TPLO for ACL Injuries in Dogs

Dr. Michael Dutton, Board certified ABVP Canine and Feline Specialist, performs TPLO surgeries at Hopkinton Animal Hospital.

Tibial plateau levelling osteotomy (TPLO) is a surgical procedure used on dogs who have torn their anterior cruciate ligament, or ACL. The ACL is located in the pet’s knee and stabilizes the front to back motion. A torn ACL is painful and if untreated leads to early arthritis in the joint.

This surgery is highly effective in returning stability to the knee, allowing full weight bearing, and is one of the most popular orthopedic surgeries performed on dogs.

TPLO changes the mechanics of the dog’s knee so the torn ligament is irrelevant to the knee’s stability.

This procedure is highly effective in achieving its aim of returning stability to the knee, allowing full weight bearing. Approximately 90% of dogs that undergo the surgery return to normal functioning of the limb.

TPLO is major surgery, so with it comes some risk. There is the short-term risk of infection plus the risk of the screws coming loose or the bone healing slowly.These risks are most likely to occur if the pet becomes active too quickly after surgery. As with any surgery on a joint, there is also an increased risk of osteoarthrosis and degenerative disease. the complication rate is 8 to 11%.

The benefits of TPLO surgery far outweigh the risks. The likelihood of the aforementioned risks is extremely low, while the likelihood of a fully functioning limb is over 90%.

Many dogs have a torn ACL in both knees. Studies have shown over a 10-fold increase in complication rate if surgery on both knees is performed at the same time. Due to this, we will not do bilateral knee TPLO unless Dr. Dutton has approved it.

The cost of TPLO surgery can vary, depending on your veterinary surgeon, where the surgery is being performed, the size of your dog, and what part of the country you live in.

Prices for TPLO surgery here at Hopkinton Animal Hospital are $4,500 all-inclusive for dogs weighing less than 100 pounds and $5,000 all-inclusive for dogs weighing 100 pounds or more. These prices are barring post-surgical complications that are a result of owner noncompliance or costs associated with other veterinary facilities. See what’s included in our TPLO surgery price below.

Fees are due the MORNING of the surgery. We do not offer payment plans for this procedure.

If you suspect that your dog has torn his/her ACL, or if your veterinarian has suggested TPLO surgery, please call us for a phone consultation or an initial exam.

If your pet is not currently on anti-inflammatory medications (like carprofen), the initial exam will include x-rays of the knee and a 10-day course of anti-inflammatories to reduce the soft tissue swelling in the knee joint.

X-rays will determine if your dog is a candidate for a TPLO. Almost all dogs with a torn ACL are TPLO candidates, but there are a few cases where a different technique such as a tibial tuberosity advancement (TTA) or a cranial closing wedge osteotomy (CCWO) is indicated. We do not perform the TTA or CCWO surgeries here at Hopkinton Animal Hospital.

If we determine that TPLO surgery is the right course of action for your dog, we will schedule surgery at a time that works best for you, to ensure the best possible recovery for your pet.

The breakdown of the surgery is:

  • The dog will be anesthetized.
  • Antibiotics and painkillers will be administered.
  • An incision will be made, and the torn ends of the cranial cruciate ligament will be entirely removed. The medial and lateral meniscus cartilages (which serve as knee shock absorbers) will be examined for damage. If they are torn, they will be removed.
  • A curved cut will be made in the top of the tibia bone to fit the tibial plateau.
  • The tibial plateau is then rotated to a level of about 5 degrees. Plates and screws are then fitted to hold the tibial plateau in its new place.
  • Post-surgery x-rays will be reviewed to determine proper placement.
  • Most pets will be discharged late afternoon of surgery.

Costs for TPLO surgery at Hopkinton Animal Hospital include:

  • Initial exam and initial x-rays
  • Day of surgery (in between 7:30 to 8:30 a.m. at Hopkinton Animal Hospital, please fast your pet for at least 4 hours before then)
    • IV
    • Pre-anesthetic blood work
    • Chest x-ray if needed
    • Pain medications
    • Anesthesia
    • Detailed pre-op x-rays
    • Surgery including plate and screws
    • Post-op x-rays
    • Recovery day in the hospital
    • Take home pain medications and antibiotics (if needed)
    • Cold laser therapeutic treatment on day of surgery
    • E-collar
  • 10-14 days recheck
    • Exam
    • Cold laser therapeutic treatment
  • 8 weeks recheck
    • Exam
    • Sedation if needed
    • X-rays
  • Any service that does not occur at Hopkinton Animal Hospital.
  • Correction of post-surgical complications that are a result of owner noncompliance. Examples are: Pet able to lick incision open because not using the protective e-collar as directed for TWO WEEKS or too much activity resulting in lameness or damage to the TPLO plate or screws. We understand the e-collar is frustrating for all. In the long run, it is best for your pet to use it for two full weeks.

We recommend several gentle at-home rehabilitation procedures you can perform on your dog after TPLO surgery. Please reference your TPLO Discharge Instructions before beginning any of these rehabilitation exercises with your dog. You will also receive email messages when each exercise is appropriate to begin with your dog.

1. Passive Range of Motion

2. Three Legged Standing

3. Figure 8 Walking