Cranial Cruciate Rupture — TPLO Surgery

The bone labeled "B" is cut and rotated to make a level plateau for the femur

The bone labeled “B” is cut and rotated to make a level plateau for the femur

We had computer problems this week and the blog is late in being published. This is the third series in surgical repair for cranial cruciate rupture. Hopefully you all can get an idea about how the repair is done but if you have any questions, please don’t hesitate to ask or call me at 864 962 0101.

The femur (thigh bone) meets the tibia (lower leg bone) behind the patella (knee cap) and the cruciate ligaments (cranial and caudal) have the important function of keeping the femur from sliding back and forth on the tibia.  Cranial cruciate rupture can happen due to predisposing factors such as breed, age-related wear, trauma, abnormalities of formation, or a steep slope on the tibia.

TPLO surgery is designed to decrease the slope of the tibia thereby keeping the femur from moving too far.  The surgeon first removes the torn ligament from the area and examines the meniscus.  The meniscus is the shock absorber of the knee and in 40-50% of dogs it is torn.  The surgeons try to repair or save as much of the meniscus as possible.

The slope of the tibial plateau is measured and a curved cut through the bone is made.  The cut head of the tibia is then rotated until the plateau reaches an angle between 2 to 14 degrees with 5 degrees being the original recommendation.  A metal plate with screws is used to hold the bone in place.  A plateau of 0 degrees is avoided since it can cause strain and tear the caudal cruciate ligament.

About 50% of dogs will start to walk on the limb within 24 hours of surgery.  Within 5 days most will begin weight bearing on the leg and by 2 weeks will be moderately weight bearing.  Radiographs are taken 6-8 weeks post-surgery.

2 months post-surgery leash walks are gradually increased with most restrictions of exercises being discontinued by 4 months but full working activities such as hunt, field, agility, etc. should not begin until 6 months post-surgery.  Radiographs should be taken yearly to monitor arthritis.

Complications of this surgery can be due to many factors including anesthesia, age and weight of the pet and surgical competence.  Steroids given post-surgery can cause decreased bone healing so should be avoided.

The most common cause of complication is letting the pet have too much activity too soon.  Too much activity in the early period of healing (first 2 months) can lead to:

1)    Poor healing of the bone

2)    Straining of the patellar ligament

3)    Plate breakage

4)    Loosening of the screws with subsequent shifting of the plateau

All recommendations for post-surgery should be followed closely by the pet and owner.  Rehabilitation trained therapists are found to be one of the best things you can do for the successful recovery of your pet. 

I have some articles that I can email you and your surgeon concerning the benefits of rehabilitation immediately post-surgery — let’s get your pet healthy!

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