TPLO cruciate ligament repair surgery
OVER the years, there have been multiple different methods proposed and used to repair cranial cruciate ligament ruptures in the dog.
These different methods have their place in different situations, but they also have their limitations.
The primary limitation in many methods is their usefulness in larger breed dogs.
When synthetic “replacement” cruciate ligaments are placed in larger breed dogs, their sheer size and weight can lead to breaking of these implants and a poor surgical outcome.
As a result of the perceived poor performance of more traditional surgical methods in larger dogs, new methods for cruciate ligament disease were sought that were more reliable in these patients.
The top plateau of the tibia (shin bone) in dogs tends to slope backwards and when the cruciate ligament is torn this leads to the femur (thigh bone) wanting to slide backwards down the slope.
The result is a forward thrusting of the tibia with each step that stretches the joint capsule, causes pain and promotes rapid arthritis development.
The TPLO operation uses an oscillating bone saw to cut the top portion of the tibia and rotate it into a position that creates a flat or near flat plateau on top.
The bone is then stabilised with a plate and screws and once healed, the dog then has a permanently flattened tibial plateau.
As a result the thrusting force is eliminated, lameness resolves and the progression of arthritis in the cruciate deficient stifle is dramatically slowed.
This technique involves careful aftercare to ensure the bone heals well, but has shown superior results especially in larger dogs (over 20kg).
The initial signs of cruciate ligament rupture are a sudden onset of limping in a hind leg, often severe.
A partial tear may present as ongoing intermittent limping in a hind leg that is exacerbated by exercise. Partial tears progress to full tears and often cause significant arthritis to develop along the way.
It is always best to have a limp assessed to try to bring the best long term outcome for the patient.