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TPLO - The technique

All cruciate ligament techniques are performed following a arthroscopic (keyhole) examination of the joint, checking for evidence of meniscal cartilage ligament and assessing whether to remove the remnant of the cruciate or leave it in situ.

As mentioned before TPLO is a technique which neutralises the forces acting on the cranial cruciate ligament. In this way after the surgery, the knee joint is stable without the cranial cruciate ligament, or the partially torn ligament is 'off loaded' so it doesn't continue to be traumatised.

This it does by changing the 'tibial plateau angle' or TPA. The tibial plateau angle is the angle between the load bearing surface of the tibia and a right angle of the shaft of the tibia, from joint to joint.

If you think about it - the steeper the angle, the more forward push there is to each step.

The TPLO surgery alters the TPA, dramatically reducing the forward thrust of the tibia during loading.

The bone is moved by cutting a curved cut at the top of the tibia, and fixed in its new position using a bone plate and screws. At Peninsula Vetcare, I use a combination of Biomedtrix 'Curve' plates and Synthes locking TPLO plates - which is the one pictured above. Both are world-standard implants, and I choose which one fits the tibia of an individual dog. I do not use cheap copies which are available, but are subtly inferior leading to the potential for dangerous complications to occur. 

The advent of locking screw technology  (where the screws are connected to the plate by a thread, and not just pressure on the bone), makes the TPLO cut heal very reliably.