09/18/2024
Did you know we now offer TPLOs?
Dr. Melanie Garbel has been helping the team become acquainted with her TPLO surgeries and how she likes everything done, down to a T.
For those of you who might wonder what a TPLO is, read on!
One of the most common injuries to the knee in dogs is tearing of the cranial cruciate ligament (CCL). This ligament is like the anterior cruciate ligament (ACL) in humans. There are actually two cruciate ligaments inside the knee: the cranial cruciate ligament and caudal cruciate ligament. They are called cruciate because they cross over each other inside the middle of the knee.
When the CCL is torn or injured, the shin bone (tibia) slides forward with respect to the thigh bone (femur). This movement is known as a positive drawer sign. Most dogs with this injury cannot walk normally and they experience pain. The resulting instability damages the cartilage and surrounding bones and leads to osteoarthritis.
When the cranial cruciate ligament is torn, surgical stabilization of the knee joint is often required, especially in larger or more active dogs. Surgery is generally recommended as soon as possible to reduce permanent, irreversible joint damage and to relieve pain.
The development of tibial plateau leveling osteotomy (TPLO) was a major advancement in the treatment of CCL rupture. This surgery changes the angle and relationship between the thigh bone (femur) and the shin bone (tibia).
The overall intent of the TPLO surgery is to reduce the amount that the tibia shifts forward during a stride. This is accomplished by making a semicircular cut through the top of the tibia, rotating the top of the tibia, and using a bone plate to allow the tibia to heal.
This realignment of the surfaces within the knee (stifle) helps to provide stability during a stride and helps to reduce future joint inflammation and osteoarthritis. By carefully adjusting the angle or slope of the top of the tibia, surgeons can create a more normal configuration of the knee joint and reduce mechanical stress.
To better understand the purpose of leveling the tibia, we often use the analogy of a wagon on a hill. Imagine a wagon tied to a post on the slope of a hill. If the rope holds, the wagon does not roll downhill. If we add excess weight (or downward force) to the wagon, the rope could break, and the wagon will roll down the hill. However, if the wagon is on level ground, it will not roll with added weight, even if the rope is broken.