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TPLO stands for tibial plateau levelling osteotomy and is one of the surgeries used to manage either full or partial cranial cruciate ligament (CCL) rupture. The CCL is in the stifle (knee) joint and, along with other ligaments and muscles, stabilises the joint.<\/p>\n
The tibia (or shin bone) is cut at the top, and the bone is rotated to change the angle at the stifle joint. A metal plate and screws are used to hold the bone in its new position while it fuses.<\/p>\n
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How does TPLO surgery work?<\/h2>\n
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\nIn a normal dog, the stifle is subjected to a force called cranial tibial thrust when bearing weight. This force acts to push the tibia forward in relation to the femur (or thigh bone).<\/p>\n
The cranial cruciate ligament constraints this and prevents the tibia from moving forward maintaining joint stability. If the cranial cruciate ligament ruptures this force is not protected against and the tibia will slide forward during weight bearing making the joint unstable.<\/p>\n
By changing the angle of the top of the tibia (which is called the tibial plateau) this force can be neutralised, resulting in a stable joint on weight bearing.<\/p>\n
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\n- A curved saw is used to cut the tibia at premeasured points.<\/li>\n
- The cut piece of bone is then rotated to flatten the tibial plateau angle \u2013 the amount of rotation is calculated before surgery from the radiographs (x-rays).<\/li>\n
- The piece of bone is held in this position by a temporary pin.<\/li>\n
- A specialised plate is then applied to the inside aspect of the tibia, and screws are placed in both sections to hold the rotated bone in position until it fuses in its new place.<\/li>\n
- The temporary pin is then removed, and the soft tissues and skin are closed over the implants with sutures (stitches).<\/li>\n
- Radiographs are taken after the surgery to confirm the new angle of the stifle joint and ensure implant placement is satisfactory.<\/li>\n<\/ul>\n
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How does TPLO surgery work?<\/h2>\n
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<\/div>
<\/p>\n
In a normal dog, the stifle is subjected to a force called cranial tibial thrust when bearing weight. This force acts to push the tibia forward in relation to the femur (or thigh bone).<\/p>\n
The cranial cruciate ligament constraints this and prevents the tibia from moving forward maintaining joint stability. If the cranial cruciate ligament ruptures this force is not protected against and the tibia will slide forward during weight bearing making the joint unstable.<\/p>\n
By changing the angle of the top of the tibia (which is called the tibial plateau) this force can be neutralised, resulting in a stable joint on weight bearing.<\/p>\n
\n<\/div><\/div><\/div><\/div><\/div><\/div>
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<\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/section>
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<\/div>\n<\/div><\/div>
<\/div>
<\/p>\n
\n- A curved saw is used to cut the tibia at premeasured points.<\/li>\n
- The cut piece of bone is then rotated to flatten the tibial plateau angle \u2013 the amount of rotation is calculated before surgery from the radiographs (x-rays).<\/li>\n
- The piece of bone is held in this position by a temporary pin.<\/li>\n
- A specialised plate is then applied to the inside aspect of the tibia, and screws are placed in both sections to hold the rotated bone in position until it fuses in its new place.<\/li>\n
- The temporary pin is then removed, and the soft tissues and skin are closed over the implants with sutures (stitches).<\/li>\n
- Radiographs are taken after the surgery to confirm the new angle of the stifle joint and ensure implant placement is satisfactory.<\/li>\n<\/ul>\n
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Does my dog need a TPLO surgery?<\/h2>\n
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If your dog has a full or partial rupture of the cranial cruciate ligament then TPLO is likely to be indicated to stabilise the stifle.<\/p>\n
Cranial cruciate ligament rupture is normally manifested as a hind limb lameness, stifle swelling and pain and, in cases of full rupture, palpable instability of the joint.<\/p>\n
In certain cases, for instance, if there are other problems with the stifle or unrelated issues, alternative management may be recommended.<\/p>\n
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In some dogs, the anatomical shape of the tibia or the steepness of the plateau may make another procedure, or even a combined technique, preferable.<\/p>\n
Instability can be assessed by a veterinary surgeon using specific tests. These are called the cranial draw test and the tibial compression test. In cases of a partial rupture, instability is not always present.<\/p>\n
The surgery and alternatives will always be discussed with you prior to admission so an informed decision can be made regarding the surgery. Surgery will only be carried out if we believe it is in the best interests of you and your pet.<\/p>\n
\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/section><\/p>\n
Does my dog need a TPLO surgery?<\/h2>\n
\n<\/div>
<\/p>\n
If your dog has a full or partial rupture of the cranial cruciate ligament then TPLO is likely to be indicated to stabilise the stifle.<\/p>\n
Cranial cruciate ligament rupture is normally manifested as a hind limb lameness, stifle swelling and pain and, in cases of full rupture, palpable instability of the joint.<\/p>\n
\n<\/div><\/div><\/div>
<\/div>
<\/p>\n
In certain cases, for instance, if there are other problems with the stifle or unrelated issues, alternative management may be recommended.<\/p>\n
In some dogs, the anatomical shape of the tibia or the steepness of the plateau may make another procedure, or even a combined technique, preferable.<\/p>\n
\n<\/div><\/div><\/div><\/div>
<\/div>
<\/p>\n
Instability can be assessed by a veterinary surgeon using specific tests. These are called the cranial draw test and the tibial compression test. In cases of a partial rupture, instability is not always present.<\/p>\n
\n<\/div><\/div><\/div>
<\/div>
<\/p>\n
The surgery and alternatives will always be discussed with you prior to admission so an informed decision can be made regarding the surgery. Surgery will only be carried out if we believe it is in the best interests of you and your pet.<\/p>\n
\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/section><\/div><\/div>
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<\/div>
\n\n
<\/div>\n<\/div><\/div>
<\/p>\n
To achieve this, a surgical approach is made to the inside aspect of the tibia. A curved saw is used to cut the tibia at premeasured points. The cut piece of bone is then rotated to flatten the tibial plateau angle \u2013 the amount of rotation is calculated before surgery from the radiographs (x-rays).<\/p>\n
The piece of bone is held in this position by a temporary pin. A specialised plate is then applied to the inside aspect of the tibia, and screws are placed in both sections to hold the rotated bone in position until it fuses in its new place.<\/p>\n
The temporary pin is then removed, and the soft tissues and skin are closed over the implants with sutures (stitches). Radiographs are taken after the surgery to confirm the new angle of the stifle joint and ensure implant placement is satisfactory.<\/p>\n
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Are there alternatives to TPLO?<\/h2>\n
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There are several alternative managements to TPLO, each with its own indications and risk profile.<\/p>\n
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