The TPLO changes the biomechanical properties of the canine stifle joint. The downward, backward sliding motion is eliminated following surgery resulting in joint stability. The stability is primarily a straight-forward biomechanical effect of the level tibial plateau, however the TPLO also results in repositioning of the caudal cruciate ligament, which adds to overall joint stability in dogs.
Anesthesia, needed for a canine TPLO is extremely safe using today’s anesthetic agents, equipment and monitoring devices. Once the patient is safely anesthetized a morphine epidural is performed to block the sensory innervations of the stifle. Motor dysfunction is minimal. In other words dogs can walk immediately following surgery.
Specific radiographs (X-Rays) are obtained for tibial plateau angle measurements and preoperative planning for your dog's TPLO surgery (figure 1). Once in the operating room, arthroscopy is used to confirm the diagnosis, debride (clean-up) the torn ligament and inspect the remainder of the joint and treat meniscal pathology.
Following arthroscopy a relatively small surgical approach is made to the top of your dog's tibia. In most instances a surgical jig is placed to hold the limb in alignment and to assist in limb straightening when needed (figure 2).
A specific vibrating saw is used to perform a precise osteotomy (see arrows) without damaging surrounding soft tissues. The top portion of bone is rotated an appropriate amount (figure 3) and fixed in place using a specific plate (figure 4). The joint is tested for stability and the site is closed with buried sutures.
At Colorado Canine Orthopedics the TPLO procedure takes on average between 40 and 60 minutes. Postoperative radiographs confirm tibial plateau angle (ideally about five degrees) and plate placement (figure 5). The previous downward backward sliding motion is eliminated providing stability in dogs with complete tears and preserving the remaining ACL in dogs with incomplete tears.
Patients wake up free of pain due to the the epidural and are discharged several hours later. At Colorado Canine Orthopedics almost all dogs having a TPLO can go home the day of surgery. A 24/7 ICU is available if a patient needs to spend the night.