Questions on orthopaedic procedures.
It is the most robust and gives a more rapid recovery in comparison with other techniques used for this problem. Small, light body mass patients can be treated successfully with medical treatment (pain killers) and a long period of restricted activity, but the recovery period is typically longer than that required following surgery. There are several surgical procedures that can be used to treat cranial cruciate ligament problems, including techniques that replace the damaged ligament and ‘tibial osteotomy’ techniques which modify the shape of the top part of the tibia to make the stifle stable in the absence of a functional CCL. In most cases, tibial osteotomy techniques result in faster recoveries and, of these, TPLO appears to be the most robust technique with a favourably low complication rate.
TPLO stands for tibial plateau levelling operation and is the procedure of first choice for most dogs suffering from rupture or disease of the cranial cruciate ligament in the stifle (the knee joint). When the joint becomes unstable and rather than flexing and extending normally during weight bearing it gives way, and the tibia is pushed forwards. TPLO involves a cut of the tibia (the shinbone) and accurate modification of the slope of the top (the plateau) of the bone. This allows the stifle joint to be re-stabilised during weight-bearing and locomotion. The modified shape of the tibia is maintained using bone screws and a plate. These maintain the corrected shape of the tibia during the healing period of approximately 8 weeks.
A number of different surgical procedures are performed to treat different presentations or severity of hip dysplasia. Very young puppies (4 months or less) with hip laxity can be treated to modify growth and reverse developing hip dysplasia. A minimally invasive technique selectively arrests growth of just the underside of the pelvis, to overcome the early changes of hip dysplasia. Puppies aged 5 to 11 months with mild hip dysplasia can benefit from pelvic osteotomy surgery which overcomes the tendency for the hips to subluxate (partial dislocation). For most severely affected puppies and adult dogs with hip osteoarthritis secondary to hip dysplasia, total hip replacement is the surgical procedure of choice. This is a reliable procedure with a good long-term prognosis, even in puppies.