What is a TPLO?
This is a surgery to reduce the instability in the knee due to an anterior cruciate ligament tear. Movement in the knee after a tear causes pain and damage to soft tissue and cartilage. The earlier methods for repair were based on trying to support the knee with suture or grafted tissue. With larger dogs, these sutures were not adequate to stabilize the knee in some cases. Dr. Slocum, a veterinarian, who's dad was a human orthopedic surgeon, developed a different approach to stabilize the knee in the early 80's, and it still is the most common method used by veterinary surgeons to repair anterior cruciate ligaments in larger dogs.
How is it done?
To simplify it, a circular cut is made in the top of the tibia, and that portion is rotated about 1 centimeter, and then a plate and screws are used to hold it in the new position. After 8-12 weeks, the bone is healed in a new position. The new position reduces the movement of the knee, without the requirement of sutures.
During the TPLO the knee is inspected for meniscus damage and remnants of the torn ACL ligament are removed to reduce inflammation.
What should I expect post-surgery?
Your dog will have a shaved leg. There will be sutures in the skin. Depending on the sutures the surgeon uses, they may need removal. Some amount of swelling and redness in the leg can be seen in the first two weeks. A collar can be used to prevent excessive licking if that occurs.
You will want to plan ahead for how you will restrict your dog's activity depending on your dog's personality. Typically, they need to be kept on a leash when outdoors, and may need to be kenneled or confined when you are gone if they are highly active dogs. We also add sedation in some cases.
Each week your dog will walk progressively better and the majority of cases are walking with little to no lameness by the time the bone is healed at 10-12 weeks.
We encourage physical therapy and use of pain medications until the use of the leg is normal. You may need to use arthritis protection medications after the knee is healed depending on the level of arthritis the knee had prior to surgery.