If your dog has been diagnosed with a torn anterior cruciate ligament (ACL) you are probably considering surgery. Surgery is the best way to repair a torn ACL. While a few small breed dogs weighing less than 20 pounds may do okay without surgery (less than 15%), most small dogs and all dogs 20 pounds and over need surgery. There are several different procedures used to repair a torn ACL. This article will focus on the Tibial Plateau Leveling Osteotomy (TPLO).
The Tibial Plateau Leveling Osteotomy was invented by Dr. Barclay Slocum and his wife, a scientist named Teresa Devine, M.S.. Prior to the invention of the TPLO, all surgical procedures repairing torn ACL’s helped dogs feel better, but knees still had some instability where dogs developed post operative arthritis.
Dr. Slocum developed a technique where dogs could return to athletic function. Dr. Slocum combined his knowledge of the dynamics of the knee joint in dogs plus the experience from his father, a human orthopedic surgeon who did osteotomies (cut and then repaired bones to solve complex human orthopedic issues), which led him to develop the TPLO. Dr. Slocum‘s technique involves cutting the shin bone to redirect the angle of the knee joint so the ACL is no longer needed to prevent painful motion in the knee joint.
The TPLO is performed by first taking x-rays of the knee joint and measuring the angle of the top of the shin bone (the tibial plateau angle). Then calculations are made to determine how to cut the bone to reduce the angle thus preventing the painful movement in the joint when a dog stands, walks, or runs with a torn ACL. After careful calculations and preparation the surgery begins. First, the joint is explored and the meniscus evaluated for damage and released. Then a special bone saw is used to make a curved cut on the top and medial (inside) part of the shin bone. The portion of the bone above the cut is then rotated to provide the correct angle of the tibial plateau. Once rotated into the precise position, the two pieces of bone are re-connected using a special plate and screws that is specific to each patient. After surgery the patient has a 6-8 week post-operative recovery and physical therapy.
Any dog with a torn ACL can have a corrective TPLO. However, the procedure tends to be reserved for large, athletic, or working dogs that need a great outcome after surgery. The procedure is much more difficult, lengthy, and costly requiring more expertise and special equipment including; a special curved bone saw, specific plates and screws, 4-6 x-rays, and a significant investment in training on the part of the surgeon.
Dr. Alec Land from Diley Hill Animal Emergency Center trained with Dr. Slocum more than 20 years ago where he learned to do the TPLO urgery. Since then, he has successfully performed TPLO surgeries on hundreds of dogs. Dr. Land also performs several other surgeries for torn ACL, including TTA. After consultation and evaluation, the procedure that is best for your pet will be determined.
“Sandy” Land was Dr. Land’s first TPLO in 1989