TPLO (Tibial Plateau Leveling Osteotomy)
Ruptured Cruciate Ligament-A Common Knee Injury in Dogs.
Rupture or tearing of the cruciate ligament is one of the most common orthopedic injuries in dogs and a major cause of arthritis. The cranial cruciate ligament is inside the stifle joint, connecting the femur and tibia bones. It helps maintain a stable joint by preventing forward and backward sliding of the femur on the top of the tibia (tibial plateau), as well as preventing internal rotation and hyperextension.
When the cranial cruciate ligament tears, pain, swelling and obvious lameness occur. Partial tearing can cause less pain and mild lameness. Simple rest and anti-inflammatory medications do not help with these symptoms. To diagnose rupture of the cranial cruciate ligament, Dr. Jacques will examine your dog's gait, feel the joint, and check for abnormal forward and backward mobility of the joint (called cranial drawer or cranial tibial thrust). It may be necessary to put your dog under sedation to allow x-rays to be taken to look for arthritic changes and swelling.
TPLO Surgery:
Pre-operative x-rays are taken to measure the tibial plateau angle, which is used to calculate the degree of rotation required to level the tibial plateau. During the TPLO surgery, the angle of the tibial plateau is altered by making a curved cut on the top of the tibia and then rotating the piece so that the load-bearing surface of the bone is flat. The miniscus cartilage is also evaluated and may require surgery (meniscal release) at that time. A stainless steel plate is then attached to hold the piece of bone in this new position as it heals.
Pain Management:
Pain management is important to your pet's recovery. We take a proactive approach to ensure that your pet is as comfortable as possible during the recovery and healing process using advance care pain medications.
Potential Complications:
As with any surgery, complications may arise. Most complications arise from the dog licking or chewing at the surgical site. This can cause minor to severe complications. Use of an E-collar (cone collar) can help prevent the licking until the sutures/staples are removed. Complications following TPLO surgery are infrequent but possible. Fracture of the narrow front part of the tibial crest can occur, but will usually heal without further surgery. Osteomylelitis, an acute or chronic bone infectiion, usually caused by bacteria, can occur and is treated with antibiotics. Tearing of the meniscus can occur, and might require further surgeries. If your dog is not restricted during the healing phase a number of problems can arise including breakage or loosening of the screws and plate holding the bones, straining of other ligaments in the stifle, and poor or slow healing of the bone. Arthritis is usually present at the time of surgery. TPLO surgery cannot reverse the arthritic and degenerative state of the joint, but the surgery can help to minimize the progression.