Orthopedics / TPLO cruciate ligament repair
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What is the Cruciate Ligament?
The first sign of a cruciate injury is usually limping in one of the back legs. In the more chronic presentation, this can just start out as a stiffness and then progress to limping. At other times, a dog will become lame acutely and hold the leg up in the air. Limping in dogs is a sign of discomfort and pain. Often times the dog will appear to improve and start using the leg better, but may still limp. Some dogs might even become normal with rest, but then when reintroduced to activity, start limping again. Unfortunately, because of the way a dog uses its leg in running, playing, and even walking, surgery is indicated to return them to soundness and prevent or reduce arthritis formation. Tibial plateau leveling osteotomy (TPLO) is a highly successful way to treat this problem surgically.
Diagnosis is best performed by orthopedic physical exam and radiographs (x-rays). The doctor will palpate for drawer movement or tibial thrust – see diagram above to the left – indicating the cruciate ligament is torn.
Tibial thrust means that the joint is unstable because of injury or rupture of the cruciate ligament.
Blood work is then recommended to ensure your animal is ok for anesthesia and anti-inflammatory drugs.
How does a TPLO help?
The cranial cruciate ligament normally connects the femur (thigh) and tibia (shin) bones and maintains these bones in proper orientation when a dog walks or runs. When the ligament is ruptured, the tibia is allowed to slide forward in relation to the femur (Tibial Thrust). This abnormal motion occurs with every step the dog takes, and this causes pain, inflammation, and ultimately, arthritis. The TPLO stops this abnormal motion, making pain and inflammation subside and minimizing the progression of arthritis.
What happens in the TPLO surgery?
TPLO surgery involves cutting the top portion of the tibia and rotating it, thus changing the way that the femur and tibia interact during movement. The modified tibia bone is then held together with a bone plate and screws. The plate and screws are necessary until the bone has healed together where it was cut. This healing typically takes approximately eight to twelve weeks.
The TPLO, unlike conventional procedures, changes the biomechanics within the stifle by rotating the tibial plateau. Cranial tibial thrust is thus negated and balance is reestablished within the stifle resulting in a stable, pain free joint.
Using the latest implant technology is critical.
All of our TPLO surgeries are plated with the locking system. The plate we use is pictured to the left. A locking system is the newest and most advanced TPLO plating system – it out preforms older technology. All specialty hospitals use this system.
What care is required after surgery?
Your pet will usually be discharged to home the day following surgery. Activity will be restricted for approximately 12 weeks – it is most critical for the first eight weeks while the bone is healing. We thoroughly discuss aftercare and rehabilitation at the pre-surgical consult and at the time of discharge.