TPLO cru­ci­ate lig­a­ment re­pair surgery

Wangaratta Chronicle - North East Regional Extra - - NEWS - with Tim Craig BVSC, VET­ERI­NAR­IAN

OVER the years, there have been mul­ti­ple dif­fer­ent meth­ods pro­posed and used to re­pair cra­nial cru­ci­ate lig­a­ment rup­tures in the dog.

Th­ese dif­fer­ent meth­ods have their place in dif­fer­ent sit­u­a­tions, but they also have their lim­i­ta­tions.

The pri­mary lim­i­ta­tion in many meth­ods is their use­ful­ness in larger breed dogs.

When syn­thetic “re­place­ment” cru­ci­ate liga­ments are placed in larger breed dogs, their sheer size and weight can lead to break­ing of th­ese im­plants and a poor sur­gi­cal out­come.

As a re­sult of the per­ceived poor per­for­mance of more tra­di­tional sur­gi­cal meth­ods in larger dogs, new meth­ods for cru­ci­ate lig­a­ment dis­ease were sought that were more re­li­able in th­ese pa­tients.

The top plateau of the tibia (shin bone) in dogs tends to slope back­wards and when the cru­ci­ate lig­a­ment is torn this leads to the fe­mur (thigh bone) want­ing to slide back­wards down the slope.

The re­sult is a for­ward thrust­ing of the tibia with each step that stretches the joint cap­sule, causes pain and pro­motes rapid arthritis de­vel­op­ment.

The TPLO op­er­a­tion uses an os­cil­lat­ing bone saw to cut the top por­tion of the tibia and ro­tate it into a po­si­tion that cre­ates a flat or near flat plateau on top.

The bone is then sta­bilised with a plate and screws and once healed, the dog then has a per­ma­nently flat­tened tib­ial plateau.

As a re­sult the thrust­ing force is elim­i­nated, lame­ness re­solves and the pro­gres­sion of arthritis in the cru­ci­ate de­fi­cient sti­fle is dra­mat­i­cally slowed.

This tech­nique in­volves care­ful af­ter­care to en­sure the bone heals well, but has shown su­pe­rior re­sults es­pe­cially in larger dogs (over 20kg).

The ini­tial signs of cru­ci­ate lig­a­ment rup­ture are a sud­den on­set of limp­ing in a hind leg, of­ten se­vere.

A par­tial tear may present as on­go­ing in­ter­mit­tent limp­ing in a hind leg that is ex­ac­er­bated by ex­er­cise. Par­tial tears progress to full tears and of­ten cause sig­nif­i­cant arthritis to de­velop along the way.

It is al­ways best to have a limp as­sessed to try to bring the best long term out­come for the pa­tient.

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