Orthopedic Surgery / TPLO Procedures

Maggie traveled to the Stonecliff Animal Clinic from Novia Scotia a few months ago. The Price Edward Island Veterinary College had referred her to Dr. Kelly because he is one of only a handful of veterinarians licensed to perform a special procedure called a Tibial Plateau Leveling Osteotomy. Her owners Kate MacNeil and Dr. Shelley Falik were interested in having Maggie's knee repaired after her anterior cruciate ligament had ruptured. Maggie, a beautiful 90 pound Golden Retriever was always a very active dog, spending her time frolicking in the ocean waves or chasing her favorite friend Clancy another Golden Retriever. Her owner's were not certain which activity might have caused the injury which had made her lame off and on since January. Initially Kate thought maybe it was her hips that were bothering her and their local veterinarian put her on a joint supplement. Her condition gradually worsened, and an xray taken at the veterinary school at PEI confirmed she had an anterior cruciate ligament (ACL) tear.

The knees are very important to a dog regardless of their size. Rising from sleep, squatting for defecation, even bending to sit all requires strength in those joints. The cruciate ligaments are the structures within the knee that support the joint. Injury to these ligaments can occur at any time to any breed of dog, though medium and large breeds tend to have a higher incidence. The injury is most often sudden, after a leap from a porch, or dashing after a ball. Injured dogs are what we describe as "three-legged," reluctant to put any weight on the affected hind limb. Most often this is due to a tear or complete break in the ACL. Without this ligament the knee becomes very unstable and painful. Some dogs are genetically more prone to ACL rupture due to the conformation of their hind limb. This can lead to a chronic condition which creates non-specific rear limb lameness eventually resulting in a complete rupture. These dogs characteristically sit with their leg straight out, instead of a normal square sit.

Historically, ACL ruptures have been surgically repaired by replacing the ligaments with some material such as suture, or transplanting other ligaments within the stifle. These surgeries have been very successful though return to total function is often not achieved and the formation of arthritis as a secondary complication is very common. Unless the underlying conformational defect is corrected, there continues to be abnormal forces produced in the knee resulting in continued strain and in many cases failure of the prosthetic ligament. One of the procedures Dr. Kelly uses to repair this ruptures is called Tibial Plateau Leveling Osteotomy(TPLO). Dr. Kelly was the only doctor licensed to perform this surgery in Vermont for many years, and his experience is readily seen in the recovery of his patients. There is still only a handful of surgeons across the country licensed to perform the TPLO, and so finding an experienced surgeon can be very difficult.

The TPLO surgery actually changes the slope of the knee and thus eliminates the need for the ligaments all together. * By changing the angle of the knee, and stabilizing it with special bone plates, most dogs leave the clinic walking on their repaired leg the next day. This technique has been used on canine athletes such as Ididarod sled dogs that must return to full function. Even dogs that have already had ACL surgery by the traditional methods without success can benefit greatly by this procedure.

Maggie had her knee operated on in August. By evening she would go out for her first walk, accompanied by a technician. We would medicate her for pain, and make her as comfortable as possible. The following day she was walking with little support, and traveled back home to Cape Breton, Nova Scotia. Though Maggie needed to take it easy for the next 6-8 weeks to let the bones heal, she would be allowed short leash walks. Gradually the distance would be increased.

Maggie's family traveled back to Vermont in October for a radiograph to evaluate the bone healing progress. She is now healed completely, and has begun the rehabilitation phase of her recovery. Kate MacNeil reports that Maggie is now walking 2 miles a day, and eagerly awaits the ok to romp with her friend and chase sticks and apples out of the orchard. Her beautiful golden coat has grown back, and her limp has disappeared. Congratulations Kate and Shelley, you have done a wonderful job with Maggie's recovery!

For more information on the TPLO surgery or any other orthopedic procedure performed at SAC, please give the clinic a call at 802-222-4903. If you're considering this procedure for your pet, please read our detailed TPLO Q&A.

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