Understanding TPLO Surgery: A Guide for Pet Owners | Evolution Veterinary Specialists

Understanding Cranial Cruciate Ligament Disease (CCLD) and TPLO Surgery: A Comprehensive Guide for Pet Owners

Cranial Cruciate Ligament Disease (CCLD) is one of the most common causes of rear limb lameness in dogs, leading to pain, decreased mobility, and arthritis if not addressed properly. The good news is that there are effective treatments available, including Tibial Plateau Leveling Osteotomy (TPLO) surgery, which can offer long-term relief and help your dog return to their normal activities. In this guide, we’ll explore what CCLD is, how it affects your dog, and how TPLO surgery can provide the best chance for recovery.

What Is Cranial Cruciate Ligament Disease (CCLD)?

The cranial cruciate ligament (CCL) is a key stabilizing ligament in the knee (or stifle) joint in dogs. It works similarly to the ACL in humans. However, unlike humans, CCL injuries in dogs are more often caused by gradual degeneration over time rather than a sudden traumatic event. This condition is known as Cranial Cruciate Ligament Disease (CCLD), which can lead to instability in the knee joint, pain, arthritis, and ultimately, reduced mobility.

Factors that can contribute to CCL injury include:

Breed: Dogs of all breeds and sizes can be affected by CCLD.
Age: Older dogs are more susceptible due to the natural degeneration of ligaments over time, though this happens in young adult dogs as well.
Obesity: Excess weight places added strain on the knee joints, increasing the likelihood of injury.
Genetics and Conformation: Some dogs are predisposed due to their skeletal structure or genetic factors.
Previous Injuries: A history of joint instability or injury in the knee can increase the risk of CCL damage.

Common Symptoms of CCL Injury

When a dog suffers from CCL injury, you may notice symptoms such as:

Lameness or limping in the rear leg, especially after activity
Difficulty rising from a seated or lying position
Stiffness in the affected leg, particularly after rest
Decreased activity level or reluctance to jump or run
Muscle atrophy (shrinking of the muscle in the affected leg)
Sitting with the affected limb extended (a common sign in CCL-injured dogs)
Clicking or popping noises when the knee is flexed or extended

As the injury progresses, the lameness can become more pronounced, and arthritis may develop in the affected joint.

Diagnosing CCL Injuries

To diagnose a torn or partially torn CCL, veterinarians will typically use X-rays, along with gait observation and physical examination. Special tests such as the cranial drawer test and the tibial compression test are used to assess the stability of the knee joint and confirm if the CCL is damaged. In some cases, arthroscopy (a minimally invasive camera procedure) may be used to assess the joint and confirm the extent of the injury, particularly for partial tears.

What Is TPLO Surgery?

The Tibial Plateau Leveling Osteotomy (TPLO) is a surgical procedure designed to stabilize the knee joint after a CCL injury. TPLO surgery changes the angle of the tibial plateau (the top surface of the shin bone) to prevent abnormal movement in the joint, essentially removing the need for the CCL to maintain stability.

Want to see how the TPLO procedure works? Check out this helpful animation that illustrates the surgery step by step:
Watch the TPLO Animation

During TPLO surgery:

The surgeon makes a semicircular cut in the tibia.
The tibial plateau is rotated to change its angle, which stabilizes the knee joint without the CCL.
The bone is then stabilized with a locking plate and screws while it heals.

This procedure has been shown to provide superior results in terms of long-term stability and faster recovery compared to traditional treatments.

Why TPLO Surgery?

TPLO is often considered the gold standard for treating CCL injuries due to several key benefits:

Effectiveness: TPLO significantly improves the stability of the knee joint, reducing pain and preventing further injury.
Faster Recovery: Compared to traditional surgeries, dogs undergoing TPLO surgery typically experience a faster return to comfortable use of the affected limb.
Pain Relief: Most dogs feel significantly better after surgery, with reduced pain and improved function.
Long-Term Function: TPLO helps prevent arthritis and degenerative joint disease from progressing rapidly, allowing dogs to resume activities like running, jumping, and playing.

Preparing for TPLO Surgery

Before surgery, your veterinarian will perform a thorough evaluation, which may include X-rays and bloodwork to assess your dog’s overall health and suitability for anesthesia. It’s important to discuss any questions or concerns with your veterinarian, particularly about anesthesia risks, especially for older dogs or those with pre-existing health conditions.

The TPLO Surgical Process

TPLO surgery typically takes about one hour to perform. The surgeon will make an incision to access the knee joint, make the necessary adjustments to the tibial plateau, and secure it with a locking plate and screws. Most dogs recover well from the surgery, but as with any procedure, there are risks. Selecting a skilled and experienced veterinary surgeon is crucial to ensuring the best possible outcome.

Post-Surgery Recovery

The recovery process is crucial for the success of the surgery. Here’s what to expect in the weeks following TPLO surgery:

Initial Recovery:

After surgery, your dog will need to stay calm and rested for several weeks to allow the bone to heal properly. Limited movement is essential to avoid complications.
It is important to restrict activity, limiting your dog’s movements to prevent strain on the surgical site.

Follow-Up Care:

Two weeks after surgery, your dog will return to the vet for suture removal and a post-operative check-up.
Two months after surgery, your dog will undergo follow-up X-rays to ensure proper healing of the tibial bone.

Physical Therapy:

Physical therapy helps rebuild atrophied muscle faster and can help with earlier return to high-level activities. As such it is often recommended for performance and working dogs. Dogs that fulfill less demanding jobs, such as routine pet activities, don’t typically require physical rehabilitation and rebuild muscle over a slightly longer period.

Home Adjustments:

At home, you’ll need to make sure your living space is dog-friendly. Consider using ramps for stairs or non-slip mats for slippery floors to help your dog navigate safely during recovery.

Aftercare: What to Watch For

It’s important to monitor your dog during recovery for any signs of complications. Watch for:

Excessive swelling or bleeding
Sudden lameness or worsening pain
Infection (redness, warmth, or discharge at the incision site)

If you notice any of these signs, contact your veterinarian immediately.

Success Rate and Long-Term Outlook

TPLO surgery is highly successful in treating CCL injuries, with many dogs returning to normal or near-normal activity levels after a full recovery. While all dogs with CCL injuries will develop some level of arthritis over time, the key to a successful long-term outcome is early intervention and maintaining a healthy weight to reduce stress on the joints.

Conclusion

Cranial Cruciate Ligament Disease is a serious condition that can cause significant pain and reduced mobility in dogs. Fortunately, with proper diagnosis and treatment, particularly through TPLO surgery, many dogs can recover and return to a full and active life. By understanding the procedure, recovery process, and aftercare involved, you can make an informed decision about the best treatment plan for your dog. Always consult with your veterinarian to discuss the best options for your dog’s specific needs. With the right care, your dog can soon be back to their happy, active self!