TPLO, or tibial-plateau-leveling osteotomy, is a

surgery Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery s ...

performed on dogs to stabilize the

stifle joint The stifle joint (often simply stifle) is a complex joint in the hind limbs of quadruped mammals such as the sheep, horse or dog. It is the equivalent of the human knee and is often the largest synovial joint in the animal's body. The stifle join ...

after ruptures of the

cranial cruciate ligament The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments (the other being the posterior cruciate ligament) in the human knee. The two ligaments are called "cruciform" ligaments, as they are arranged in a crossed formation. In t ...

(analogous to the

anterior cruciate ligament The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments (the other being the posterior cruciate ligament) in the human knee. The two ligaments are called "cruciform" ligaments, as they are arranged in a crossed formation. In ...

CLin humans, and sometimes colloquially called the same). In the vast majority of dogs, the cranial cruciate ligament (CrCL) ruptures as a result of long-term degeneration, whereby the fibres within the ligament weaken over time. The precise cause of this is not known, but genetic factors are probably most important, with certain breeds being predisposed (including Labradors,

Rottweilers The Rottweiler (, , ) is a breed of domestic dog, regarded as medium-to-large or large. The dogs were known in German as , meaning Rottweil butchers' dogs, because their main use was to herd livestock and pull carts laden with butchered mea ...

, Boxers, West Highland White Terriers and Newfoundlands). Supporting evidence for a genetic cause was primarily obtained by assessment of family lines, coupled with the knowledge that many animals will rupture the CrCL in both knees, often relatively early in life. Other factors such as

obesity Obesity is a medical condition, considered by multiple organizations to be a disease, in which excess Adipose tissue, body fat has accumulated to such an extent that it can potentially have negative effects on health. People are classifi ...

, individual conformation, hormonal imbalance and certain inflammatory conditions of the joint may also play a role. The cranial cruciate ligament runs from the cranial mid part of the tibial intercondylar eminence to the lateral condyle of the

femur The femur (; : femurs or femora ), or thigh bone is the only long bone, bone in the thigh — the region of the lower limb between the hip and the knee. In many quadrupeds, four-legged animals the femur is the upper bone of the hindleg. The Femo ...

. Normally, the CrCL prevents caudal (backward) movement of the femur relative to the tibia. Due to selective breeding, the tibial plateau slope has become sloped too far backwards so there is a constant stress on the Cranial cruciate ligament. Over time this leads to a degenerative rupture. When it ruptures, the joint becomes unstable which causes pain and can lead to chronic progressive

arthritis Arthritis is a general medical term used to describe a disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth, Joint effusion, swelling, and decreased range of motion of ...

in the stifle if untreated.Cranial Cruciate Ligament (CrCL) Failure: canine and feline (cat and dog) veterinary factsheets
/ref> In a TPLO procedure, the

tibial plateau Tibial may refer to: * Tibia bone * Tibial nerve * Anterior tibial artery * Posterior tibial artery * Anterior tibial vein * Posterior tibial vein The posterior tibial veins are veins of the leg in humans. They drain the posterior compartment ...

, the portion of the

tibia The tibia (; : tibiae or tibias), also known as the shinbone or shankbone, is the larger, stronger, and anterior (frontal) of the two Leg bones, bones in the leg below the knee in vertebrates (the other being the fibula, behind and to the outsi ...

adjoining the stifle, is cut and rotated so that its slope changes to approximately 5 degrees from the horizontal plane. This prevents the

from sliding down the slope of the tibial plateau when the dog puts weight on its knee. This surgery generally results in faster recovery times compared to other procedures to stabilize the knee. Most dogs (over 90%) are expected to regain a very active and athletic lifestyle with no post-operative complications and without the need for any long-term pain relieving medication. Many surgeons are now conducting TPLOs on small dogs, believing that these pets, like large dogs, have a faster and more complete return to function than with other procedures. A systematic review of the evidence has shown that "…functional recovery in the intermediate postoperative time period was superior following TPLO compared with lateral extracapsular suture."

Alternative procedures

Tibial tuberosity advancement Tibial tuberosity advancement (TTA) is an orthopedic procedure to repair deficient cranial cruciate ligaments in dogs. It has also been used in cats. This procedure was developed by Dr. Slobodan Tepic and Professor Pierre Montavon at the School ...

* Tightrope CCL * Triple tibial osteotomy * Simitri Stable in Stride * Cranial tibial wedge osteotomy

Alternative procedures

References

Further reading