A common procedure among veterinarians specialized in orthopedics, this surgery has shown good results in restoring mobility and reducing pain in dogs suffering from a cranial cruciate ligament (CCL) rupture.
This complex operation requires a strict post-operative rehabilitation period, as illustrated by a case study with Dr. Barbara Koller.
TPLO: A Surgical Procedure to Treat CCL Injuries
The TPLO (Tibial Plateau Leveling Osteotomy) is a surgical procedure performed on dogs to treat cranial cruciate ligament (CCL) injuries, a common condition, particularly in large and medium-sized breeds such as Labradors, Golden Retrievers, Rottweilers, and German Shepherds.
The goal of TPLO is to modify the angle of the tibial plateau surface to stabilize the knee joint without the need to replace the cranial cruciate ligament. This procedure helps reduce the forces acting on the knee joint, thereby minimizing abnormal movements that cause pain and instability.
This surgery helps restore functional stability to the knee joint and limits early arthritis that may develop as a result of such an injury.
The surgery involves cutting a portion of the tibia and repositioning it at a different angle to prevent joint displacement.
A related surgical approach involving the tibia is described in our clinical case on bilateral tibial crest surgery in dog.
It is followed by a rehabilitation period and post-operative care to ensure proper healing.
TPLO is particularly suited for young, active, or large-breed dogs.
Post-Operative Follow-Up of a TPLO Case with Dr. Barbara Koller
A veterinarian specialized in physiotherapy and rehabilitation medicine, Dr. Barbara Koller practices in Austria.
Experienced in the care and management of athletic dogs, Dr. Koller has worked in clinics dedicated to racing greyhounds. She is also a trainer and lecturer in physiotherapy.
Equipped with the dynamic gait analysis tool, Tendiboots™ Canine, below is one of the clinical cases in post-operative follow-up of a TPLO by Dr. Koller.
Records taken 8 weeks after the surgery
During these analyses, Dr. Koller was able to observe the following results:
• The stride length is significantly reduced by more than half (7 cm) on the right rear limb compared to the left rear limb (16 cm). As compensation, the stride length diagonally on the left front limb is increased (25 cm).
• The peak vertical GRF is only half as strong (5.5 N/kg) on the right rear limb compared to the left rear limb (11.3 N/kg). As compensation, the support on the left front limb is slightly more pronounced than on the right front limb.
• The stride cycle time is significantly reduced (383 ms on the right rear limb versus 759 ms on the left rear limb). Diagonally, this is compensated by an increase in the left front limb (847 ms) compared to the right front limb (762 ms).
• The ground contact time is clearly shortened on the right rear limb (45%) compared to the left rear limb (67%).
Rehabilitation plan applied by Dr. Koller
• Manual therapy
• Release of fascial adhesions at the surgical scar site and across the entire iliopsoas muscle.
• Focussed extracorporeal shockwave therapy, twice a week (2 Hz, 0.15 mJ/mm²).
Records taken 12 weeks after the surgery
Dr. Koller observes that the right and left rear limbs are now symmetrically bearing weight. No compensatory movement is noted in the front limbs.
Reminder of the parameters collected by Tendiboots™ Canine.
Testimonial from Dr. Barbara Koller on Tendiboots™
“For me, ‘tendiboots’ is an essential tool for demonstrating the therapy and the success of the therapy to the owners in particular.
I like to use it for lengthy therapies so that owners in particular can also objectively recognise the small advances in therapy.
It is not always possible to recognise step lengthening or a firmer footing of the paw.
With ‘tendiboots’ I now have a tool to objectively show the owners (and myself) any progress, no matter how small.
The ‘tendiboots’ are easy to use and are very well accepted by the dogs. For the owners and also for us, it has become an indispensable tool in the treatment of orthopaedic and physiotherapeutic cases.”
FAQ
After a tibial plateau leveling osteotomy (TPLO), visual assessment alone cannot confirm symmetrical load redistribution. Tendiboots™ Canine dynamic analysis quantifies the peak vertical ground reaction force (GRF) and stride length of each limb. In the case followed by Dr. Barbara Koller, at 8 weeks the operated hindlimb reached only 5.5 N/kg versus 11.3 N/kg on the contralateral limb; by 12 weeks both hindlimbs were bearing weight symmetrically with no forelimb compensation. It is these numbers, not the eye alone, that confirm functional recovery.
Three markers are especially telling post-TPLO. Stride length collapses on the operated limb (7 cm on the right hindlimb versus 16 cm on the left in Dr. Koller’s case), with compensatory lengthening on the diagonal contralateral forelimb (25 cm). Ground contact time also drops (45% versus 67%), and stride cycle duration shortens on the operated side (383 ms versus 759 ms). This diagonal load shift signals a protective offloading pattern that rehabilitation must correct.
Subtle residual lameness or partial weight-bearing can persist without being visible, especially in a dog already walking without obvious limping. As Dr. Koller notes, step lengthening or a firmer footing of the paw are not always recognizable by eye. Reproducible quantitative data objectify these micro-improvements and help prevent premature return to activity, which would overload the consolidating osteotomy site.
Some improvements — step lengthening, firmer footing — are not visible to the naked eye, which makes communication with the owner difficult. The graphical representations of the Tendiboots™ analysis provide an objective record that is comparable from one session to the next. As Dr. Koller puts it, it is an essential tool for showing owners, and the therapist, every gain however small, and for supporting adherence during long rehabilitation courses.
TPLO changes the tibial plateau angle to stabilize the stifle without replacing the ruptured cranial cruciate ligament, neutralizing the cranial tibial thrust responsible for pain and instability. This limits the early osteoarthritis that tends to follow such an injury. The technique is particularly indicated in young, active, or large-breed dogs — Labradors, Golden Retrievers, Rottweilers, German Shepherds — in whom restoring functional stability is decisive for locomotor recovery.
