What you need to know about TPLO surgery in dogs

TPLO stands for tibial plateau leveling osteotomy. It’s a surgical treatment used to stabilize the stifle or knee joint of a dog following a common, often progressive injury known as a cranial cruciate ligament (CCL) rupture. It’s one of several types of CCL surgeries including lateral suture and tibial tuberosity advancement (TTA). Lateral suture surgery is also known as extracapsular lateral suture stabilization or ELSS.

The CCL is one of two cruciate ligaments inside the knee, the other being the caudal cruciate ligament. When Fido’s CCL is injured over time or as a result of a traumatic injury, their tibia or shin bone slides toward the thigh bone or femur, resulting in pain and trouble walking normally. A CCL rupture in dogs is similar to an anterior cruciate ligament (ACL) tear in humans, which is why TPLO or other CCL surgeries are sometimes referred to as ACL surgeries.

TPLO surgery can help stabilize the knee joint and reduce the amount that the tibia shifts forward as your pup walks, ultimately relieving their pain and preventing irreversible joint damage.

When does a dog need TPLO surgery?

If your dog has suffered a rupture to its CCL, your vet may recommend TPLO surgery, particularly if your dog is large and athletic. Smaller dogs weighing less than 22 pounds may not need TPLO surgery — your vet may instead recommend six weeks of strict exercise restrictions. Most dogs will likely require an operation to stabilize the joint and relieve pain.

During TPLO surgery, the surgeon will remove the torn ends of the CCL and address the damaged areas of the meniscus cartilages before deciding whether they, too, require removal. The knee is reconfigured and a titanium plate is used to hold the new configuration in place, eliminating the need for an artificial ligament to stabilize the joint.

After the operation, your veterinarian will send you home with post-operative care instructions. You may notice some lameness, balance issues, as well as joint and muscle pain in your pup. You must limit their activity for six to eight weeks following the surgery to ensure normal function returns to the joints within three months.

Patience and preparation will help you and your pup sail through the six to eight weeks of recovery time following TPLO surgery. Here are a few steps you could follow.

Make a few changes around the house — Because your dog’s mobility will be restricted, we recommend the following supplies to ensure a smooth recovery:

• A properly-sized crate. If your dog is crate trained, find a crate that’s large enough for them to stand up in and turn around.
• Gates. Create a gated-off area in your home, such as the kitchen or living room, to restrict them to certain areas.
• Throw rugs. Rooms with hardwood floors, tile, or linoleum can be particularly difficult for dogs to walk on, especially after surgery. If the room you’ve chosen has slippery surfaces like these, be sure to place some throw rugs with rubber backing on the floor to help your dog walk around more easily.

Continue consulting your vet — Routine rechecks following TPLO are scheduled at two weeks postoperatively, with recheck radiographs (X-rays) obtained at the eight-week point. Additional rechecks may be scheduled as needed per your vet’s recommendation.

Confine and limit exercise — You should limit exercise and confine your dog to controlled leash walks for six to eight weeks postoperatively while the bone heals. They are allowed to walk on the affected leg, but no jumping, furniture climbing, or running. They should be confined to a crate or very small room while healing.

Keep that e-collar on — Don’t take your pup’s e-collar off until the incision has fully healed. Licking the wound may lead to infection.

Work on rehabilitation — Rehabilitation is often recommended to rebuild muscle strength, improve mobility, and decrease swelling. You can opt for professional post-operative rehabilitation, which covers a range of services, including stretching, nutrition management, cryotherapy, and aquatic therapy among others. Many pet parents also request at-home rehabilitation guidance from their veterinarians.

Work in supplements and weight management — Adding a joint supplement to your dog’s diet can help with arthritis post-surgery. It’s also useful to keep an eye on weight gain as excess weight can not only lengthen recovery, it can also predispose your dog to a future CCL rupture or tear.

Many surgeries plus post-care rehabilitation are covered by pet insurance. Find the best plan for you with our pet insurance review.

Like any surgery, there is always the risk of potential complications, though the rate of complications for TPLO surgery is minimal. These are the most common risks:

• Infection. Research shows an infection, the most common complication of TPLO surgery, occurs in less than 10% of all patients. It’s typically caused by dogs licking their incisions. To prevent infection, ensure your dog’s e-collar is on at all times, and consult your veterinarian to make sure the site is healing well.
• Patellar luxation. A luxating patella refers to an out-of-place kneecap (or patella) and is a potential complication of TPLO surgery in larger breeds. This can be corrected surgically or non-surgically, depending on the degree of injury.
• Implant failure. Implant failure or rejection is a potential complication in any surgery where foreign hardware is added to the body.
• Fracture of the bone. Your pet may suffer a tibial fracture following TPLO surgery. Research shows simultaneous bilateral TPLO in particular is associated with a higher percentage of tibial tuberosity fracture. In most cases, the fracture of the bone will occur at the time of the surgery when the plate is being placed. If a fracture is discovered later, the plate may need to be surgically removed.

There are a few treatment options for a ruptured CCL, including tuberosity advancement (TTA), capsular suture stabilization, and others. Here’s why TPLO is often recommended over other procedures:

• Faster recovery. TPLO surgery has a faster recovery time than other procedures and is best for avoiding reliance on long-term pain medications.
• Arthritis prevention. TPLO may help prevent the progression of arthritis better than other procedures. It allows very active dogs, such as ones that do competitive or performance athletics, to resume normal exercise.
• High success rate. Success rates for this surgery are very high (90%-95%), and the rate of complications is minimal.