Hopkinton Animal Hospital
TPLO surgery for ACL Injuries
Medicine to prevent or diagnose many problems commonly seen in cats, dogs, and exotic pet.
Tibial plateau levelling osteotomy (TPLO) is a surgical procedure used on dogs who have torn their anterior cruciate ligament, or ACL. The ACL is located in the pet’s knee and stabilizes the front to back motion. A torn ACL is painful and if untreated leads to early arthritis in the joint.
This surgery is highly effective in returning stability to the knee, allowing full weight bearing, and is one of the most popular orthopedic surgeries performed on dogs.
How Effective Is TPLO Surgery?
TPLO changes the mechanics of the dog’s knee so the torn ligament is irrelevant to the knee’s stability.
This procedure is highly effective in achieving its aim of returning stability to the knee, allowing full weight bearing. Approximately 90% of dogs that undergo the surgery return to normal functioning of the limb.
Considerations and Complications of TPLO Surgery
TPLO is major surgery, so with it comes some risk. There is the short-term risk of infection plus the risk of the screws coming loose or the bone healing slowly.These risks are most likely to occur if the pet becomes active too quickly after surgery. As with any surgery on a joint, there is also an increased risk of osteoarthrosis and degenerative disease. the complication rate is 8 to 11%. The benefits of TPLO surgery far outweigh the risks. The likelihood of the aforementioned risks is extremely low, while the likelihood of a fully functioning limb is over 90%. Many dogs have a torn ACL in both knees. Studies have shown over a 10-fold increase in complication rate if surgery on both knees is performed at the same time. Due to this, we will not do bilateral knee TPLO unless Dr. Dutton has approved it.
What To Do If You Suspect Your Dog Has a Torn ACL?
If you suspect that your dog has torn his/her ACL, or if your veterinarian has suggested TPLO surgery, please call us for a phone consultation or an initial exam.
If your pet is not currently on anti-inflammatory medications (like carprofen), the initial exam will include x-rays of the knee and a 10-day course of anti-inflammatories to reduce the soft tissue swelling in the knee joint.
X-rays will determine if your dog is a candidate for a TPLO. Almost all dogs with a torn ACL are TPLO candidates, but there are a few cases where a different technique such as a tibial tuberosity advancement (TTA) or a cranial closing wedge osteotomy (CCWO) is indicated. We do not perform the TTA or CCWO surgeries here at Hopkinton Animal Hospital.
What to Expect During Surgery
If we determine that TPLO surgery is the right course of action for your dog, we will schedule surgery at a time that works best for you, to ensure the best possible recovery for your pet.
The breakdown of the surgery is:
The dog will be anesthetized.
Antibiotics and painkillers will be administered.
An incision will be made, and the torn ends of the cranial cruciate ligament will be entirely removed. The medial and lateral meniscus cartilages (which serve as knee shock absorbers) will be examined for damage. If they are torn, they will be removed.
A curved cut will be made in the top of the tibia bone to fit the tibial plateau.
The tibial plateau is then rotated to a level of about 5 degrees. Plates and screws are then fitted to hold the tibial plateau in its new place.
Post-surgery x-rays will be reviewed to determine proper placement.
Most pets will be discharged late afternoon of surgery.
What a TPLO Procedure and Work-up Consists of
If your pet has a TPLO procedure with Hopkinton Animal Hospital it will include the following visits and services:
Initial exam and initial x-rays
Day of surgery (in between 7:30 to 8:30 a.m. at Hopkinton Animal Hospital, please fast your pet for at least 4 hours before then)
IV
Pre-anesthetic blood work
Chest x-ray if needed
Pain medications
Anesthesia
Detailed pre-op x-rays
Surgery including plate and screws
Post-op x-rays
Recovery day in the hospital
Take home pain medications and antibiotics (if needed)
Cold laser therapeutic treatment on day of surgery
E-collar
10-14 days recheck
Exam
Cold laser therapeutic treatment
8 weeks recheck
Exam
Sedation if needed
X-rays
What Can I Do to Help Rehabilitate my Dog?
We recommend several gentle at-home rehabilitation procedures you can perform on your dog after TPLO surgery. Please reference your TPLO Discharge Instructions before beginning any of these rehabilitation exercises with your dog. You will also receive email messages when each exercise is appropriate to begin with your dog.
