 What is TPLO?
The tibial plateau leveling osteotomy, or TPLO, is used to neutralize the effect of the upper leg bone (femur) rolling forward on
the lower leg bone (tibia). The procedure levels the lower part of the knee joint (tibial plateau), thereby eliminating the need
for the anterior cruciate ligament (ACL) to act as a restraint.
In other words, thinking of the ACL as a cable restraining a car from rolling downhill, this procedure levels the
surface and eliminates the need for the cable. Injuries to the joint cushioning material (meniscus) can also be corrected
during the surgery to prevent further arthritic changes in the joint.
After surgery, the dog will need to be confined for eight weeks. The only activities allowed are: on a carpeted
surface under control of the owner -- no playing!; being left in a traveling dog kennel; short walks of less than 1/8 mile
under direct owner supervision.
Does My Dog Need TPLO?
Since dogs stand on their toes, with their ankles up in the air and their knees bent forward, the lower part of the
knee joint (tibial plateau) is sloped forward. Weightbearing activities create a force that pushes the top leg bone (femur)
down the sloping tibial plateau. The anterior cruciate ligament (ACL) is the only thing keeping this force in check. Acting like a
cable restraining a car on a hill, the ACL restricts the downward motion of the femur.
Every step a dog takes adds stress to the ACL, and over time, this stress can rupture the ACL. This can happen
from a single incident, which causes a sudden and severely painful ACL rupture and subsequent lameness. There are also
partial ruptures, caused by small ruptures causing slight pain and mild lameness.
The most common cause of rear limb lameness in the dog is rupture of the ACL. This leads to arthritis in the
dog's knee joint including cartilage damage, bone spur production, and injury to the meniscus. which cushion the joints. The
tibial plateau leveling osteotomy (TPLO) has proven effective in returning the knees to full function.
What is TTA?
Tibial Tuberosity Advancement, or TTA, is the new anterior cruciate ligament (ACL) stabilization surgery that many believe is a
good alternative to TPLO (Tibial Plateau Leveling Osteotomy). The procedure has been around since 2001, with more than
2,500 procedures being performed through the world by 2005. Developed in Switzerland by Dr. Slobodan Tepic and others at
the University of Zurich, the technique has been gaining popularity in the United States.
The main advantage to TTA over TPLO surgery appears to be an easier recovery for your dog. Initial
complications are often due to the dog's premature, unrestricted activities.
Potential advantages include improved action in the knee joint, resulting in less arthritis and other joint
complications. One main disadvantage compared to TPLO is that the limb alignment can't be addressed with TTA. The main
goal of the technique is to align the straight ligament over the knee to be perpendicular to the lower part of the knee joint
(tibial plane). While the patient may regain early leg function, the recovery is exactly the same as TPLO.
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