TPLO ACL Repair

The TPLO surgery is a patented procedure that requires a specialized training course. It also requires: expensive surgical equipment, special custom-fit bone plates and screws, a longer surgery time, and extra operating room personnel.

Any size dog can be a candidate for TPLO. The procedure is most commonly performed on large and giant breeds, dogs with an athletic lifestyle, bow-legged dogs, and dogs which have had previous cruciate repairs that have failed. Young dogs are especially good candidates for the procedure due to reduced long-term arthritis and their ability to resume an active lifestyle. More frequently, smaller dogs are benefiting from the enhanced performance achieved with this procedure.

To return stability to the joint, other cruciate repair techniques replace the cruciate ligament. The TPLO procedure rotates the tibial plateau (bottom of the knee joint) until it is nearly level, changing the biomechanics of the knee joint. As a result, the patellar tendon and posterior cruciate ligament take over the function of the ruptured ACL. Essentially a biomechanical tweak of the knee allows other healthy knee structures to replace the torn ligament (ACL).

Only veterinary surgeons that have completed a specialized training course taught by the developer of the procedure can perform the TPLO surgery. The procedure is technically demanding and currently only a handful of veterinary surgeons in Missouri have completed the required certification process. Dr. Allen has performed well over 4,000 of these procedures and has further refined the technique for optimal patient outcomes.

Complications arising from the TPLO surgery are rare. However, some infrequent complications include patellar tendonitis, incision line irritation or fluid pocket (seroma), fractures of the tibia crest, infection, and implant loosening or bending. Most complications are easily managed with conservative measures. The published re-operation rate is 5%. Dr. Allen’s rate is 1.6%. As guardian/patient compliance with post-operative care increases, complications decrease.

It is common for swelling and mild bruising to occur at and below the surgery site. Most dogs will be slightly toe-touching the day after surgery. Your dog will be sore, but comfortable, on anti-inflammatory and oral pain medication after an initial 12-24 hours on potent pain-killers (narcotics) given in the hospital.

Cold packs will decrease the swelling and pain during the first few days back home. For the first two weeks, you will need to help support your dog with a belly sling when he goes out to the bathroom. Also during this time, you will need to administer antibiotics and pain medication. Your pet must be strictly confined for the first two months. Leash restriction will continue for a total of four months, with gradual increases in activity over the last two months. A detailed home instruction sheet will be provided and discussed during the hospital discharge.

Recheck examinations are important to make certain that your pet is recovering at a normal rate. Two-month post-operative X-rays are important to make certain that implants are in place and to assure adequate bone healing prior to increased activity allowance.

In one study, 38% of dogs ruptured the anterior cruciate ligament in the opposite knee within 18 months. In certain breeds, especially Rottweilers and Labrador Retrievers, it is very common to diagnose ruptures in both knees at the time of the first surgery. To reduce the chance of ruptures in the opposite knee, you must repair the injured knee as soon as possible, keep the dog’s weight under control, maintain your dog’s muscle mass with regular exercise, and reduce ‘fence running’ and wildlife pursuits. Squirrels, chipmunks, and rabbits are the bane of a dog’s knee, as is obesity.