By Dr Tanya Grantham and Delia Mallinick
My companion is going for Cranial Cruciate Ligament CCL – TPLO( Tibial Plateau Leveling Osteotomy) surgery, now what? When the Cranial Cruciate Ligament (CCL) is damaged the stifle (knee) becomes unstable. The tibia (shin bone) is able to move forward in relation to the femur (thigh bone). Surgical intervention is often required, especially in larger breeds of dogs. It is advisable to have surgery sooner rather than later to prevent irreversible damage to the joint as well as to help relieve pain. One of the main goals of surgery is to return your dog to weight bearing of the affected limb, as soon as possible. This limits the strain placed on the opposite leg, and the opposite Cranial Cruciate Ligament (CCL)
Any Cranial Cruciate Ligament (CCL) repair surgery typically consists of an initial examination of the inside of the knee. The shock absorber, also called the meniscus, is examined. Any damaged part will be removed as this can be a source of great pain.
What does the TPLO surgery involve? This surgery changes the angle and relationship of the femur and the tibia. The surgery will reduce the amount that the tibia moves forward when the dog takes a stride. This is accomplished by making a cut through the top of the tibia. The top of the tibia is then rotated and anchored in place with a bone plate to allow the bone to heal. In a sense, the surgeon has created a fracture. The realignment of the bones in the knee helps to provide stability when the dog takes a step.
What is the recovery time? Most patients will be toe-touching on the operated leg within 72 hours of surgery. Weight bearing will increase gradually with time. Full recovery and return to function can take up to 16 weeks. This depends on your dog’s lifestyle.
What can I expect post surgery? Your dog will be painful. This is major surgery. Use the medications. Follow veterinary instructions. Your dog will soon start to feel better and want life to return to normal. Do not be tempted! A bone takes 6 weeks to heal. Excessive forces applied to the surgical site, too soon, can result in severe damage and another operation. Controlled leash walks begin at one week post-op and ideally should be performed three times a day. The length of the walks will increase gradually from 5 minutes per walk, up to 20 minutes per walk. What are the post op do’s and don’ts? No running, no jumping and no rough playing! Management of movement is required for a minimum of 6 weeks post surgery with the patient going out on a leash for potty breaks. Depending on the dog, this may mean cage rest. Pain management after knee surgery is very important. Please ensure to use all the medications that have been prescribed, until they are finished. This is important to encourage use of the leg as soon as possible and to counteract muscle wastage.
What do I need to look out for after the surgery? Around the knee and at the wound: Swelling, Heat, Oozing, Licking of stitches, worsening of lameness instead of improvement. If any of the above occur, call your veterinarian or surgeon, or return to the practice with your dog.
Will my companion need physio? Yes, the patient will require physiotherapy after the surgery. This will help speed up the healing and strengthen the operated limb setting up the procedure for greater success.
When should I book an assessment for my companion? As soon as your companion goes in for surgery, phone and book your assessment for 4 weeks post op so that we can see your companion at the scheduled time.
How long will my companion need to come for physio? After the assessment we will book 6 to 8 sessions with a reassessment at the 9th session where all the measurements will be redone to see what progress has been made and to see if therapy needs to continue.
How many times a week will my companion need to come for physio? We recommend a minimum of once a week but more sessions a week may be needed. This will be discussed at your assessment.
Will my pet medical insurance cover the physiotherapy sessions? – Check with your Pet Medical Insurance provider what is covered within your policy.
