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Tibial Plateau Levelling Osteotomy (TPLO)

Cranial cruciate ligament injury in dogs is one of the most common causes of hind leg lameness presented to our veterinarians. It is also commonly referred to as an ACL injury. Surgery often needs to be performed to eliminate this instability or cranial tibial thrust. We routinely perform the TPLO procedure for Cranial Cruciate Ligament rupture on dogs of all sizes from Chihuahuas to Great Danes. Early surgical intervention for cruciate tear is beneficial.

If you suspect your dog has ruptured its cruciate ligament, please phone Allambie Vet on 02 9905 0505 or follow the link below to make an appointment with our experienced surgeons.

What is a TPLO and why does my dog require the procedure?

A TPLO is used to correct problems caused by a partial or complete tear in the cruciate ligament (CCL) of the knee joint, also known as the stifle. When your dog stands, if you look from the side, you can see that your dog’s knee is bent at a slight degree of flexion. As a result of this bending, the CCL in dogs is always load-bearing, i.e. it always has tension. This constant tension on this ligament makes it quite susceptible to injury.

Every time the dog goes to stand or put weight on the injured leg, the femur slides/rubs on the back of the tibia. This rubbing causes pain and inflammation, which is very uncomfortable. This is why most dogs with a damaged CCL will not even put any weight on the leg; if they do, they will toe-touch the leg to the ground.

How does this procedure fix the problem?

The first part of the surgery involves removing the torn ends of the cruciate ligament and examining the meniscus cartilage. The medial meniscus is also damaged in 30 to 40% of dogs with a torn cruciate ligament. When the femur bone shifts backwards, it pinches the meniscus, causing it to tear from the back part of the stifle joint and flip forward. A torn meniscus will make your dog much more painful than a cruciate ligament tear alone because every time the knee moves, the meniscus gets caught. Any tears that are causing catching in the joint will be removed at this stage. The next part of the surgery involves making a curved cut in the top of the tibia bone (osteotomy) to include the tibial plateau (level area at the top of the tibial bone). The tibial plateau is then rotated along the cut to level the slope. A plate and screws hold the tibial plateau in place so the bone can heal in its new position.

The TPLO surgery completely alters the dynamics of the knee. Once the bone is cut and rotated, the tibia will no longer slide against the femur. The knee is immediately stabilized. Doing so eliminates the need for the CCL ligament entirely and immediately returns stability to the joint. Once the knee is stabilized, the dogs will begin to use the limb again. As a result of the surgery correcting this issue immediately, dogs will start using their leg very quickly after treatment – minimizing muscle loss in the postoperative period.

What happens after the surgery?

After your dog's surgery, we will provide them with post-operative care for 24-36 hours. Our team of vets and nurses will give them strong intravenous pain relief and constant care during their stay. 

For overnight monitoring and continued pain relief, patients are transferred to Northside Emergency Service and returned to our hospital the following morning. Depending on their temperament and recovery, some patients may be able to go home the same day.

Once your dog is ready to be discharged, we will arrange a discharge time to discuss the necessary post-operative care and address any concerns or questions you may have.

Recheck Appointment

We see our patients 5 days for a post-operative re-check. Followed by 14 days to remove stitches and start a course of four (4) Zydax injections, each one week apart, to help prevent arthritis. 

Follow-up radiographs to monitor bone healing at 8 weeks post-surgery. This allows assessment of the bone healing before increasing the level of exercise.

What should I do to prepare for my pet’s surgery?

Before bringing your dog home from the hospital, it is essential to have prepared a “home hospital bed” for them to rest in. Your dog’s movement must be restricted for 6-8 weeks to allow adequate healing- this includes no stairs, no playing with other dogs, no off-lead walking and no jumping. 

Keeping them in a dog crate or small room on a non-slip surface is the safest way to ensure they do not harm themselves. Your dog will not be able to have a bath or be groomed for a couple of weeks after the surgery, so it is recommended you bath your dog before surgery – this also minimizes the risks of skin infections. Your pet should also have a flea treatment before admissionYour dog needs to be fasted for the general anaesthetic. Please give them their regular dinner the night before admission and no food after midnight. Water does not need to be restricted at any time. 

Call the Allambie Vet team if you have any questions about your dog’s hospital stay or procedure.

What exercise can my dog do post-surgery?

You must restrict your dog's activity for 10-12 weeks following surgery to permit normal healing. During this period, the dog's activities will be gradually increased to build muscle, stretch scar tissue and strengthen the bone. During this time, strict confinement is required:

  1. Your dog can be inside, on carpeted surfaces, under your direct supervision.
  2. Avoid all slippery surfaces, stairs and any form of jumping.
  3. They must always be on a leash when outside for airing and toileting.
  4. When not under your direct supervision, they must be confined to a small room (approximately 2m x 2m).

For the first four weeks after surgery, restrict your dog to slow walks inside the house and on a leash when taken out to the toilet.

After four weeks, you can begin walking your dog on a long leash outside. Start with a short (e.g. 5-10 minute) walk, then if they are tolerating this well, increase the duration of the walk every few days.

6-8 weeks after surgery, we would like to see your dog back for a recheck and radiographs to evaluate the healing of the surgery site. If healing is progressing normally, you may start to exercise your dog off the leash. Off the leash, activity should occur only after your normal long-leash walk and under your supervision. As with the leash walks, you should start with 5 minutes off leash and double the time every 3-4 days as long as your dog is comfortable. Jumping or free running with other animals or after toys should not be permitted.

10-12 weeks after surgery, A final examination will be needed to evaluate final healing. Instructions will then be given for returning your pet to normal activity.

If any time during healing, your dog appears to have increased pain or other set-backs, please contact us.

Post-operative complications and recovery

Post-operative complications are uncommon with this procedure and most can be avoided with good quality home care after surgery. Possible complications include:

  • Late meniscal injury (2%)
  • Infection (4%)
  • Implant failure (rare)
  • Soft tissue swelling around the surgery site (rare)

We expect 90-95% of dogs to return to near-normal function within 3-6 months after surgery. This includes regular lead exercise without significant lameness. Dogs with significant osteoarthritis & meniscal damage may require lifelong osteoarthritis management to achieve the best outcome.

Physical therapy and rehabilitation strongly recommended after this procedure. This can usually start 2 weeks after surgery- once the stitches are removed. 

What is included in the TPLO estimate at Allambie Vet?
  • Pre-operative care and planning, including pre anaesthesia blood test
  • Anaesthesia 
  • Surgery TPLO performed by Dr Eugene Buffa, Specialist Surgeon and Implants 
  • Pain Management
  • Wound management, infection control medications
  • Post-operative radiographs
  • Hospital discharge
  • Follow-up post-operative consultation at 3 days, 10 days and weekly for 4 weeks to get Zydax injections
  • Follow-up radiographs at 8 weeks

Additional fees you may incur would be further anti-inflammatory, antibiotics or calming medications after surgery outside of what is dispensed the day of surgery. 

Any potential risks/complications post-operative would incur additional fees. Complications are uncommon with this procedure, and most can be avoided with good-quality home care after surgery. 

To obtain an accurate cost estimate, you will need a consult with a veterinarian. However, contact us below and we can do our best to provide you with as much information as possible.

How can I book a TPLO?

If you are an existing client of Allambie Vet, please get in touch with our receptionist at 02 9905 0505. Our receptionist will be able to review your pet's records and book an appropriate appointment. 

If you would like a second opinion on any surgical conditions with your pet, we recommend the following:

Emailing Allambie Vet with as much detail as possible regarding your pet

This information lets us decide which of our veterinarians would be best suited. We have multiple vets with special interests in surgical conditions and have completed further studies.

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