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TPLO (knee) surgery for dogs


Like us humans, dogs can suffer from joint problems. You may hear of sportsmen and women tearing their ‘ACL’ (anterior cruciate ligament) putting them out of action for a while. Sadly, the same can happen to our beloved dogs (and cats).

What is a cruciate ligament?

The cruciate ligaments are structures located within the stifle (knee) joint that contribute to joint stability and avoid abnormal joint movements. They join the femur (thigh bone) and the tibia (shin bone) together inside the joint. There are two cruciate ligaments in the knee: a cranial ligament and a caudal ligament. Lesions affecting the caudal ligament are extremely rare in dogs and the vast majority of “cruciate disease” affects the cranial ligament. The cranial cruciate ligament is the same as the anterior cruciate ligament in a human (ACL) which many people, especially sportspeople, frequently injure. 

What causes the cruciate ligament to tear?

Unlike humans, dogs tend to suffer from a cranial cruciate ligament rupture (tear) due to the progressive weakening of the ligament which is caused by a predisposition, for example, obesity. This means normal daily exercise can result in the partial or total rupture of the ligament causing lameness in the leg and potentially severe discomfort – you may see your dog lifting their leg up when they try to walk or run.

What are the treatment options when this happens?

For some dogs, conservative management may be appropriate involving rest, time, pain management and physiotherapy. However, in many cases, surgery is required. There are several surgical procedures available to stabilise the joint. TPLO is currently thought to be the best option for both stability and post-operative recovery.

The surgical procedures performed in dogs differ from those carried out in humans because the ligament isn’t replaced in dogs as it is in humans. In the human knee, the bones are stacked on top of each other in standing with no bend whereas a dog always has a natural bend in their knee. In dogs, the joint becomes unstable because the relative angle of the bones to one another puts too much stress on the cranial cruciate ligament leading to its rupture. If you can correct the relative angle of the bones to one another in a dog’s knee, you can make the joint stable without having to replace the ligament.

Replacing the cranial cruciate ligament has been attempted in dogs. However, it was found that the replacement ligament also ruptures too frequently to make it a sensible treatment option. In humans, the ligament usually ruptures due to excessive force and replacement is the preferred option.

Can you tell me more about a TPLO – what does it mean?

TPLO is the acronym of “tibial plateau levelling osteotomy”. The surgery is based on cutting the proximal part of the tibia (the shin bone next to the knee joint) along a curved line and then rotating the joint surface down to a lower angle. This eliminates the abnormal movements that would be present when the cranial cruciate ligament is ruptured.

And so why is TPLO commonly used in cruciate ligament disease?

Slocum TPLO is regarded as the gold-standard procedure as it represents a permanent, reliable way of restoring excellent joint function in dogs affected by a cranial cruciate ligament rupture. This procedure offers the highest success rate when compared to other alternative surgeries. It is well-standardised and carries minimal risks.