patients. It is effective in treating cruciate ligament disease in patients of all shapes and sizes. The geometric modification that the TPLO produces in the knee joint allows most patients to walk on the affected limb quickly, safely and gets them back to chasing that ball! 

This disease in canines is caused by. a plethora of factors including but not limited to:  aging, obesity, genetics, skeletal conformation, and breed. This disease is very different from ACL rupture in humans, which is primarily traumatic. 

* Partial tears almost always progress to full tears given time. 

The TPLO is the most common procedure performed by NAVO and as a result, we are equipped and able to  treat a wide variety of patient sizes and shapes and give you and your baby the results you deserve.  

We know how inconvenient a torn cruciate ligament  is  for you and how painful it is for your pup.  We would like to help you every step of the way, from the initial consultation to the resolution of your dog's pain/ lameness. 

Before scheduling TPLO: Be aware and prepared for the following so that you already set up to succeed

1. This procedure will requires 8 weeks of rest/ confinement for most patients- it takes on average 8 weeks for the bone to become completely fused. During the 8 weeks, your pup will need to be confined to  a small area/ small room/ playpen/ etc where your pup cannot jump or run on the leg. This is to protect the implants while the bone heals. 

*your pup SHOULD NOT take 8 weeks to use the leg, however. Most are using the leg well after a week or so and should not require prolonged assistance. 

2. The most common cause of re-operation in TPLO patients is an infection on the implant/ plate. The solution to this issue is ALWAYS removal of the implant after the bone has fused. If there is an infection of the implant, no topical or oral antibiotic will resolve this. The most common source of TPLO implant infection is licking at sutures post- op. All patients who receive a TPLO need a cone that prevents licking at the incision post op. Once the incision is completely healed, the sutures are removed, and your pup can then discontinue use of cone.  

What you can  expect following TPLO surgery: 

Patients will need to be rested for at least 8 weeks following TPLO surgery. Modern TPLO implants are made of steel and are very strong, however, we would strongly recommend keeping your dog from playing/ running/ jumping on the leg until you have had radiographs to confirm the bone has healed. 

*NAVO will dispense medication for energetic pups that will  help them rest following TPLO surgery. This medication is both safe and effective to take daily during the recovery period. 

Most patients who receive a TPLO will be walking on the leg very soon after surgery, sometimes the day of surgery. However, all potty breaks need to be on a leash until the bone is confirmed to be healed via radiograph at 8 weeks. 

A cone is needed post operation for every single pup. This is very important to use until the sutures are removed at 2 weeks. This cone prevents licking at the incision, which is the primary cause of implant infection. Implant infection generally requires implant removal once the bone has healed. 

You will be sent home with written discharge instructions that are personalized for your dog with instructions regarding medications, activity, rehabilitation and what to expect regarding the recovery timeline. We will work with you and your primary veterinarian to ensure both you and your companion are pleased. 

Summarized: The three unbreakable rules of TPLO post op care: 

1. No licking at the sutures, EVER -  Use the cone for first 2 weeks to prevent an infection. 

2. Only let the pup leave confinement on a leash for 8 weeks, or until the bone is confirmed healed via xray. 

3. No walking on any slippery surface until the bone is healed.