Case Studies


TPLO - Tibial Plateau Levelling Osteotomy - after cruciate ligament rupture

Alfie is an 11 year old chocolate Labrador who presented to us in January for lameness in his left hind leg.  He was admitted for radiographs and a cruciate rupture was diagnosed.  The cruciate ligament is a band of tough fibrous tissue that attaches the front of the femur (thigh bone) to the back of the tibia (shin bone).  It prevents the femur moving backwards relative to the tibia and helps to prevent the stifle (knee joint) over rotating or extending.  When this ligament ruptures it is due to the ligament fraying over a period of time  (much like fraying of a rope).  This can be caused by degeneration over time or due to breed disposition.  The frayed ligament causes inflammation within the knee.  This coupled with the mechanical lameness through loss of the ligament causes the dog to limp.  

There are several treatment options available,  which is assessed case by case.  The recommendation for Alfie was a TPLO (Tibial Plateau Levelling Osteotomy)  procedure.  Recovery after a TPLO has been shown to be advantageous over other techniques with a shorter recovery in the short-term and better long-term outcome.  As a general rule approximately 90% of dogs will return to normal activity after a TPLO.      

The TPLO procedure involves a semi-circular cut in the top of the tibia, the segment is then rotated to change the slope of the top of the tibia.  This prevents the femur 'sliding' off the back of the tibia.  The bone is then fixed in place with a metal plate and screws into the new position.  In Alfie's case the ligament was completely torn therefore all of the fragments were removed.   

As you can see from the images we perform this surgery under the highest possible standards.  We have a theatre dedicated to orthopaedic procedures and use pre-packaged, disposable consumables to ensure sterility is maintained throughout.  In Alfie's procedure Veterinary Surgeons Penny Barnard-Brown and Martin Hobbs performed the surgery with theatre nurse, Katie Piper RVN monitoring his anaesthetic. Within the images you can see his leg with the implant in place (lower middle) and then Alfie after surgery (bottom right).

Alfie recovered very well and after an overnight stay in our hospital, to provide pain relief, he then went home.  With all TPLO procedures the surgery is not the only part of the treatment.  His owners will now need to follow a strict physiotherapy regime at home, which will be regularly monitored, with hydrotherapy also being recommended as part of the plan.

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