TPLO is a surgical procedure for cranial cruciate ligament (CCL) tears in dogs, and occasionally cats. The CCL is located inside the knee (stifle), and its main role is to prevent the shin bone (tibia) from sliding forward relative to the thigh bone (femur). In dogs, it plays an even more important role than the ACL does in people — without it, the joint will always become misaligned during weight-bearing.
Unlike people, dogs usually don’t tear their CCL from a single injury. Instead, the ligament gradually degenerates over time. We’re still not sure why it happens — it may be due to how the joint is loaded (biomechanics) or something within the ligament itself (biology).
Once the ligament tears, the joint becomes unstable, leading to inflammation, pain, and eventually arthritis. Often, the CCL is frayed and still providing partial stability, but the joint is irritated. Regardless, CCL disease typically causes ongoing lameness if not treated. CCL disease can affect dogs of all sizes, ages, and activity levels.
Think of the stifle joint as having two slippery surfaces. The femur surfaces are very round, while the tibial surfaces have a downward slope. The job of the CCL is to keep the femur aligned in the middle of the slope. Once the CCL ruptures, the joint becomes unstable as the femur “slides” down the slope of the tibia during weight-bearing.
The goal of TPLO is to flatten, or level, the slope, so the femur does not slide downward. In other words, TPLO alters the shape of the joint such that the joint no longer requires the CCL.
There are two main parts to the surgery. First, the inside of the joint is inspected, either by opening it up (arthrotomy) or through minimally invasive “keyhole” surgery with a small arthroscope. Arthroscopy provides better visualization and is less traumatic, but requires specialized equipment and an experienced surgeon. The CCL rupture is confirmed, and any meniscal injury is treated by trimming the damaged portion.
Then, the bone is cut with a special saw, and the tibial plateau segment is rotated into the desired position. The cut in the bone is stabilized with a bone plate and screws.
Every TPLO has the same goal — stabilizing the knee — but the exact procedure is tailored to each dog. Factors such as the amount of instability, the presence of other issues like limb deformities or patellar luxation, and the size of the patient all influence the details of the surgery. Implant selection, quality of equipment, and method of joint examination also vary.
Most dogs begin using the leg within a few days, but full recovery takes several months. Strict activity restriction is critical in the first four weeks after surgery, and consistent use of the limb with some limping is expected. By 4–6 weeks, most pets are walking on a leash comfortably, and bone healing is well underway. Full return to normal activity — including running and playing — usually happens after about three months, depending on your dog’s age, size, and activity level, as well as whether any additional procedures were performed.
As with any surgery, TPLO carries risks. Most dogs experience only mild, transient effects such as swelling or bruising. More serious problems — such as infection, implant loosening, meniscal injury, or delayed bone healing — occur less often, and they are usually treatable. Certain dogs, like giant breeds and English Bulldogs, are at higher risk of major complications.
Studies have shown that over 90% of owners are very satisfied with the outcomes of TPLO. Our expectation is that dogs should be able to return to, or close to, pre-injury levels of activity. Even some working or agility dogs can return to peak performance. However, dogs with pre-existing severe abnormalities such as advanced arthritis or concurrent deformities may not achieve a fully desirable result.
TPLO is a very common surgery and offered by many veterinarians, but the surgeons’ training and experience can vary widely. Some are general practitioners, others have residency training or board certification, and a small number are recognized leaders in the field through high case-loads, research, and teaching.
When deciding where to go, it’s reasonable to ask:
These questions can help you find the right match for your pet’s ne
At Animal Orthopaedic Clinic of Florida, every patient benefits from unmatched expertise. Our head clinician is an internationally recognized leader and researcher in veterinary orthopaedic surgery. Using evidence-based, individualized care, we are dedicated to giving your dog the best chance at long-term, pain-free mobility.