CANINE TPLO: TIBIAL PLATEAU LEVELING OSTEOTOMY

WHAT ARE POSSIBLE COMPLICATIONS?

Progressive arthritis within the affected
WHAT
AREbePOSSIBLE
HAT
ARE
POSSIBLE
COMPLICATIONS?
joint may
seen in
some dogs, especially
WHAT
ARE
POSSIBLE
COMPLICATIONS?
COMPLICATIONS?
if
ligament
deficiency
has
long
Progressive arthritis within
the been
affected

Progressive
arthritis
within
the
affected
standing
(over
several
months)
joint
may be seen
in some
especially
• Progressive
arthritis
within dogs,
the affected
joint may
joint
may
be
seen
in
some
dogs,
especially
if beligament
Medial
meniscal
injuries
may
occur
and
deficiency
has
been
long
seen in some dogs, especially if ligament
defiif diagnosed
ligament asdeficiency
has been
long
are
audible
“clicking”
within
standing
(over
months)
ciency has
beenseveral
long standing
(over several months)
(over several
thestanding
joint after
surgery months)
(when meniscus
Medial
meniscal
injuries
may
occur
and
• Medial
meniscal
injuries
may occur
areand
diMedial
meniscal
injuries
may
occur
becomes
dislodged,
displaced
or isand
trapped
are
diagnosed
as audible
“clicking”
agnosed
as audible
“clicking”
within
the
joint
after
diagnosed
as
audible
“clicking”
within
in are
an abnormal
position
between
thewithin
bones
the
joint
after
surgery
meniscus
surgery
(when
meniscus
becomes
dislodged,
thethe
joint
after
surgery
(when
meniscus
in
joint);
this
is(when
usually
a raredisbecomes
displaced
placed
ordislodged,
is trapped
in an
abnormal
position
bebecomes
dislodged,
displaced
is trapped
occurrence
especially
if ora isortrapped
damaged
intween
anmeniscus
abnormal
position
between
the
bones
inthe
an bones
abnormal
position
between
the bones
the
joint); or
this
is usually
a rare
wasin removed
was
released
in joint);
the
joint);
is usually
especially
ifthis
a damaged
meniscus
was
inoccurrence
the
thissurgery
is
usually
a ararerare
during
the
initial
occurrence
especially
if
a
damaged
removed or was
released during
initial surgery
occurrence
especially
if athe damaged
meniscus
was
removed
or
was
released
meniscus was removed or was released
during
the
initial
surgery
during the initial surgery
low,low,
but but
may may
causecause
implant
 • Infection
Infectionrates
ratesareare
loosening
(characterized
by persisimplant or rejection
loosening
or
rejection
(characterized
by persistence
or with
recurrence
tence
or recurrence
of lameness
or with ofswelling
Infection
rates
areorlow,
cause
lameness
with
without
swelling
out
and/or
drainage
of but
fluid may
at the
surimplant
loosening
or
rejection
and/or
drainage
of
fluid
at
the
surgical
site)
gical site) that requires surgical removal of the
(characterized
bylow,
persistence
ordocumented.
recurrence
Infection
rates once
aresurgical
but
may
cause
that
requires
removal
of
the
metallic
implants
bone
healing
is
of lameness
without
swelling
metallic
implantswith
onceoror
bone
healing
is
implant
loosening
rejection
and/or
drainage
of
fluid
at
the
surgical
site)
documentedby persistence or recurrence
(characterized
that requires surgical removal of the
of lameness with or without swelling
metallic implants once bone healing is
and/or drainage of fluid at the surgical site)
POSTOPERATIVE REHABILITATION
POSTOPERATIVE
POSTOPERATIVE
REHABILITATION
REHABILITATION
POSTOPERATIVE
REHABILITATION
4135 Old Town Road
P.O. Box 1168
Huntingtown, MD 20639
4135 Old Town Road, P.O. Box 1168
Local:
410.414.8250
4135 Old
Town Road
Huntingtown, MD 20639
Metro:
301.843.8290
P.O.
Box 1168
Local: 410.414.8250 | Fax: 410.414.2222
Fax: 301.855.9106
Huntingtown,
MD 20639
4135
Old Town
Road
Local:
410.414.8250
Acknowledgement:
Brochure
content provided in part
P.O.
Box
1168
Acknowledgement:
Brochure
content
provided
in part by
301.843.8290
by Amy LacosseMetro:
for
Calvert
County
Public
Schools
Huntingtown,
MD
20639
AmyCommunity
Lacosse
for
Calvert
County
Public
Schools
Fax: 301.855.9106
Mentorship
Program project.
Local:
410.414.8250
Community
Mentorship
Program project.
Metro:
301.843.8290
Acknowledgement: Brochure content provided in part by
Amy LacosseFax:
for Calvert
County Public Schools
301.855.9106
CANINE TPLO:
TIBIAL PLATEAU
LEVELING OSTEOTOMY
of rear limb lameness in the dog. The actual
of is
rear
limb
lameness inand
theincludes:
dog. The actual
cause
likely
multifactorial
WHAT
ISISCRUCIATE
LIGAMENT
DISEASE?
WHAT
CRUCIATE
LIGAMENT
DISEASE?
cause
is Cranial
likely
multifactorial
and includes:
WHAT
IS CRUCIATE
DISEASE?
(Anterior) LIGAMENT
Cruciate
Ligament
(CCL or
by either or both cranial drawer or cranial tibial
by either(i.e.
or both
cranial
drawer
or cranial
tibial
thrusting
shown
below
as asliding
forward
torn
oror only
torn (stretched
(stretched
only with
with
a few
few disrupted
disruptedof
thrusting
(i.e.
shown
below
as
sliding
forward
of
torn
(stretched
or
only
with
a
few
disrupted
tornfibers)
(stretched
orrespect
only do
with
a
few
disrupted
fibers)
the
tibia/T
with
the
femur/F).
have
any
fibers) ligaments
ligaments
dotonot
not
have
any palpable
palpableligathe
tibia/T
with
respect
to
the
femur/F).
fibers)
ligaments
do
not
have
any
palpable
instability.
The
may
bebecharacterized
ments
do not have
any
palpable
The instainstability.
Theinstability
instability
mayinstability.
characterized
damaged it will be removed; if not, a releasin
damaged itwill
will
be
removed;toifhopefully
not, a releasing
technique
be
performed
preven
WHAT
ARE
OF
TPLO
WHAT
AREGOALS
GOALS
OF
TPLOSURGERY?
SURGERY?
technique
will
be
performed
to
hopefully
preven
WHAT
ARE
GOALS
OF
TPLO
SURGERY?
WHAT
ARE
GOALS
OF
it
from
future
entrapment
or
damage.
The
top o
The
joint
is
approached
to
examine
the
degree
of
Cranial
(Anterior)
Cruciate
Ligament
(CCL
or
The joint is approached to examine the degree of
WHAT
IS (Anterior)
CRUCIATE
Cranial
Cruciate
Ligament
(CCL causes
or
it
from
future
entrapment
or
damage.
The
top
of
The
joint
is
approached
to
examine
the
degree
of
ACL)
disease
is
one
of
the
most
common
medial
meniscal
injury;
if
the
medial
meniscus
is

Trauma
ACL)
disease
is
one
of
the
most
common
causes
the
tibia
is
then
cut
using
an
oscillating
bone
saw
TPLO
SURGERY?
medial meniscal injury; if the medial meniscus is
LIGAMENT
DISEASE?
ACL)ofdisease
is
one
of
the
most
common
causes
instability.
The
instability
may
be
characterized
medial
meniscal
injury;
if
the
medial
meniscus
is
 rear
Trauma
thethat
tibia
isbe
then
cut using
an
oscillating
bone saw
limb
ininthe
dog.
The
either
both
ororcranial
tibial
damaged
ititwill
ififof
not,
a areleasing
rear
limblameness
lameness
theand
dog.loss
The
actual
either
bothcranial
cranialdrawer
drawer
cranial
tibial
damaged
will
beremoved;
removed;
not,
releasing
bilitybyby
may
beoror
characterized
by either
or both
cranial
so
this
free
segment
bone
can beofrotated
b
 of
Ligamentous
stretching
ofactual
The
joint
iswill
approached
to examine
the
degree
me- by
of rear
lameness
in stretching
the dog.
The
actual
by thrusting
either
or both
cranial
drawer
or
cranial
tibialofof
damaged
itwill
be
removed;
ifof
not,
a releasing
Cranial
(Anterior)
Cruciate
Ligament
(CCL
or
ACL)
disease
cause
isLigamentous
likely
multifactorial
and
includes:
so
that
this
free
segment
bone
can
be
rotated
(i.e.
shown
below
as
sliding
forward
technique
be
performed
to
hopefully
prevent
 limb
and
loss
of
cause
is
likely
multifactorial
and
includes:
thrusting
(i.e.
shown
below
as
sliding
forward
technique
will
be
performed
to
hopefully
prevent
a
predetermined
amount
in
order
to
achieve
drawer or cranial tibial thrusting (i.e. shown below as
integrity
over
time
(partial
tearing)
cause
is likely
multifactorial
and
includes:
dial
injury;
if amount
the
medial
meniscus
is
damthrusting
(i.e.with
shown
below
as
sliding
forward of
technique
willentrapment
be
performed
to
hopefully
prevent
the
respect
totothe
ititfrom
future
orordamage.
The
top
a meniscal
predetermined
in
order
toof
is one
of the
most
common
causes
of (partial
rear
limbtearing)
lameness in
thetibia/T
tibia/T
with
respect
thefemur/F).
femur/F).
from
future
entrapment
damage.
The
top
ofachieve
integrity
over
time
more
level
tibial
plateau
slope
(i.e.
bringing
tha
sliding
forward
of
the
tibia/T
with
respect
to
the
femur/F).
 Abnormal
joint
conformation
WHAT
IS
CRUCIATE
LIGAMENT
DISEASE?
torn
(stretched
or
only
with
a
few
disrupted
WHAT
ARE
GOALS
OF
TPLO
SURGERY?
the
tibia/T
with
respect
to
the
femur/F).
it
from
future
entrapment
or
damage.
The
top
of
WHAT
IS
CRUCIATE
LIGAMENT
DISEASE?

Trauma
torn
(stretched
or
only
with
a
few
disrupted
the
tibia
is
then
cut
using
an
oscillating
bone
saw
aged
it
may
be
removed;
if
not,
a
releasing
technique
WHAT
ARE
GOALS
OF
TPLO
SURGERY?

Trauma
the
tibia
is
then
cut
using
an
oscillating
bone
saw
more
level
tibial
plateau
slope
(i.e.
bringing
the
the dog. Theactual
cause is likelyjoint
multifactorial
and includes:
Abnormal
conformation
red
line
almost
inofofan
line
with
the
green).
Cranial
(Anterior)
Cruciate
Ligament
fibers)
The
joint
isisapproached
to
the
degree
ofof Surger
Cranial
(Anterior)
Cruciate
Ligament (CCL
(CCL oror
causing
stresses
within
the
fibers) ligaments
ligaments do
do not
not have
have any
any palpable
palpable
joint
approached
toexamine
examine
the
 Trauma
the
tibia
isThe
then
cut
using
oscillating
bone
saw
sosomay
that
this
free
segment
bone
can
bebe
rotated
by
  undue
Ligamentous
stretching
and
loss
that
this
free
segment
bone
can
rotated
by
be
performed
toin
hopefully
prevent
itdegree
from
future
Ligamentous
stretching
and
lossofof
red
line
almost
line
with
the
green).
causing
undue
stresses
within
the
ACL)
disease
isisone
ofofthe
most
common
causes
instability.
The
instability
may
be
characterized
medial
meniscal
injury;
if
the
medial
meniscus
isis Surgery
ACL)
disease
one
the
most
common
causes
instability.
The
instability
may
be
characterized
medial
meniscal
injury;
if
the
medial
meniscus
fee
includes
initial
diagnostics,
surgery
• Trauma
ligament
F
a apredetermined
amount
in
order
to
achieve
a
so
that
this
free
segment
of
bone
can
be
rotated
by
integrity
over
time
(partial
tearing)
 Ligamentous
stretching
and
loss
of
predetermined
amount
in
order
to
achieve
a
integrity
over
time
(partial
tearing)
or itdamage.
The topdiagnostics,
theaareleasing
tibia
is then
ofof rear
feedamaged
includes
initial
surgery
by
removed;
ififofnot,
rear limb
limb lameness
lameness inin the
the dog.
dog. The
The actual
actual
byeither
eitherororboth
bothcranial
cranialdrawer
drawerororcranial
cranialtibial
tibial entrapment
damaged
it will
willbe
be
removed;
not,
releasing
ligament
F
hospitalization,
medications,
wound
healing
an
level
tibial
plateau
slope
(i.e.
bringing
the
amore
predetermined
amount
in
order
tobringing
achieve
a
• Ligamentous
loss
integrity
 stretching
Abnormal
joint
conformation
integrity
overand
time
(partial
tearing)
level
tibial
plateau
slope
(i.e.
the
Abnormal
joint
conformation
cause
isof
multifactorial
thrusting
technique
will
be
performed
prevent
cause
islikely
likely
multifactorialand
andincludes:
includes:
thrusting(i.e.
(i.e.shown
shownbelow
belowasassliding
slidingforward
forwardofofmore
technique
will
bemedications,
performed
tohopefully
hopefully
prevent
wound
healing
cut hospitalization,
using
an oscillating
bone to
saw
so that
this
free and
red
line
almost
in
line
with
the
green).
Surgery
more
level
tibial
plateau
slope
(i.e.
bringing
the
initial
physical
rehabilitation
visit,
and
8-wee
causing
undue
stresses
within
the
red
line
almost
in
line
with
the
green).
Surgery
the
tibia/T
with
respect
to
the
femur/F).
it
from
future
entrapment
or
damage.
The
top
of
 (partial
Abnormal
joint
conformation
over time
tearing)
causing undue stresses within the
the tibia/T with respect to the femur/F).
T
it from future entrapment or damage. The top of
initial
rehabilitation
and
8-week
segment
ofphysical
bone
can
be
rotated
by avisit,
predetermined
TFF
fee
includes
diagnostics,
surgery,
within
Trauma
the
then
cut
using
an
bone
saw
ligament
fee
includes
initial
diagnostics,
surgery,
red
line
almost
inisinitial
line
with
the
green).
Surgery
Trauma
thetibia
tibiais
then
cut
using
anoscillating
oscillating
bone
saw
ligament
postoperative
visit
for
sedation
and
radiographs.
causing
undue stresses
the
• Abnormal joint
conformation
causing
undue
postoperative
visit
for
sedation
and
radiographs.
so
that
this
free
segment
of
bone
can
be
rotated
by
angle
in
order
to
achieve
a
more
level
tibial
plateau
 Ligamentous
hospitalization,
medications,
wound
and
so that this
free segment
of
bone healing
can
besurgery,
rotated
Ligamentousstretching
stretchingand
andloss
loss
hospitalization,
medications,
wound
healing
andby
fee
includes
initial
diagnostics,
ligament
F ofof
stresses within
the ligament
a predetermined amount in order to achieve a

integrity
integrityover
overtime
time(partial
(partialtearing)
tearing)TT
Abnormal
Abnormal joint
joint conformation
conformation
Tthe
causing
causing undue
undue stresses
stresses within
within
the
ligament
ligament
a predetermined
inalmost
order
toin8-week
achieve
initial
rehabilitation
visit,
and
slopephysical
(i.e.
bringing
theamount
red line
lineand
witha the
initial
physical
rehabilitation
visit,
and
8-week
hospitalization,
medications,
wound
healing
more
level
tibial
plateau
slope
(i.e.
morevisit
levelfor
tibial
plateauand
slope
(i.e.bringing
bringingthe
the
postoperative
sedation
radiographs.
postoperative
visit
forinsedation
and
radiographs.
initial
physical
rehabilitation
visit,
and
8-week
green).
Surgery
fees
initial
diagnostics,
red
line
line
the
Surgery
red
linealmost
almost
ininclude
linewith
with
thegreen).
green).
Surgerysurpostoperative
for sedation
and
radiographs.
includes
initial
diagnostics,
surgery,
fee visit
includes
initial
diagnostics,
surgery,
gery, fee
hospitalization,
medications,
wound
healing
FF
hospitalization, medications, wound healing and
hospitalization,
medications,
wound
and
and initial
physical rehabilitation
rehabilitation
visit,healing
and 8-week
initial
initial physical
physical rehabilitation visit,
visit, and
and 8-week
8-week
postoperative
visitvisit
for
and
radiographs.
postoperative
for
sedation
radiographs.
postoperative
visit
forsedation
sedationand
and
radiographs.
TT
Specially
Speciallypositioned
positionedradiographs
radiographs (x-rays)
(x-rays) of
of the
the
knee
and
tibia
usually
confirm
the
presence
of
knee
and
tibia
usually
confirm
theof presence
of
Specially
positioned
radiographs
(x-rays)
Specially
positioned
radiographs
(x-rays)
ofthe
theand
Specially
positioned
radiographs
(x-rays)
theofknee
effusion
and
any
signs
of
arthritis
(bony
spurs
knee
and
tibia
usually
confirm
the
presence
of
effusion
and
any
signs
of
arthritis
(bony
spurs
knee
and
tibia
usually
confirm
the
presence
of
tibia
usuallypositioned
confirm theradiographs
presence of effusion
and
signs
Specially
(x-rays)
of any
the
accumulated
along
surfaces).
effusion
any
signs
of
effusionand
and
anyjoint
signs
ofarthritis
arthritis(bony
(bonyspurs
spurs
accumulated
along
joint
surfaces).
of arthritis (bony spurs accumulated along joint surfaces).
knee
and tibia along
usually
confirm
the radiographs
presence
Specially
positioned
(x-rays)
Specially
positioned
radiographsof
(x-rays) ofof the
the
accumulated
joint
surfaces).
accumulated
along
joint
surfaces).
knee
confirm
the
effusion and any signs
of tibia
arthritis
(bony
spurs
knee and
and
tibia usually
usually
confirm
the presence
presence ofof
effusion
and
effusion
and any
any signs
signs ofof arthritis
arthritis (bony
(bony spurs
spurs
accumulated along joint
surfaces).
accumulated
accumulatedalong
alongjoint
jointsurfaces).
surfaces).
Many
breeds
areare
affected
butbutsome
may
be
Many
breeds
affected
some
maymay
be bebe
Many
are
but
Many breeds
breeds
are affected
affected
but some
some
may
overrepresented:
Akita,
Labrador
retriever,
golden
overrepresented:
Akita,
Labrador
retriever,
golden
overrepresented:
Akita,
Labrador
retriever,
golden
overrepresented:
Akita,
Labrador
retriever, golden
Many breeds
are affected but
someMany
may be
overrepresentbreeds
are
affected
but
Many
breeds
arebulldog,
affected
but some
some may
may be
be
retriever,
American
bulldog,
English
retriever,
bulldog,
English
bulldog,
retriever,
American
bulldog,
English
bulldog,
ManyAmerican
breeds
are
affected
but
some
may
be
retriever,
American
bulldog,
English
bulldog,
overrepresented:
Akita,
Labrador
retriever,
golden
ed: Akita, Rottweiler.
Labrador retriever,
golden
retriever,
American
overrepresented:
Akita,
Labrador
retriever,
golden
Some
factors
include:
overrepresented:
Akita,
Labrador
retriever,
golden
Rottweiler.
Somepredisposing
predisposing
factors
include:
Rottweiler.
Some
predisposing
factors
include:
Rottweiler.
Some
predisposing
factors
include:
retriever,
retriever, American
American bulldog,
bulldog, English
English bulldog,
bulldog,
WHAT
SHOULD
EXPECT
AFTER
TPLO?
WHAT
I EXPECT
AFTER
WHAT
SHOULD
AFTER
WHAT
SHOULDI IEXPECT
EXPECT
AFTERTPLO?
TPLO? TPLO?
effusion
effusion
effusion
effusion
TPLO
usually
fulltotoreturn
return
to normal
norma
TPLO
in
full
to
TPLO
usually
results
ininfull
normal
TPLO
usually
resultsresults
fullreturn
return
normal
WHAT
SHOULD
I
EXPECT
WHAT
SHOULD
I
EXPECT
AFTER
TPLO?
WHAT
SHOULD
I
EXPECT
AFTER
TPLO?
function
in
96+%
of TPLO?
patients
wit
function
inin 96+%
ofof AFTER
patients
with
WHAT
SHOULD
I EXPECT
function
of
patients
with
effusion
function
96+%
patients
with
TPLO
usually
TPLO
usuallyresults
results inin full
full return
return toto normal
normal
AFTER
TPLO?
uncomplicated
healing.
Patients
typically
stay
TPLO
usually
results
in
full
return
to
normal
uncomplicated
healing.
Patients
typically
sta
uncomplicated
healing.
Patients
typically
stay
uncomplicated
Patients
typically
stay
function
function inin 96+%
96+% ofof patients
patients with
with
bulldog,
EnglishAmerican
bulldog, Rottweiler.
Some
predisposing
in
the
hospital
the
night
of
their
surgery
and
are
function
in
96+%
of
patients
with
in
the
hospital
the
night
of
their
surgery
and
are
retriever,
bulldog,Rottweiler.
English
bulldog,
uncomplicated
Patients
typically
stay
in the
the
hospital
night
oftotheir
surgery
in
hospital
the
their
surgery
and
ar
uncomplicated
healing.
Patients
typically
stay and
Rottweiler. Some
Somepredisposing
predisposingfactors
factorsinclude:
include:
TPLO
usually
resultshealing.
in full
return
normal
function
in are
factors
include: Some
discharged
the
following
day
to
begin
anand
8-are
  predisposing
Obesity
uncomplicated
healing.
Patients
typically
stay
ininthe
hospital
the
night
ofoftheir
surgery
discharged
the
following
day
to
begin
an
8Obesity
Rottweiler.
factors include:
the
hospital
the
night
their
surgery
and
are
discharged
day
to
begin
an
Obesity
discharged
the
following
day
to
begin
an
8
  Obesity
96+% of patients with uncomplicated healing. Patients 8discharged
the
day
toto begin
an
8-8 Obesity
week
activity
restricted
recovery.
Most
  Breed
and
joint
conformation
discharged
the following
following
day
begin
an
Obesity
week
activity
restricted
recovery.
Most
in
the
hospital
the
night
of
their
surgery
and
are
Breed
and
joint
conformation
•
Obesity
week
Breed
joint
conformation
week
restricted
recovery.
Mos
  Breed
andand
joint
conformation
typically
stayactivity
inactivity
the
hospital
the
night
ofrecovery.
their
surgery
andMos
restricted
recovery.
 problems
Breed
and
week
restricted
recovery.
Most
Breed
andjoint
jointconformation
conformation
exhibit
gradually
increasing
weight
patients
  Concurrent
orthopedic
exhibit
gradually
increasing
weight
patientsweek
Concurrent
orthopedic
problems
discharged
theactivity
following
day
to
begin
anMost
8- weight
 and
Obesity
•
Breed
joint
conformation
WHAT
IS
THE
TPLO?
gradually
increasing
patients

Concurrent
orthopedic
problems
exhibit
gradually
increasing
weight
patients
exhibit
increasing
weigh
patients

Concurrent
orthopedic
problems
WHAT IS THE TPLO?
 Concurrent
orthopedic
problems
exhibit
gradually
increasing
weight
patients
are discharged
the
following
day
to begin
an
8-week
 luxation,
Concurrent
problems
bearing
within
2-10
weeks
after
surgery.
(hip
patellar
bearing
withinwithin
2-10
weeks
after
surgery.
(hip
dysplasia,
patellar
luxation, orthopedic
WHAT
IS
TPLO?
week
activity
restricted
recovery.
Most
 Breed
anddysplasia,
joint
conformation
WHAT
ISTHE
THE
TPLO? performed
WHAT
THE
TPLO?
WHAT
ISISTHE
THE
TPLO?
WHAT
IS
TPLO?
bearing
2-10
weeks
after
surgery.
luxation,
The
tibial
plateau
leveling
osteotomy
bearing
within
2-10
weeks
after exhibit
surgery.
(hipdysplasia,
dysplasia,patellar
patellar
luxation,
• Concurrent
orthopedic
problems
(hip(hip
The
tibial
plateau
leveling
osteotomy
performed
bearing
2-10
weeks
after
surgery
(hip
dysplasia,
patellar
luxation,
bearing
within
weeks
after
surgery
(hip
dysplasia,
patellar
luxation,
activity
restricted
recovery.
Most
patients
gradknee
OCD)
Thermal
therapy,
general
wound
care,
and
The
tibial
leveling
performed
knee OCD)
Thermal
therapy,
general
wound
care,
and
The
tibialplateau
plateau
levelingosteotomy
osteotomy
performed
exhibit
gradually
increasing
weight
patients
 Concurrent
orthopedic problems
knee
The
tibial
plateau
leveling
performed
Thermal
therapy,
general
wound
and
kneeOCD)
OCD)
Thermal
therapy,
general
wound care,
care,
and
here
atatMASH
since
2004
isosteotomy
surgical
technique
The
tibial
plateau
leveling
performed
here
MASH
since
2004
isaosteotomy
asince
surgical
technique
dysplasia,
patellar
luxation,
knee
OCD)
knee
OCD)
here
at
MASH
since
2004
is
a
surgical
technique
Thermal
therapy,
general
wound
care,

Strenuous
exercise/activity
WHAT
IS
THE
TPLO?
here
at
MASH
2004
is
a
surgical
technique
knee
OCD)
passive
range
of
motion
exercises
are
Thermal
wound
care,
an
ually
increasing
weight
bearing
within
2-10
weeks
af- and
 dysplasia,
Strenuouspatellar
exercise/activity
passive
range range
of of
motion
exercises
are
The
tibial
plateau
leveling
osteotomy
performed
here at
 Strenuous
passive
motion
exercises
are
Strenuousexercise/activity
exercise/activity
bearing
within
2-10
weeks
after
surgery.
(hip
luxation,
passive
range
of
motion
exercises
are
used
toMASH
stabilize
knee
joints
have
suffered
here
since
2004
athat
surgical
technique
used
toplateau
stabilize
knee
joints
have
suffered
here
atatMASH
since
2004
isisathat
surgical
technique
used
to
stabilize
knee
joints
that
have
suffered
used
to
stabilize
knee
joints
that
have
suffered
The
tibial
leveling
osteotomy
performed
•
Strenuous
exercise/activity

Strenuous
exercise/activity
encouraged
at
home
until
the
first
hospital
passive
of
motion
exercises
are
 Strenuous
exercise/activity
encouraged
at
home
until
the
first
hospital
encouraged
at
home
until
the
first
hospital
passive
range
motion
exercises
ar
ter
surgery.
Thermal
therapy,
general
wound
care,
and
encouraged
at
home
until
the
first
hospital
knee OCD)
MASH
since
2004
is acute
a
surgical
technique
used
to
stabilize
Thermal therapy, general wound care, and
acute
chronic
cranial
cruciate
ligament
(CCL)
ororjoints
chronic
cranial
cruciate
ligament
used
toor
stabilize
knee
joints
that
have
suffered
acute
or
chronic
cranial
cruciate
ligament
(CCL)
acute
chronic
cranial
cruciate
ligament(CCL)
(CCL)
used
stabilize
knee
that
have
suffered
HOW
ISISTHE
DISEASE
DIAGNOSED?
HOW
IS
here
attoMASH
since
2004
is
a
surgical
technique
HOW
ISTHE
THEDISEASE
DISEASEDIAGNOSED?
DIAGNOSED?
HOW
THE
DISEASE
DIAGNOSED?
recheck
appointment
for
wound
healing
and
recheck
appointment
for
wound
healing
and
recheck
appointment
for
wound
healing
and
encouraged
at
home
until
the
first
hospital
recheck
appointment
for
wound
healing
and
passive
range of of
motion
exercises
arethe
encouraged
at
injury.
achieved
by
reducing
the
encouraged
at motion
home
until
first
injury.
This
isisachieved
by
the
current
 Strenuous
exercise/activity
injury. This
This
isreducing
achieved
by
reducing
thecurrent
current
passive
range
exercises
are hospita
knee
joints
that
have
suffered
acute
or
chronic
cranial
cruciinjury.
This
achieved
byisreducing
the
current
acute
chronic
cranial
cruciate
ligament
(CCL)
AAexamination
thorough
will
be
thorough orthopedic
orthopedic
examination
will
be
thorough
orthopedic
will
acute
ororstabilize
chronic
cranial
cruciate
ligament
(CCL)
physical
rehabilitation
examination
2weeks
HOW
THE
DISEASE
DIAGNOSED?
used
to
knee
joints
that
have
suffered
thorough
orthopedic
examination
will beexamination
be
physical
rehabilitation
examination
2weeks
weeks
physical
rehabilitation
examination
atat2at2atweeks
HOW
ISAATHE
DISEASE
DIAGNOSED?
physical
rehabilitation
examination
measured
tibial
plateau
angle
(TPA,
i.e.
measured
tibial
plateau
angle
(TPA,
i.e.the
theangle
angle
recheck
appointment
for
wound
healing
and
measured
tibial
plateau
angle
(TPA,
i.e.
the
angle
HOW
IS IS
THE
DISEASE
DIAGNOSED?
measured
tibial
plateau
angle
(TPA,
i.e.
the
angle
home
until
the
first
hospital
recheck
appointment
for
encouraged
at
home
until
the
first
hospital
recheck
appointment
for
wound
healing
an
performed
to
evaluate
the
reported
lameness
and
performed
evaluate the
reported
lameness
and
ate
ligament
(CCL)
injury.
This
is
bythe
reducing
the
injury.
This
achieved
byachieved
reducing
the
current
after
Unfortunately,
roughly
40-50%
performed
totoevaluate
the
reported
and
aftersurgery.
surgery.
Unfortunately,
roughly
40-50%
performed
evaluate
the
reportedtolameness
lameness
and
injury.
This
isisachieved
by
reducing
current
acute
orfluid
chronic
cranial
cruciate
ligament
(CCL)
formed
between
red
green
lines
shown
after
surgery.
Unfortunately,
roughly
40-50%
formed
between
redand
and
green
lines
shownbelow)
below)
after
surgery.
Unfortunately,
roughly
40-50%
thorough
orthopedic
examination
will
be
formed
between
red
and
green
lines
shown
below)
to
localize
the
pain,
effusion
(increased
physical
rehabilitation
examination
at
2
weeks
HOW
IS
THE
DISEASE
DIAGNOSED?
A AAthorough
orthopedic
examination
will
be
formed
between
red
and
green
lines
shown
below)
to
localize
the
pain,
effusion
(increased
fluid
recheck
appointment
for wound
healing
and
healing
and
rehabilitation
examination
thorough
examination
will be
performed
to
of
dogs
that
rupture
one
cranial
cruciate
physical
rehabilitation
examination
at 2 week
of
dogs
thatphysical
rupture
one
cranial
cruciate
totoorthopedic
localize
the
pain,
effusion
(increased
fluid
measured
tibial
plateau
angle
(TPA,
i.e.
the
angle
current
measured
tibial
plateau
angle
(TPA,
i.e.
the
angle the
from
>15º
to
5-10º,
thereby
eliminating
the
pain,
effusion
(increased
fluid
from
>15º
to(TPA,
5-10º,
thereby
eliminating
the
injury.
This
achieved
by
reducing
the
current
measured
plateau
i.e.
the
angle
ofofwound
dogs
that
one
cranial
cruciate
dogs
that rupture
rupture
one
cranial
cruciate
within
the
and
instability
totibial
performed
tolocalize
evaluate
reported
lameness
and
from
5-10º,
thereby
eliminating
the
within
thejoint),
joint),
and
anypalpable
palpable
instability
to is to
from >15º
>15º
to
5-10º,angle
thereby
eliminating
the
A thorough
orthopedic
examination
will
beany
ligament
may
rupture
the
opposite
side
within
performed
towithin
evaluate
thethe
reported
lameness
and
after
surgery.
Unfortunately,
roughly
40-50%
ligament
may
rupture
the
opposite
side
within
physical
rehabilitation
examination
at
2
weeks
forward
thrusting
of
the
tibia
or
protecting
a
within
the
and
any
palpable
instability
to
forward
thrusting
of
the
tibia
or
protecting
a
at
2
weeks
after
surgery.
Unfortunately,
roughly
40evaluate
the
reported
lameness
to
localize
the
pain,
efafter
surgery.
Unfortunately,
roughly
thejoint),
joint),
andand
any
palpable
instability
to
formed
between
redand
and
green
lines
shown
below)
formed
between
red
and
green
lines
shown
below)
from
measured
tibial
plateau
(TPA,
i.e.
the angle
the
stifle
(knee)
Some
with
partially
ligament
may
rupture
the(increased
stifle
(knee)joint.
joint.
Somedogs
dogs
with
partially
formed
between
red
green
lines
shown
below)
ligament
may
rupturethe
theopposite
oppositeside
sidewithin
within 40-50%
forward
thrusting
of
the
tibia
oror
protecting
a>15º
to
localize
the
pain,
effusion
fluid
forward
thrusting
ofangle
the
tibia
protecting
a
11-15
months.
performed
topain,
evaluate
the
reported
lameness
and
11-15
months.
partially
torn
ligament
from
further
stress.
partially
torn
ligament
from
further
stress.
to fusion
localize
the
effusion
(increased
fluid
the
stifle
(knee)
joint.
Some
dogs
with
partially
after
surgery.
Unfortunately,
roughly
40-50%
of
dogs
that
rupture
one
cranial
cruciate
the
stifle
(knee)
joint.
Some
dogs
with
partially
50%
of
dogs that
rupture
one cranial
ligament
(increased fluid within the joint), and any palpable
from
>15º
5-10º,
thereby
eliminating
the
formed
between
red
and green
lines
shown
ofmonths.
dogs
that
rupture
onecruciate
cranial
cruciat
11-15
to
5-10º,
thereby
eliminating
the
forward
thrusting
of thethe
tibpartially
torn
ligament
from
further
stress.
11-15
months.
from
>15º
toto
5-10º,
thereby
eliminating
partially
torn
ligament
from
further
stress.below)
tothe
localize
the
pain,
effusion
(increased
fluid
within
the
joint),
palpable
instability
of may
dogs
that the
rupture
one
cranial
cruciate
within
joint),
andand
anyany
palpable
instability
to to
ligament
may
rupture
the
opposite
side
within
from
>15º
to
5-10º,
thereby
eliminating
the
forward
thrusting
of
the
tibia
or
protecting
a
rupture
opposite
side
within
11-15
months.
instability
to
the
stifle
(knee)
joint.
Some
dogs
with
partially
ligament
may
rupture
the
opposite
side
withi
ia or protecting
a partially
fromprotecting
further stress.
forward
thrusting
of torn
theligament
tibia or
a
within
the
joint),
and Some
any palpable
instability
to
the
stifle
(knee)
joint.
dogs
with
partially
ligament
may
rupture
the
opposite
side
within
the stifle (knee) joint. Some dogs with partially
11-15
months.
forward
thrusting
of thefrom
tibiafurther
or protecting
a
partially
torn
ligament
stress.
11-15 months.
the stifle (knee) joint. Some dogs with partially
partially torn ligament from further stress.
11-15 months.
partially torn ligament from further stress.
effusion
effusion