Tibial plateau leveling osteotomy (TPLO) is commonly performed to treat dogs suffering from cranial cruciate ligament (CCL) rupture.
Cranial cruciate ligament rupture is one of the most common orthopedic injuries in dogs. Some cases occur acutely, due to trauma caused by a fall, hit-by-car injury, or other high-force injuries. However, most CCL ruptures are caused by slow, gradual degeneration of the ligament. In many cases, a CCL injury begins as a partial tear, progressing to a full-thickness CCL tear over time.
Cranial cruciate ligament injuries are most likely to occur in older, large breed dogs. Spayed or neutered dogs are thought to be at higher risk of this condition. Cranial cruciate ligament rupture is also associated with obesity, poor physical condition, genetic influences, and conformation.
When performing a TPLO, the patient is placed under anesthesia and the surgeon begins by creating an incision craniomedial to the stifle and proximal tibia. The stifle joint is exposed, opened, and the internal ligaments of the stifle are evaluated. Damaged menisci and other injuries within the joint may be addressed at this time.
Once the joint has been thoroughly evaluated, a TPLO jig is placed to stabilize the bone segments prior to osteotomy. A curved TPLO saw is used to perform the osteotomy, detaching the proximal tibia from the distal tibia. The proximal tibial bone segment is then rotated into position, with its positioning precisely determined by evaluation of preoperative radiographs. Once the bone is correctly positioned, it is secured with a TPLO plate.
A 2013 study comparing clinical outcomes in patients receiving surgical treatment for CCL rupture found that patients receiving TPLO demonstrated, on average, a 93% return of limb function one year postoperatively. Additionally, a higher percentage of TPLO patients experienced a full return of limb function than patients receiving TTA.
Overall, TPLO is a very effective method for addressing CCL rupture in young, active, large-breed patients.
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