Tibial plateau level osteotomy (TPLO) is a surgical treatment for correcting ruptured cranial cruciate ligaments in dogs. The increase in popularity of this procedure primarily results from subjective clinical experience showing better limb function and less progression of osteoarthritis. This procedure changes the biomechanics of the canine stifle joint, making the cranial cruciate ligament unnecessary for stifle joint stability. The tibial plateau is leveled from a mean angle of 20 to 35 degrees to an angle of 6.5 degrees, which reliably eliminates cranial tibial subluxation by converting cranial tibial thrust into caudal tibial thrust that is constrained by the caudal cruciate ligament. The surgical technique requires special training. Preoperative radiographs obtained while the patient is under general anesthesia are required to obtain accurate measurements of the tibial plateau angle in preparation for surgery. Potential surgical complications include but are not limited to intraoperative hemorrhage, intraarticular placement of surgical hardware, tibial crest fractures, fixation failure, patellar desmitis, osteomyelitis, and draining tracts.
COMMENTARY: Small animal practitioners have several options for managing cranial cruciate ligament injury in dogs. Despite the recent attention, the exact details of the TPLO may remain unclear. To that end, this article reviews all aspects of the TPLO and can assist the practitioner in advising the owner of the full extent of their therapeutic options.
Understanding tibial plateau leveling osteotomies in dogs. Palmer RH. VET MED 100:426-435, 2005.