TPLO – Tibial plateau levelling osteotomy
One procedure we carry out here quite often is something called a TPLO - Tibial plateau levelling osteotomy.
This is a relatively major but routine surgery which is required when a cruciate ligament ruptures.
The cruciate ligament stabilises the knee joint (stifle) whilst bearing weight.
Ligament damage can occur due to trauma, conformation or birth defect, old age or degenerative disease. It is particularly common in large or giant breeds of dog, but any breed can be affected.
Clinical signs can include;
hindlimb lameness
difficulty getting up
difficulty getting in or out of the car
occasionally there can be clicking coming from the joint.
Clinical assessment of the dog can include:
muscle wastage
pain on flexion and extension of the leg
thickening of the stifle joint
x-rays to confirm diagnosis of a cruciate rupture.
Management can include, restricting exercise and anti-inflammatory medications, hydrotherapy, overweight dogs benefit from going on a diet for weight loss and surgery. However, the majority of cases end with surgery.
Tibial plateau levelling osteotomy (TPLO) is an operation which changes the angle of the shin bone, it is then rotated and stabilised with a metal plate and screws.
Post operative care includes a Robert Jones bandage which helps prevent swelling and restricts movement. This is usually removed the next day.
A buster collar is essential to prevent patient interference and wound care and there is a very strict protocol of restricted exercise which must be followed. This includes confinement or use of a cage. Jumping and climbing should be avoided at all costs. Pain during recovery is managed using a tried and tested regime of painkillers and medications and a course of antibiotics.
We will need to recheck the joint by taking x-rays after 6 weeks and if all is looking well, exercise can be steadily increased. There are also various therapies such as Hydrotherapy which can assist with recovery.
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