Why should I bring my pet to Wilbury for TPLO Surgery?
At Wilbury we are proud to have been providing an Orthopaedic referral service for over 29 years. Our Advanced Practitioner in Small Animal Orthopaedics Peter Haggis is committed to providing the highest standards of care for dogs with cranial cruciate ligament ruptures.
What is TPLO Surgery?
TPLO is the abbreviation for Tibial Plateau Levelling Osteotomy. This is a surgical procedure used to treat cranial (or anterior) cruciate ligament rupture in the stifle joints (knee) of dogs. It involves changing the angle of the top of the tibia (shin bone) by cutting the bone, rotating it, and stabilising it in a new position with a plate and screws.
Cranial cruciate ligament rupture is the most common cause of hind leg lameness in dogs. As a result, TPLO surgery is one of the most common orthopaedic surgical procedures performed on dogs at Wilbury.
How does TPLO Surgery Work?
Following rupture of the cranial cruciate ligament, the knee becomes unstable. When the dog takes weight on the limb this instability allows the tibia to move forward relative to the femur. The knee feels as though it is ‘giving-way’ and this can cause the dog to appear severely lame.
The reason the tibia moves forward when weight-bearing is that the top of the tibia does not sit at 90 degrees to the length of the bone. This is in contrast to people where the tibia is parallel to the ground when standing upright with our legs straight.
TPLO surgery aims to make the tibia vertical to the long axis of the bone and, in doing so, prevent the tibia moving forwards. The knee thus feels stable for the dog when weight-bearing, despite the fact that the ligament has been ruptured.
What are the Most common Signs that my Pet Needs TPLO Surgery?
Tibial Plateau Levelling Osteotomy surgery is a major procedure with possible complications. As a result, it is only performed in dogs where the benefits of surgery outweigh the possible risks and where alternative methods of treatment are less successful.
Dogs that are suitable for TPLO surgery are those with a ruptured cranial cruciate ligament that have persistent lameness and knee joint instability.
What does TPLO Surgery Involve?
Very specific X-rays need to be obtained of the knee and shin bone. The presence and severity of osteoarthritis can be assessed and the angle of the top of the shin bone measured to allow planning prior to surgery. The position of the cut on the bone, the amount the bone needs to be rotated, and the size of plate necessary to stabilise the bone in its new position can be evaluated.
Surgery may be performed on the same as the investigations. Antibiotics and painkillers are administered at the time of anaesthesia and the hind leg is clipped from the level of the hip to the hock. Prior to performing the TPLO, a small incision or cut is made into the knee joint to enable inspection of the structures within it. Many dogs with ruptured cranial cruciate ligaments tear one of the menisci (cartilage pads in the joint) and damaged portions need to be removed. After cutting and rotating the top of the tibia, the bone is stabilised with a special plate that has been designed especially for tibial plateau levelling surgery. Some of the screws are “locked” into the plate which makes the repair stronger.
X-rays are obtained at the end of the operation to assess the new angle of the top of the shin bone and check the position of the plate and screws. Most dogs can go home the day after surgery.
What can I Expect if my Pet Undergoes TPLO Surgery?
Aftercare following TPLO surgery is very important, and rehabilitation can take several months. Courses of painkillers and antibiotics are prescribed at discharge. If the dog tends to excessively lick the wound it may be necessary to use a plastic collar. Visits to a local Vet are necessary within the first two weeks to check the wound and remove any sutures.
Exercise must be very restricted for the first few weeks to allow healing and is primarily for toileting purposes. The dog must be kept on a lead or harness to prevent strenuous activities such as running, jumping or playing. At other times confinement to a pen or a small room is necessary with avoidance of jumping and climbing. After a few weeks, exercise may be gradually increased in a controlled manner (on a lead). Hydrotherapy may also be recommended.
A check-up will be carried out at Wilbury six to eight weeks after the operation, to monitor the function of the leg and knee. X-rays are obtained to evaluate healing of the osteotomy. Depending on progress, advice will be given about increasing exercise. Further clinical and radiographic examination may be necessary on an individual case basis.