TPLO – Tibial Plateau Leveling Osteotomy. Stabilizes knee using a bone plate and screws after cutting the tibia (osteotomy) and modifying the tibial plateau angle.

Extracapsular Repair (also known as Standard ACL Repair) – utilizes a synthetic ligament made out of monofilament nylon to replace the damaged ligament and eliminate instability in the knee joint

Factors Influencing Choice of Surgical Procedure:

Patient Size

    – TPLO is favored in large breed and giant breed dogs
    – Extracapsular repair less likely to fail when used in medium or small breed dogs

Activity Level

    – TPLO favored in working and competitive dogs
    – TPLO may be best choice for dogs whose owners have an active lifestyle (running, hiking, snowshoeing, etc)
    – Larger dogs with a sedentary lifestyle can do well with an extracapsular repair

Age of Patient

    – TPLO is not advised in immature dogs with CrCL injuries if the growth plates in the tibia are still open (this is evaluated with x-rays)
    – Healing of the osteotomy site in the tibia may be slower in geriatric dogs when compared to healing times in younger adult dogs

Tibial Plateau Angle

    – Tibial plateau angle is measured from a lateral x-ray of the tibia on the day of surgery
    – Dogs with a steeper TPA (> 25 degrees) more likely to benefit from a TPLO
    – Normal tibial plateau angles have not been determined for all breeds of dog

Financial Considerations

    – TPLO is typically a more expensive procedure than extracapsular repair due to the equipment needed to perform the procedure and the use of stainless steel implants
    – TPLO involves at least one follow up exam with x-rays (at 8-10 weeks post-op)
    – Some patients who may benefit from a TPLO receive an extracapsular repair due solely to the cost differential between the two procedures