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TPLO surgery radiographs for diagnosis

What to expect before, during, and after TPLO surgery

If your veterinarian has recommended a TPLO (Tibial Plateau Leveling Osteotomy) surgery for your dog, or you are researching it as an option, you probably have a few questions. This blog post addresses the top questions we get asked from dog owners about TPLO.  In this article, we’ll walk through the process for what happens before, during, and after your pet’s surgery.

TPLO Surgery stifle illustrationWhy do dogs need TPLO surgery?

A dog’s CCL, which is similar to a person’s anterior cruciate ligament (ACL) in their knee, can degenerate or weaken over time for various reasons. Because the CCL weakens over time, it can rupture with seemingly minimal trauma. A CCL rupture is the leading cause of hind limb lameness in dogs and can cause instability in the stifle (knee) joint. TPLO is often recommended for medium- to large-breed dogs, as well as canine athletes, as it restores them closer to normal function.

You can read more about CCL Tears and what they are in one of our previous blog posts here.

Why TPLO instead of another surgery?

TPLO is one of the best-studied surgeries and has been performed for more than 20 years. The TPLO procedure is also the most likely to restore near-normal limb function, particularly for medium- to large-breed dogs and canine athletes.

Booking a Consult with a surgeon:

At Animal Surgical & Orthopedic Center, we pride ourselves on having the highest number of board-certified surgeons available for consults in the greater Seattle area. Every consultation you book with us will be with the surgeon who will be performing your pet’s operation. You can book your first consultation with one of our surgeons today by calling (206) 545-4322.

TPLO surgery radiographs for diagnosisDiagnosis for a CCL Rupture:

When you meet with one of our surgeons, the first thing they will do is examine your dog and palpate (feel) the knee. Most dogs with a ruptured CCL will have instability within the knee called “cranial drawer movement” or “cranial tibial thrust”. This is the primary indicator of a ruptured CCL. In dogs with chronic or partial tears of their CCL or in very tense dogs, “cranial drawer movement” may not be detectable. In these cases, radiographs are helpful and usually confirm some degree of osteoarthritis and swelling of the joint; however, the CCL itself is never visible on radiographs.

 Scheduling the surgery

Although you should never feel pressured into surgery at our clinic, you should still retain the ability to schedule surgery in an expeditious manner suitable to your schedule. With six surgeons available, there should be plenty of options open to serve the specific needs of your schedule.

Preparing your home:

Prior to your pet’s surgery, you should speak with your veterinarian about how to best confine your dog during their recovery. Making your dog as comfortable as possible is just as important as a good rehabilitation plan.

Since your dog’s mobility will be restricted, we recommend taking the following steps:

  • If your dog is crate trained, find a crate that’s large enough for him/her to stand up in & turn around.
  • Create a gated off area in your home, such as the kitchen or living room to restrict them to certain areas.
  • Rooms with hardwood floors, tile, or linoleum can be particularly difficult for dogs to walk on, especially after surgery. If the room you’ve chosen has slippery surfaces like these, be sure to place some throw rugs with rubber backing on the floor to help your dog walk around more easily.

TPLO surgery operating table What to Expect During TPLO Surgery:

What happens during the TPLO procedure?

The TPLO surgery produces functional stability of the knee by flattening the slope of the tibial plateau. To start, your surgeon will explore the knee joint and remove the torn ends of the CCL. They will change the structure of the knee joint by making a semi-circular cut at the top of the tibia (shinbone). Your surgeon will rotate this small section of bone to reduce the tibial plateau slope (an average of approximately 25°in dogs) to approximately 5-7°.

The two segments of bone are then stabilized with a plate and screws until the bone heals. By rotating the tibial plateau and “leveling” it, the goal is to prevent the femur (thigh bone) from sliding down the slope of the tibia and helping to stabilize the knee.

At ASOC, all our surgeons are board-certified and have extensive experience performing TPLO surgeries. ASOC was the first practice to perform TPLO in the Greater Seattle area.

Will my pet experience any pain?

At ASOC we use several different methods and modalities for pain management.

Anesthesia protocols commonly include the following:

  • Injectable narcotics/analgesics – Given before, during, and after surgery as needed to stay ahead of the pain. These are used either as intermittent injections or constant rate infusions.
  • Epidurals – Helps lower the doses required to maintain general anesthesia and can relieve discomfort for 8-12 hours after surgery.
  • Nocita- A long-acting (3 day) local anesthetic block administered during surgery.
  • Cold Compression Therapy Provides post-operative control of swelling and pain with the use of cold and compression.
  • Post-operative oral pain medication combinations to be sent home for the first 1-2 weeks after surgery

What is the success rate of TPLO?

The success rate of TPLO surgery is extremely high, with as many as 90-95% of dogs returning to near-normal function. Most dogs achieve about 95% of their normal limb function and return to their prior level of activity approximately 10-12 weeks post-TPLO surgery.

At ASOC, our board-certified surgeons have helped thousands of dogs return to normal activities pain-free or largely pain-free. ASOC has always been a leader in adopting practices to improve outcomes and lower complication rates.

After your surgery: What happens next?

Consult directly with the surgeon at rechecks

Our surgeons feel it is important to remain available for your questions and concerns before and after surgery. Routine rechecks following TPLO are scheduled at 2 weeks postoperatively, with recheck radiographs (x-rays) obtained at the 8-week point.  Additional rechecks may be scheduled as needed.

Recovery & Rehabilitation:

Your dog’s activity level must be restricted to short leash walks only (preventing running/jumping activities) for a full 10-12 weeks.

This means no jumping on or off the bed, on/off the couch, or on people. We recommend starting with very short walks to urinate/defecate only and then gradually increase the duration of those walks through the rehabilitation period.

Access to stairs should be limited as much as possible, especially for the first 2-4 weeks after surgery. Help guide your pet up and downstairs with a short leash, harness, or sling. If you have stairs in your home, limit your dog’s access with a baby gate to prevent unsupervised use.

When your pet is alone, he/she should be restricted to a small area or a crate. Adequately restricting your pet’s activity level plays a major role in successful outcomes post-surgery.

We recommend refraining from active play until your veterinarian tells you otherwise (likely until after the 8-week post-op radiographs to confirm bone healing).

You can find more information regarding post-op care on our website. https://www.animalsurgical.com/for-pet-owners/recovery-at-home/

If you’re ready to book your appointment to consult with one of our surgeons about TPLO for your dog, give us a call at (206) 545-4322, or ask your veterinarian for a referral to Animal Surgical and Orthopedic Center.

We look forward to helping your pet live a happy, pain-free lifestyle!

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Posted August 25, 2020 by Animal Surgical in Joint pain management with No Comments

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