The first part of the surgery involves removing the torn ends of the cruciate ligament and examining the medial and lateral meniscus cartilages. If a tear of either meniscus is found, the damaged part of the meniscus is removed. If a partial tear of the cruciate ligament is noted, the ligament is left intact as it has a good chance to heal following the TPLO surgery. A curved cut is made in the top of the tibia and the bone is rotated in order to level the slope of the tibial plateau. A plate and six screws are used to hold the bones in place. If your pet is a very large dog, a larger plate is typically used and eight screws are inserted into the bone. The cut in the bone will heal in about 6 to 8 weeks.
Give prescribed medications that control pain (analgesics) and reduce swelling in the stifle joint (nonsteroidal anti-inflammatories). Check the incision for signs of infection daily which include swelling, pain, discharge and redness. A cold compress should be applied to the stifle three times daily, for 20 minutes to reduce swelling. Starting on the third day after surgery, a warm compress should be applied to the stifle before range of motion exercises. At the conclusion of each exercise session, a cold compress should be applied to the stifle for about 5 minutes. This "at home" rehabilitation therapy should be continued until your pet is using the limb well.
Return to us for an evaluation of the incision and stifle joint at two weeks after surgery.
Radiographs (x-rays) of the stifle joint are made at 2 months after surgery to check the healing of the bone. Ten to 15 minute leash walks three times daily can be started once the bone is healed (about 2 months); the length of the walks is gradually increased on a leash over the next two months. After four months the exercise restriction is lifted.
Working dogs should not return to their normal activities until six months have elapsed.
About 90% of the dogs having the TPLO regain normal or near normal function of the limb (full weight-bearing). We have operated many dogs that have resumed normal working activities (police dogs, hunting, agility).
Dogs that have sustained a blowout fracture of the tibial plateau as a result of falling after surgery may not regain as good of function on the limb.
Dogs that have been previously operated using another technique frequently are improved with the TPLO surgery, but the outcome may not be as good, versus a virgin knee that has received the TPLO surgery.
The TPLO procedure will help to minimize the progression of degenerative joint disease. One study demonstrated a four fold reduction in the progression of arthritis following TPLO surgery, versus dogs that received the lateral imbrication technique.