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Canine TPLO Misconceptions

X-ray animation of torn ACL

  1. Dogs, like humans, may not require surgery following an ACL tear.
    Not true. Unfortunately, the anatomy and biomechanics of the canine stifle (knee) differs from humans. The primary difference being significantly greater tibial plateau angle or slope in dogs compared to humans. The canine slope results in joint sub-luxation (dislocation) during weight bearing. This radiographic animation demonstrates the detrimental instability during weight bearing following a canine ACL tear. Because of this, untreated canine ACL tears result in progressive clinical signs, meniscal tearing, severe osteoarthritis (OA) and debilitating lameness.
  2. The same surgical techniques used in humans are effective in dogs.
    Not true. Replacement techniques using biological grafts are the standard for humans with ACL tears. Similar grafts and techniques have been unsuccessful in dogs due to persistent biomechanical stress. This stress is due to the sloping tibial plateau present in dogs but not humans.
  3. Recovery from a TPLO is more difficult than old style replacement techniques.
    Not true. In many instances we have seen dogs with a “fishing line” repair or tight rope have a more prolonged recovery than dogs who have undergone a TPLO.
  4. Postoperative pain is greater following TPLO than old style replacement techniques.
    Not true.
    Almost all TPLO patients are very comfortable following surgery. In fact, the surgeons at Colorado Canine Orthopedics find TPLO patients to be more comfortable following surgery than following many other procedures. This comfort is, in large part, due to the stability afforded by today’s bone plate technology. The bone/plate/screw combination provides better stability than any other repair on any other type of tissue. Stability equals comfort.
  5. Recovery time is greater following TPLO.
    Partially true. It is true that bone healing takes longer than soft tissues. Old style repairs are as strong as they will ever be as soon as the surgeon ties the knot. However old style repairs are not as strong as the TPLO at anytime after surgery. Bone healing is a double-edged sword; it takes longer to heal, but heals stronger than any other connective tissue in the body! Complete bone healing takes about three months but varies from animal to animal and is somewhat dependent on age.
  6. More strict confinement of a dog is needed following the TPLO than other procedures.
    Not true. The TPLO is the strongest ACL technique performed. Following any surgery, dogs require some degree of restriction. TPLO patients should be restricted to the house with leash walks only. Stairs are usually permitted with supervision. The TPLO is one of the strongest repairs in all of veterinary surgery, but squirrel chasing and excessive rough-housing should be avoided.
  7. TPLO increases the risk dogs will tear their other side. TPLO can give dogs back an active lifeNot true. In fact, quite the opposite is the case. Because canine ACL tears are almost always caused by biomechanical
    wear and tear, not trauma as in humans, 40% of animals that tear one side will someday tear the other. The best way to minimize this risk is to equalize weight bearing by performing a TPLO on the affected side. Weight loss is also important in overweight animals. Nearly all dogs left untreated will tear the other side because of shifting weight to the intact side.
  8. TPLO is only for show or performance dogs.
    Not true. Most surgeons agree the TPLO is the best procedure whether your pet’s an agility star, tennis ball player or lap warmer. ACL tears are painful for dogs and TPLO offers the best option for successful repair.
  9. TPLO is expensive.
    Partially true. Old style repairs can be performed less expensively. The old techniques often involve the use of simple hand instrumentation and a piece of fishing line. The TPLO involves the use of sophisticated plating equipment, surgical drills and specialized saws. At Colorado Canine Orthopedics we frequently see patients with unsuccessful old style repairs. It goes without saying these situations result in added expense for the client and additional surgery for the pet. See Cost of TPLO at Colorado Canine Orthopedics.
  10. TPLO prevents or reverses osteoarthritis.
    Unfortunately, Not true. Almost all dogs with ACL tears develop OA. In fact almost all dogs have OA at the time of diagnosis. Most surgeons agree the TPLO is the best option to minimize OA.

More questions? Get answers to frequently asked questions about TPLO for dogs

 

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