Franklin Vets Blog

TPLO surgery for dogs with cruciate injuries

May 18, 2020

Cruciate ligament injury is the most common cause of hind leg lameness in dogs. We see dogs with strained, ruptured, or degenerate cruciate ligaments virtually every day at our clinics. The majority of dogs affected by this condition are medium to large size, adult to middle-aged, but it can affect any dog.

Most cases have arthritis in their stifle (knee) joint for a long time before the ligament snaps. This is the opposite of the human cruciate injury, in which trauma is the most common cause and arthritis develops later.

Most dogs will do much better with surgery for this injury, even the smaller breeds. A damaged cruciate ligament will never heal back to normal. There are a variety of techniques available, but for larger dogs (over 15kg) one of the techniques that alter the alignment of the bones to each other is most suitable. Many techniques that can do this, each one having pros and cons.

The most successful and popular technique around the world with specialist surgeons is the TPLO (Tibial Plateau Levelling Osteotomy). This involves making a single curved saw cut in the tibia, then rotating the joint surface around a calculated number of degrees, and finally stabilising the fracture with a bone plate and screws.

Lateral view of dog TPLO surgery

Lateral view of TPLO

Medial view of TPLO

Medial view of TPLO

Franklin Vets Pukekohe offers this procedure. Dr Paul Eason has been doing surgery on dogs with cruciate injury for over 30 years and can offer a range of techniques including TPLO, TTO, TTA, and extracapsular nylon.

As usual, our cruciate “packages” include pre-surgical consultation, full blood tests, x-ray exam pre and post-surgery, the surgery itself, 24 hours in the clinic, and 2 weeks of pain-killing medication after surgery. Post-surgery revisits are also included, though there is a small charge (currently $151) for sedation and x-ray at 6 weeks post-op. We also include full instructions for a post-surgical home rehabilitation programme.

Not all dogs and not all stifle joints are suitable for TPLO or TTA. We will need to make a final decision on technique based on the examination and x-rays. To save cost, we normally carry out the x-rays under the same anaesthetic as the surgery, so be prepared that the final choice of procedure may change between x-ray and surgery. This will be communicated with you on the day.

Cost of cruciate surgery packages (range depends on the size of the patient) are as follows:

  • Extracapsular nylon $2000-2500
  • TTA $3400-3500
  • TTO $3700-3800
  • TPLO $4000-4400
  • Additional costs apply if there are other ruptured ligaments, luxating patella, or any other injuries.

Please give us a call 09 238 7486 if you would like to discuss cruciate surgery in your dog.

Current thinking (which fits with our own experience) is that cruciate surgery involving bone realignment (eg TPLO) is best done very early in the degenerative cycle. This often means operating on the joint before the ligament has completely snapped. The surgery is easier, the recovery faster, and the arthritis progression is reduced. So, if you have a niggling hindleg lameness in your medium to large breed of dog, please let us have a look at it as soon as possible so we can see if surgery is going to be of help to you. Delaying investigation of a stifle lameness and therefore delaying surgery, results in less satisfactory results long term.

Paul Eason BVM&S MANZCVS (Surgery; Emergency and Critical Care Medicine)