Tibial Plateau Leveling Osteotomy for Cranial Cruciate Ligament Disease in Dogs

June 17, 2020

Cranial cruciate ligament (CCL) disease is one of the most common orthopedic injuries to affect dogs. Although many surgical procedures can correct an unstable knee joint after CCL injury, tibial plateau leveling osteotomy (TPLO) is considered the gold standard treatment, particularly for larger and more active dogs. Avets’ surgery department has extensive experience in performing TPLO procedures, and is available to help your dog get back on her feet again after a CCL injury. 

What is my pet’s CCL?

Your pet’s CCL is one of the most important stabilizing ligaments in her knee joints. The ligament is composed of a band of tissue that connects the distal femur to the proximal tibia in an X-like arrangement, along with the caudal cruciate ligament. A connective tissue cushion, the meniscus, also helps stabilize the knee joint. Together, these structures allow the knee to function as a stable hinge joint, and to sustain significant impact during physical activity. 

How does CCL injury occur in pets?

CCL injury is often caused by a combination of factors, which may include:

  • Genetics
  • Breed
  • Skeletal conformation
  • Poor physical condition
  • Obesity
  • Ligament degeneration

CCL rupture often occurs suddenly when a pet is participating in physical activity, such as a game of frisbee or fetch, and lands on the back leg in a way that strains the ligament. The final tear, whether partial or complete, is considered an acute injury, although typically the damage occurs because the CCL has slowly and quietly deteriorated to a point where it is vulnerable to injury. 

What are CCL injury signs in pets?

CCL injury causes rear leg lameness that can vary in severity If not treated, other clinical signs can develop, such as:

  • Decreased activity level
  • Difficulty rising 
  • Difficulty jumping onto elevated surfaces
  • Muscle atrophy
  • Decreased range of motion
  • Stiffness

Tibial Plateau Leveling Osteotomy for Cranial Cruciate Ligament Disease in Dogs

How is CCL injury treated?

CCL treatment can involve surgical or medical (i.e., non-surgical) treatment, depending on your pet’s age, activity level, size, skeletal conformation, and degree of joint instability. Surgical procedures, which permanently correct the knee joint’s instability, are typically preferred. 

The goal of surgical treatment is not to repair or replace the CCL with a graft, as it cannot heal itself, but rather to replace the ligament with suture material or change the mechanics of the knee joint so that the CCL is no longer needed for support.

How is a TPLO performed in pets?

During a TPLO, a circular cut is made around the top of the tibia, and the segment created is rotated so that the contact surface, or tibial plateau, is level, instead of angled. This creates a more stable knee joint that no longer requires a CCL for normal function. The bone segment is reattached with bone plates and screws so it can heal in its new orientation. 

What can I expect after my pet’s TPLO surgery?

You will receive detailed instructions about your dog’s gradual return to normal activity in the  months following her TPLO surgery. You must strictly follow the activity restrictions prescribed during recovery, because if your pet is too active, her surgical site may fail to heal, and may require extensive surgical repair. 

If your family veterinarian has diagnosed your pet with a CCL injury, contact us to discuss whether she would be best treated with TPLO.