The signs of TPLO failure and complications in dogs are something you may be wondering about if your dog just underwent surgery. Today, our Laguna Woods vets will explain some signs you should look out for during post-operative recovery.
The Goal of TPLO Surgery
To better understand what could go wrong with a TPLO, it is helpful to first have a basic understanding of what happens when a dog undergoes a TPLO surgery.
If your dog tears their cranial cruciate ligament, your veterinarian will most likely recommend surgery to repair it. The procedure used to repair the cruciate ligament is known as TPLO, which stands for Tibial Plateau Leveling Osteotomy. The surgery can help your dog resume normal running and jumping!
Unlike other surgeries, TPLO restores mobility to your dog's knee without relying on the damaged ligament for stability. TPLO surgery eliminates the need for the cranial cruciate ligament by reconfiguring your dog's knee.
To perform TPLO surgery, a surgeon makes a curved cut to the patient's tibia before rotating the tibial plateau (top section) to level the tibia and femur. Once the tibial plateau is in the desired position the TPLO surgery is completed by attaching a metal plate to stabilize the knee as it heals around the new configuration.
Recovering from TPLO Surgery
Following TPLO surgery, dogs can walk on the leg within 24 hours, and most can bear moderate weight on the leg within 2 weeks.
Recovering from TPLO surgery is a lengthy process for dogs, but the recovery time is still much shorter than comparable surgeries, ranging from 12 to 16 weeks. Your dog should be able to resume full physical activity 6 months after TPLO surgery.
TPLO Complications in Dogs
Depending on the underlying dynamics, TPLO complications in dogs can be classified as minor, major, or catastrophic. A minor complication can be resolved without the need for treatment. A major complication necessitates additional surgical or medical treatment and can result in death or loss of mobility and quality of life.
Some complications that can arise include:
Surgical Wound Infection
As with other types of surgery, an incision infection is possible. Surgical wound complications after TPLO are estimated to occur in 7.8 percent of cases. When not treated promptly and appropriately, even superficial soft tissue infections have been shown to progress to implant infections and bone infections.
Patellar tendinosis is inflammation of the tendon that connects the kneecap (patella) to the tibia. Affected dogs experience pain and lameness, but this condition is relatively benign and improves with rest and medication.
Screw Loosening or Breaking
A dog's bone plate must remain in place for at least 12 weeks to allow the bone to heal and repair the damage caused by injury. A loose plate can press on a nerve, causing localized pain in the dog. A broken screw interferes with healing and may cause joint damage.
Plate Slipping, Bending, or Breaking
When the dog is allowed too much activity early in the healing process, the plate or screws are frequently damaged. Sometimes the plate will pull away from the bone or even break. In some cases, the TPLO plate is rejected by the dog's body because it is perceived as a foreign object.
A Fracture or Infection of the Bone
Tibial tuberosity fractures have been reported in 1 to 9% of dogs following TPLO surgery. Incorrect positioning and the use of oversized saw blades are both risk factors. Body weight, tibial plateau angle (TPA) change and preoperative TPA were all significantly higher in dogs with this type of fracture.
Osteomyelitis, the medical term for a bone infection, is difficult to treat. This type of infection necessitates strong antibiotics and typically requires 4 to 6 months of treatment to resolve. A wound culture can aid in determining which antibiotics will be most effective.
A Meniscal Tear
Dogs with a meniscal tear frequently exhibit what is known as a "meniscal click," which is essentially a clicking noise that is one of the telltale signs of an injury. If the surgeon notices any signs of damage during the TPLO surgery, the meniscus is removed. If it is not removed, there is a chance that it will tear later, necessitating a second surgery.
Signs to Look Out For
If your dog exhibits any of these symptoms during the recovery period, contact your veterinarian immediately. The sooner the problem is addressed, the better the chances of recovery.
- Swelling that lasts longer than 5-7 days after surgery.
- Significant discharge
- Discharge with an unpleasant odor
- Pain symptoms despite medication
- Inability to bear weight for 5-7 days following surgery
- Anything out of the ordinary or concerning