The tibial plateau leveling osteotomy (TPLO) is one of the most common orthopedic surgeries performed at Neighborhood Veterinary Centers. If your veterinarian has recommended this procedure for your pet, you likely have a lot of questions, or may be feeling overwhelmed at the sheer amount of TPLO information and advice. 

To ease your fears and help you feel more confident about your pet’s upcoming surgery, we list pet owners’ most common TPLO questions and answer each one in detail. 

Question: Why is a TPLO recommended for my dog?

Answer: A TPLO is an orthopedic procedure that stabilizes the stifle (i.e., knee) joint in a dog’s hind limb after a cranial cruciate ligament (CCL) rupture. In a healthy stifle, the cranial and caudal cruciate ligaments (i.e., a pair of fibrous bands that meet in a cross or “X” pattern inside the knee joint) allow the knee to act as a hinge joint and keep the femur (i.e., thigh bone) and tibia (i.e., shin bone) aligned during extension, when the dog is in a weight-bearing or standing position). When the cranial (i.e., top or front-most band) cruciate ligament is partially or fully torn, or ruptured, the stifle joint is destabilized and painful. When an injured dog attempts to bear weight to stand, walk, or run on the limb, the tibia slides forward out of position, and cannot accept any weight-bearing forces. Dogs with a CCL injury will avoid using the painful and weakened limb and may appear to lean (i.e., off-load), limp, or stand on tip-toe.

Q: How will a TPLO restore my dog’s mobility?

A: Because torn ligaments cannot be reconnected or repaired, CCL injuries are corrected by altering the stifle’s biomechanics. During a TPLO, the surgeon cuts a semi-circular wedge of bone from the tibial plateau (i.e., the load-bearing portion that articulates with the femur). This wedge is then rotated based on patient-specific measurements, and reattached using a specially designed plate and screws. The rotation, which is precisely calibrated using surgical planning software and your dog’s pre-surgical X-rays, flattens or levels the tibial surface, which prevents abnormal motion and keeps the tibia solidly in place when force is applied during movement or weight bearing, rather than sliding forward under pressure from the femur and ground forces.

The TPLO is generally considered the most stable surgical option for CCL injury, especially for large dogs weighing more than 40 pounds. TPLO may also be advised for athletic or active, small-breed dogs.

Q: Are there complications or risks involved in TPLO surgery for dogs?

A: Although the TPLO has an excellent success rate, no surgical procedure is 100% risk-free. TPLO complications are rare, but can arise during surgery or at any time during the at-home recovery period. These may include:

  • Anesthetic complications
  • Incision or joint infection
  • Delayed bone healing
  • Chronic arthritis
  • Reduced limb use 
  • CCL injury on the opposite leg

As part of our commitment to advanced veterinary care, Neighborhood Veterinary Centers takes extensive precautions to minimize complications, including pre-surgical testing, extensive anesthetic safety protocols, a state-of-the-art surgical suite, specialized orthopedic instrumentation, and a guided, closely monitored recovery and rehabilitation phase. Owners who strictly adhere to their veterinary team’s post-operative instructions can successfully minimize many of the recovery-related risks.

Q: What will the TPLO recovery process be like for my dog?

A: Similar to human orthopedic surgery, a canine patient’s outcome heavily depends on their recovery and rehabilitation. The standard TPLO recovery process includes:

  • Pain management — Recovering dogs are prescribed several pain medications to ensure they are comfortable throughout the healing process, because pain increases inflammation and interferes with healing. 
  • Incision care — The incision site is monitored daily to keep the area clean and dry. We recommend using an Elizabethan collar to prevent your dog from chewing or licking the site. Staples or sutures are generally removed in 10 to 14 days. 
  • Rest and exercise restriction — Dogs are kept on strict crate rest and exercise restrictions (e.g., no running, stairs, jumping, or off-leash activity) until your veterinarian confirms adequate bone healing, usually around 8 to 12 weeks after surgery. If necessary, sedatives or anti-anxiety medication may be prescribed during recovery so dogs stay calm and relaxed during this restricted period.
  • Rehabilitation — At-home rehabilitation exercises, as well as professionally guided rehabilitation (i.e., physical therapy) at Neighborhood Veterinary Centers will likely be recommended to reduce pain, build confidence, and promote early, safe limb use. Dogs who take part in rehabilitation generally experience a faster and more complete return to function. 
  • Regular follow-up appointments — Regular rechecks will be required to ensure your pet’s bone is healing at the appropriate speed and to identify early complications, such as over-use, incision infection, muscle atrophy, or inflammation.

Proper TPLO recovery is as integral as a proper surgery. Owners who are facing an upcoming surgery should pay close attention to their veterinarian’s recommendations and be prepared for a gradual healing process. 

Neighborhood Veterinary Centers is proud to offer state-of-the-art orthopedic surgical care and rehabilitation for southeast Texas pets. If your pet needs help getting back on their paws, contact our skilled veterinary team.