TPLO (ACL Surgery) Starting at $2500

TPLO ACL Surgery

The most common traumatic orthopedic injury in dogs of all ages and breeds is a tear of the cranial cruciate ligament, or CCL. By the late 1990s, tibial plateau leveling osteotomy, or TPLO surgery, became a common technique to address the condition due to its significant success in large and active canine patients.

Anatomy of the Stifle Joint

The cruciate ligaments are important stabilizing elements within the canine stifle joint, or knee. There are two cruciate ligaments, one anterior and one posterior, which are the cranial and caudal cruciate ligaments, respectively. Both canines and humans commonly injure their cranial cruciate ligaments, though we know this ligament better as the anterior cruciate ligament in humans.

About TPLO or ACL Surgery

Early signs of CCL stress or partial rupture in canines include stiffness or mild lameness. Symptoms increase as the CCL tears further, and a full tear usually results in marked lameness in the affected leg. In some cases, the knee will make a clicking or popping sound as the dog walks. This can indicate damage to the cartilage cushions within the knee. If a dog ruptures its CCL, stifle instability ensues. Veterinarians often describe this instability as cranial tibial thrust or “drawer” movement. This shearing motion causes excessive wear of the cartilage on the ends of the bones within the joint, and stretches the surrounding tissues, causing pain. It can also injure the medial meniscus within the stifle. The tibial plateau leveling osteotomy procedure can eliminate excessive tibial thrust, thus creating a more functionally stable joint and sound gait.

Diagnosis and Procedure

We diagnose a CCL tear by feeling and X-raying the knee. While the radiograph will not show the CCL itself, radiography will indicate osteoarthritic changes and joint swelling. To perform TPLO surgery, a specially designed blade makes a curved cut through the tibia. Surgeons then precisely rotate the top portion of the tibia to level the slope of the tibial plateau and prevent the instability and sliding that occurs with a CCL tear. A bone plate and screws are then placed on the tibia to stabilize it and allow healing to occur.

Outcome and Prognosis

Reports consistently indicate that dogs that undergo TPLO or ACL surgery have an excellent functional outcome and decreased development of osteoarthritis. With TPLO surgery for dogs, it’s possible to return your dog to nearly normal long-term function following CCL rupture, which has not been the typical expectation with any of the traditional techniques attempted before. A potential reduction in the progression of arthritis is an additional benefit. Strict confinement will be crucial for several weeks after surgery to avoid potential difficult complications, which you’ll discuss further during your appointment with the surgeon.

TPLO (ACL Surgery) Starting at $2500

​Tibial Plateau Leveling Osteotomy (TPLO) Introduction Cranial cruciate ligament (CCL) tear is the most common traumatic orthopedic injury seen in dogs of all ages and breeds. By the late 1990’s Tibial Plateau Leveling Osteotomy (TPLO) has become a commonly performed technique to address the condition due to its significant success in large and active canine patients. Anatomy of the stifle (knee) The cruciate ligaments are important stabilizing elements within the canine stifle joint. There are two cruciate ligaments in the knee, called the cranial (anterior) and caudal (posterior) cruciate ligaments. The cranial cruciate ligament (CCL) is commonly injured in both canines and humans (referred to as the ACL in humans). Effects of CCL rupture Early signs of CCL stress or partial rupture include stiffness or mild lameness. As the CCL continues to tear further, symptoms increase. A full tear usually results in marked lameness in the affected leg. In some cases, the knee will make a clicking or popping sound as the dog walks. This often indicates damage to the cartilage cushions (menisci) within the knee. When the CCL is ruptured, stifle instability ensues. This instability is often described as cranial tibial thrust or “drawer” movement. This shearing motion causes excessive wear of the cartilage on the ends of the bones within the joint, and stretches the surrounding tissues, causing pain. It can also injure the medial meniscus within the stifle. The Tibial Plateau Leveling Osteotomy (TPLO) can eliminate excessive tibial thrust, thus creating a more functionally stable joint and sound gait. CCL diagnosis Diagnosis of a CCL tear is made by palpation (feeling the knee) and radiographs (x-rays). The radiographic findings associated with a ruptured CCL include osteoarthritic changes and joint effusion (swelling). The actual ligament cannot be seen on the radiographs. Description of procedure A curved cut (osteotomy) through the tibia bone is made using a specially designed saw blade. The top portion of the tibia is then rotated a precise number of degrees in order to level the slope of the tibial plateau and prevent the instability and sliding that occurs with a CCL tear. A bone plate and screws are then placed on the tibia to stabilize it and allow healing to occur. Prognosis with TPLO The TPLO technique has gained acceptance throughout the country due to consistent reports indicating that dogs treated with TPLO have a excellent functional outcome and decreased development of osteoarthritis. The exciting aspect of this technique is the possibility of returning your dog to nearly normal long-term function following CCL rupture (which has not been the typical expectation with any of the traditional techniques attempted before) and the prospect of a reduction in the future progression of arthritis. Recovery Strict confinement will be crucial for several weeks after surgery to avoid potential difficult complications. This will be discussed further during your appointment with the surgeon.

"Cornell University Veterinary Specialists" 
​https://www.cuvs.org/sites/default/files/documents-2017-01/cuvs-client-info-sheet-tibial-plateau-leveling-osteotomy.pdf