Tibial Plateau Leveling Osteotomy (TPLO) for Treatment of Ruptured Cranial Cruciate Ligament

TPLO Fixed Price

New Pricing for all TPLOs Price (ex GST) Price (inc GST)
All dogs (including pre-op and post-op X-rays) $1950 $2145

*For any repeat surgeries (dog’s that have had their knee operated on) please add $300 ex GST.

Our surgeon has had over 20 years experience and has done over 400 TPLO surgeries and  over 1000 orthopaedic knee surgeries.

TPLO is a very intensive procedure requiring exact precision to treat the cranial cruciate ligament deficiency. We accept the referrals from other veterinarians across Victoria, Australia. Waiting period is only 1-2 weeks. Patients are sent home on 2nd day after the surgery. Follow-ups are usually done either here or at the referring veterinary hospitals.

What is a Ruptured cranial ligament?

The cranial cruciate ligament (CCL) is a structure in your dog’s knee joint, that helps prevent excessive motion between the femur (thigh bone) and the tibia (shin bone). The CCL may become injured, either from trauma or due to dog’s natural leg conformation, resulting in a sudden or gradual tear of the ligament. A torn CCL causes the knee joint to be unstable, resulting in joint pain, inflammation and hind leg lameness.

This initiates the development of arthritis and may damage another structure in the knee called meniscus.

Can medication be used to treat a ruptured CCL?
Anti-inflammatory medications prescribed by your veterinarian may help to decrease the pain and inflammation in the knee joint. Strict cage rest and exercise restriction may allow your dog’s body to lay down scar tissue, in an effort to increase the stability of the knee. However, small breed dogs (under 4 kg) are typically more responsive to medical management of a ruptured CCL.For medium to large breed with ruptured CCL, especially active dogs or those with other orthopedic problems, surgical treatment is recommended.

What is Tibial Plateau Leveling Osteotomy (TPLO)?

TPLO is a surgical procedure used to treat dogs with ruptured CCL. Developed by the late Dr. Barclay Slocum, the TPLO procedure may be performed by veterinary surgeons who have completed the TPLO training course.The procedure is based on the fact that the top part of the tibia bones normally

sloped, resulting in tendency for the femur to slide backward when the dog stands and puts weight on its knee. The CCL normally holds the femur in place and prevents this motion. But when the CCL has ruptured, the femur can slide back and forth along the sloped tibia, when the dog is standing or walking. The continued motion contributes to pain and degeneration in the knee joint.

Cutting a bone to treat a ligament
TPLOA solution to the knee joint instability would be to either replace the torn CCL, or remove the slope in the tibia. The TPLO does the latter: after making a cut in the top part of the tibia, the surgeon rotates this segment of bone until it is almost perpendicular to the ground. To allow the cut bone segments to heal, the tibia is then stabilized with a bone plate and screws. The result is that when your dog stand on its leg, the femur is resting on a flat tibia surface, and there is no longer the sliding motion in the knee.

Can any size of the dog have the TPLO surgery?
The TPLO is recommended for medium to large or giant breeds of dogs, and is limited by the size of the TPLO bone plate.Most dogs greater than 15 Kg in body weight would be eligible for a TPLO.

What is the hospital stay with the TPLO procedure and what follow-up visits are needed?
Dogs are usually discharged next day in the afternoon from the AMC Boronia following the surgery. Follow-up appointments are usually scheduled at the referring hospital or at our hospital 1 week later for recheck and bandage removal, 2 weeks for recheck and skin suture removal, and in 6 weeks and 10 weeks for radiographs. Your dog may also need weekly Cartrophen shots for 5 weeks post-op.

What is the expected outcome for my dog?
Dogs who have had TPLO surgery are typically bearing some weight on their operated leg within 3 to 5 days following surgery. Your dog will need to have his or her exercise specifically restricted while the bone is healing, usually for 8 to 12 weeks. Physical therapy as well as gradual increase in on-lease activity will be permitted, according to how your dog is recovering. In general, the TPLO procedure for dogs with CCL rupture is associated with a very good early return to leg use: and some research suggests that there is less leg muscle loss and slower progression of knee arthritis following this procedure.

What is the approximate cost of TPLO surgery?
It depends upon few factors like ; Lifestyle, breed and weight of the dog, if x-rays & blood test are done or not, how old is the damage etc. Call or email us for proper estimate for your dog.

How to decide which procedure is best suited for my dog?
TPLO procedure is not for every cranial cruciate deficient dog but decision is made individually considering the following factors.

Scores
Factors 1 2 3 4 5 Total
Age(Years) >11 9-10 7-9 4-7 <4
Breed/Size Toy/small Small Medium Large Giant
Weight(kg) <7kg  7kg-14kg 14kg-20kg 20kg-32kg >32kg
Life Style Indoor Indoor/backyard confined outdoor Acerage Hiking/Hunting
Activity/Temperamnt Very Quiet Quiet Active Very active Hyper active
Habitat Plain Plain/slopes Slopes/Stairs Hilly/stairs Hilly/hiking
Duration of the Disease Recent Acute <10 days 10-25 days >25 days >3 months
Other MS (Hips/elbows) abnormalities None Mild moderate Severe, But only one joint Severe in multiple joints
Radiographic DJD Very clean No DJD Mild DJD Moderate DJD Severe DJD
Tibia/Femur configuration/deformity Excellent Good Fair Moderately deformed Severely deformed
TPA(rads) if posible (degrees) <15 15-20 20-25 25-30 >30
Overhall health Very poor Poor Fair Good Excellent
Owner’s Compliance Very poor Poor Fair Good Excellent
rDVM’s Preference Only ECR ECR/TR/TTA ECR/TR orTPLO/TTA TPLO/TTA Only TPLO
Total scores & procedure recommended 14ECR 28ECR/TR/TTA 42TPLO/TTA

TR/ECR

56TPLO/TTA 70TPLO

TPLO Postoperative Care and Rehabilitation

TPLO stands for Tibial Plateau Levelling Osteotomy.

What we do is, make a cut on your dog”s Tibia  bone using a biradial blade saw (a half circle shape blade) and manipulate the bone into a new location using the assistance of Locking Plates and screws. This alters the shape of the Tibia Plateau and therefore eliminates the need for your dogs cruciate ligament at all.

Please note: home care is essential for recovery…

PAIN RELIEF

We control pain and discomfort by 3 means:

i)    Fentanyl – Your dog will have a small clear patch on the leg where surgery has been performed. This is a *Fentanyl Patch and secretes a  strong pain relief to your dog for 5 days after surgery. This is located under the bandage applied to the leg of the surgery.

ii)   Tramadol – Opiod pain relief (may make your pet drowsy)

iii)  Carprofen – Non steroidal anti-inflammatory drug.

*In clinic we will use morphine, methadone and local anaesthesia throughout your pet’s stay in hospital.

TO TAKE HOME (MEDICATIONS & ELIZABETHEAN COLLAR)

*You will be given these medications to take home. Please follow the instructions on the label.

Pain Relief:   Carprofen & Tramadol

Antibiotics:    Amoxyclav

Tranquiliser:  ACP (on request)

* Elizabethean Collar (The most important tool!). Please ensure your pet is using this collar until otherwise advised by your veterinarian.

REVISITING (at Animal Medical Centre or you Regular Vet)

– 4 or 5 days post op: Fentanyl Patch removal

– 10 to 14 days post op: Suture removal

–  6 weeks post op: Repeat Xrays

Earlier appointments should be made if:

– the bandage becomes wet, smelly or dirty or if the fentanyl patch becomes exposed.

– there is any puss, drainage, excessive swelling, angry redness etc.

CONFINEMENT (First 4 weeks) **100% Confinement Required**

This is the most crucial part of recovery, any excessive activity can undo all our hard work. The operated leg needs to kept as rested as possible to ensure that the bone will heal.

We suggest restricting your dog to a crate or small room like the laundry or bathroom to prevent them from excessive movement. If you do not have the means to restrict your dog to such an area we do have cages available for hire. For the anxious or hyperactive dogs, please use the tranquiliser provided.

Strictly no walking. Toilet breaks are to be kept minimal, and only on a tight controlled leash. Avoid running or jumping. We expect your dog to start using the leg within 10 days after surgery. If you get your pet home and they aren’t very confident walking with the bandage you can assist them by slinging a towel underneath their belly for support.

WALKING (Week 4 onwards)

At week 4 using the tight controlled lead technique, start with 5 minutes walks in the morning and night. Each week, you may increase these walks by 5 minutes.

Example:

– Week 4   Morning – 5 min walk,   Evening – 5 min walk.

– Week 5   Morning – 10 min walk, Evening – 10 min walk.

– Week 6   Morning – 15 min walk, Evening – 15 min walk.

WOUND MANAGEMENT

The only thing protecting the wound will be you and the Elizabethean collar we provide.

If the area becomes red, swollen or is secreting a discharge.. Do not hesitate to call us.

Stitches are removed 14 days after surgery.

FOLLOW UP XRAYS (6-8 weeks after surgery)

We need to see your pet back for x-rays 6 weeks after surgery. This will tell us if the bone is healed and your dog can start returning to his/her normal lifestyle. These can be done here with us, or at your regular vet. There will be additional costs for these xrays.

ACTIVITY AFTER POST-OP XRAYS

If healing is progressing normally, you may start to exercise your dog off the lead. Off lead activity should only occur under your supervision. As with leash walks, you should start with 5 minutes off lead and increase by 5 minutes every 4-5 days as long as your dog is comfortable. Jumping or running with other dogs or toys should not be permitted.

IF ANY CONCERNS

If you are unsure or worried about anything involving your dogs recovery please call us anytime on 9762 2555. Our vet is on call 24 hours and will not hesitate in helping you with your dogs needs.