TPLO neutralizes cranial tibial thrust by leveling the tibial plateau via a radial osteotomy, with the proximal segment subsequently stabilized using a TPLO plate and screws to maintain the corrected tibial plateau angle (TPA). The procedure is the most commonly performed and most preferred technique among veterinary surgeons for cranial cruciate ligament (CCL) disease in dogs, with surgeon satisfaction reported at 97.2% in a Veterinary Orthopedic Society survey.Journal of the…

The core surgical objective is to rotate the proximal tibial segment until the tibial plateau is leveled, eliminating the cranial tibial thrust force generated during weight-bearing. A temporary fixation pin is placed to stabilize the osteotomy segment during rotation; mal-positioning of this pin is a recognized risk factor for tibial tuberosity fracture.BMC Veterinary… The absolute tibial tuberosity width (ATTW) — the narrowest mediolateral width of the tibial tuberosity cranial to the osteotomy at the patellar ligament insertion — is a key anatomic variable influencing tibial tuberosity fracture risk.BMC Veterinary… Tibial tuberosity fracture occurs in 0.4% to 9% of TPLO cases and frequently necessitates revision surgery.BMC Veterinary…

In dogs with concurrent medial patellar luxation (MPL) and CCL rupture weighing less than 15 kg, a modified TPLO incorporating medial translation of the proximal tibial segment simultaneously levels the tibial plateau and realigns the quadriceps mechanism. The overall complication rate with this modified technique is 18.4%, compared with 28.9% for traditional repair in the same population, with patellar reluxation occurring in 6.6% versus 8.8%, respectively.Veterinary and… Healing time does not differ significantly between the two approaches.Veterinary and…

A spherical osteotomy blade variant (S-TPLO) provides three rotational degrees of freedom and can address some tibial deformities that standard TPLO cannot correct, with outcomes reported as comparable to conventional TPLO.Veterinary Reco…

Overall TPLO complication rates range from 10% to 34%, with lower rates reported from experienced surgeons using modern implants. In the largest reported series performed by board-certified or residency-trained surgeons, major and minor complication rates were 31% and 8.3%, respectively.Journal of the… Overall complication rates of 18.8% to 28% have also been reported across the broader literature.Journal of the… Surgical site infection (SSI) is a prominent complication, with rates ranging from 3% to 15.8% across studies; the average rate of implant removal following SSI is approximately 2.6% to 3%.Journal of the… SSI rates are higher for TPLO than for other clean orthopedic procedures, attributed to consistent implant use, thermal damage from the saw blade, minimal soft tissue coverage over the medial tibia, and longer surgical times.Journal of the… Risk factors for SSI include German Shepherd Dog breed, intact male status, increased body weight, longer anesthesia time, implant type, concurrent meniscectomy, decreased surgeon experience, and absence of postoperative antibiotics.Journal of the… German Shepherd Dogs carry a 7.4-fold to approximately 9-fold increased odds of deep SSI requiring implant removal compared to other breeds.Journal of the…

TPA change during convalescence is a recognized complication. TPLO with locking screws is associated with a mean TPA shift of 1.29 ± 0.22° during healing, and an increase in TPA at recheck has been associated with increased risk of tibial tuberosity fracture.Journal of the…+1 In dogs greater than 50 kg, a single locking 3.5-mm jumbo TPLO plate has been reported with a major complication rate of approximately 20% and a minor complication rate of approximately 6%.Journal of the… An anatomically precontoured locking plate in a separate series showed a mean TPA change of 0.15 ± 1.32° through convalescence, with minor postoperative complications in 5.4% of patients and no major or catastrophic complications.Journal of the…

Secondary meniscal tears occur in 0.8% of TPLO cases overall, but the rate differs by whether meniscal release was performed: 1.75% without meniscal release versus 0.66% with meniscal release.Journal of the…

Post-TPLO pivot shift is an emerging concern. A monofilament anti-rotational suture (ARS) combined with TPLO has been described as a technique to reduce post-TPLO pivot shift incidence, with a novel TPLO plate designed to facilitate ARS anchoring.Frontiers in Ve…

For athletic dogs, 65% return to agility competition after TPLO, with 80% of those returning dogs doing so within 9 months postoperatively.Journal of the… The mean convalescent period for returning dogs is 7.5 months (range 3 to 12 months), and no dog that returned to competition sustained reinjury to the affected limb during follow-up.Journal of the… Meniscal injury, osteoarthritis severity, and partial versus complete CCL tear status were not significantly associated with return to competition.Journal of the…

When comparing TPLO to tibial tuberosity advancement (TTA), neither technique is clearly superior. Both achieve resolution of lameness at long-term evaluation in the majority of patients. TTA appears to produce better osteoarthritis scores up to 6 months postoperatively, while TPLO is associated with a lower rate of SSI.Frontiers in Ve…

Would you like to go deeper on SSI prevention strategies — including perioperative antibiotic protocols and implant coating options — for high-risk patients such as German Shepherd Dogs or obese dogs?