TPLO, or tibial-plateau-leveling osteotomy, is a

surgery Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...

performed on dogs to stabilize the

stifle joint The stifle joint (often simply stifle) is a complex joint in the hind limbs of quadruped mammals such as the sheep, horse or dog. It is the equivalent of the human knee and is often the largest synovial joint in the animal's body. The stifle joint ...

after ruptures of the

cranial cruciate ligament The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments (the other being the posterior cruciate ligament) in the human knee. The two ligaments are also called "cruciform" ligaments, as they are arranged in a crossed formation. ...

(analogous to the

anterior cruciate ligament The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments (the other being the posterior cruciate ligament) in the human knee. The two ligaments are also called "cruciform" ligaments, as they are arranged in a crossed formation ...

CLin humans, and sometimes colloquially called the same). In the vast majority of dogs, the cranial cruciate ligament (CrCL) ruptures as a result of long-term degeneration, whereby the fibres within the ligament weaken over time. The precise cause of this is not known, but genetic factors are probably most important, with certain breeds being predisposed (including Labradors, Rottweilers, Boxers, West Highland White Terriers and Newfoundlands). Supporting evidence for a genetic cause was primarily obtained by assessment of family lines, coupled with the knowledge that many animals will rupture the CrCL in both knees, often relatively early in life. Other factors such as

obesity Obesity is a medical condition, sometimes considered a disease, in which excess body fat has accumulated to such an extent that it may negatively affect health. People are classified as obese when their body mass index (BMI)—a person's we ...

, individual conformation, hormonal imbalance and certain inflammatory conditions of the joint may also play a role. The cranial cruciate ligament runs from the cranial mid part of the tibial intercondylar eminence to the lateral condyle of the

femur The femur (; ), or thigh bone, is the proximal bone of the hindlimb in tetrapod vertebrates. The head of the femur articulates with the acetabulum in the pelvic bone forming the hip joint, while the distal part of the femur articulates with ...

. Normally, the CrCL prevents caudal (backward) movement of the femur relative to the tibia. Due to selective breeding, the tibial plateau slope has become sloped too far backwards so there is a constant stress on the Cranial cruciate ligament. Over time this leads to a degenerative rupture. When it ruptures, the joint becomes unstable which causes pain and can lead to chronic progressive

arthritis Arthritis is a term often used to mean any disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth, swelling, and decreased range of motion of the affected joints. In som ...

in the stifle if untreated.Cranial Cruciate Ligament (CrCL) Failure: canine and feline (cat and dog) veterinary factsheets
/ref> In a TPLO procedure, the

tibial plateau Tibial may refer to: * Tibia bone * Tibial nerve * Anterior tibial artery * Posterior tibial artery * Anterior tibial vein * Posterior tibial vein The posterior tibial veins are veins of the leg in humans. They drain the posterior compartment of ...

, the portion of the

tibia The tibia (; ), also known as the shinbone or shankbone, is the larger, stronger, and anterior (frontal) of the two bones in the leg below the knee in vertebrates (the other being the fibula, behind and to the outside of the tibia); it connects ...

adjoining the stifle, is cut and rotated so that its slope changes to approximately 5 degrees from the horizontal plane. This prevents the

from sliding down the slope of the tibial plateau when the dog puts weight on its knee. This surgery generally results in faster recovery times compared to other procedures to stabilize the knee. Most dogs (over 90%) are expected to regain a very active and athletic lifestyle with no post-operative complications and without the need for any long-term pain relieving medication. Many surgeons are now conducting TPLOs on small dogs, believing that these pets, like large dogs, have a faster and more complete return to function than with other procedures.

Alternative procedures

Tibial tuberosity advancement Tibial Tuberosity Advancement (TTA) is an orthopedic procedure to repair deficient cranial cruciate ligaments in dogs. It has also been used in cats. This procedure was developed by Dr. Slobodan Tepic and Professor Pierre Montavon at the School of ...

Tightrope CCL {{Short description, Vterinary orthopedic surgical method Tightrope CCL is a veterinary orthopedic surgical method developed to provide a minimally invasive procedure for extracapsular stabilization of the canine cranial cruciate ligament-deficient ...

Triple tibial osteotomy The triple tibial osteotomy is a surgical procedure used to treat dogs that have completely or partially ruptured the cranial cruciate ligament in one or both of their stifles. The cranial cruciate ligament connects the femur with the tibia, which ...

Simitri Stable in Stride Simitri Stable in Stride is a three part modular surgical implant used during surgery performed on dogs to stabilize the stifle joint (knee) after rupture of the cranial cruciate ligament (CrCL) which is analogous to the anterior cruciate ligament ...

Cranial tibial wedge osteotomy Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position prov ...

A systematic review of the evidence has shown that "…functional recovery in the intermediate postoperative time period was superior following TPLO compared with lateral extracapsular suture."

References

{{reflist Veterinary procedures Dog health