Tibial Plateau Leveling Osteotomy (TPLO) for Dogs


The TPLO (Tibial Plateau Leveling Osteotomy) surgery has become one of the most popular orthopedic surgeries performed on dogs who have torn their cranial cruciate ligament, also commonly referred to as the dog ACL.

Developed by Dr. Barclay Slocum, the TPLO surgery was first considered a radical procedure for addressing canine ACL injuries. Now in existence for over 20 years, the surgery has proven itself, time and time again, to be an extremely effective long term solution for addressing cruciate ligament injury in dogs.

The philosophy behind the TPLO surgery is to completely change the dynamics of the dog’s knee so that the torn ligament becomes irrelevant to the stability of the knee itself.

Let’s quickly review the basics. When your dog stands, if you look from the side, you can see that your dog’s knee is bent, at a slight degree of flexion. Because of this bending, the ACL inside the knee joint is always load-bearing, meaning it always has tension on it. This constant tension on the dogs ACL, therefore makes this ligament the most susceptible to injury. In fact, injury to this ligament is hands-down the most common orthopedic injury in dogs.

When a dog tears its ACL, every time the dogs goes to stand or put weight on the leg, the femur slides/rubs on the back of the tibia. This rubbing causes pain and inflammation, which is very uncomfortable. This is why most dogs with a torn ACL will not even put any weight on the leg, or if they do, they will just toe touch the leg to the ground.

The true beauty of the surgery is that it completely alters the dynamics of the knee. Once the bone is cut and rotated the tibial plateau, where the femur and the tibia communicate, no longer can slide backwards. The knee is immediately stabilized. By doing so, this eliminates the need for the ACL ligament entirely and returns stability to the joint immediately. Once the knee is stabilized, the dog will begin to use the limb again. In fact in most cases the dogs are weight bearing within a few days after surgery if not the very next day.

Below is an xray of a dogs knee after TPLO surgery.

Click Here to Download Your Free Guide to TPLO Surgery & Recovery: Recommended by top Orthopedic Veterinary Surgeons


The cost of TPLO surgery can vary depending on who and where the surgery is being performed. The average cost ranges from $2500 – $4500. The cost depends on the veterinary surgeon and hospital. Which may include pre-surgery bloodwork, anesthesia, the surgery itself, post surgery care and medications. Some hospitals may even include post-surgical physical therapy.


There are several alternatives to TPLO surgery. Although the TPLO is a great surgery to repair a torn ACL in dogs, it is not the only option.. Therefore it is best to have a conversation with your veterinarian or veterinary surgeon and discuss all of your options. There are several things that should be considered when choosing the right surgery. Here is a list of things to consider:

  • Age of the dog
  • Size & weight of the dog
  • Disposition of the dog i.e. is the dog calm or active
  • Financial considerations
  • After surgery care
  • Degree of joint disease ie. Arthritis
  • Access to a board certified orthopedic surgeon
  • Access to a canine rehabilitation facility

Three of the most common alternatives to ACL surgery are:

  1. Traditional Extracapsular Lateral Suture Technique
  2. Tightrope Technique
  3. Tibial Tuberocity Advancement (TTA Surgery)

Regardless of which surgery you choose the key to long term success is in the after care. It is simply astonishing just how fast these dogs begin to lose muscle mass and range of motion in the knee during this period where they are not weight bearing fully on the affected leg. In the last 20 years, physical therapy principles and techniques have been developed and altered to help dogs recovery properly after major orthopedic surgery such as this. Physical therapy for dogs is more commonly referred to as Canine Rehabilitation.


The first 12 weeks following the TPLO (Tibial Plateau Leveling Osteotomy) surgery are a critical time of recovery and rehabilitation. There are certain activities and exercises that can be done to help your dog resume and develop full use of the affected limb. When done correctly and introduced at the proper time, you will significantly improve your dog’s chances for a safe and successful recovery.

This recovery period is a critical time and therefore must be taken very seriously. Though the surgery corrected the structural problem quickly, it is the post-surgical therapy and exercises that will truly made the surgery a success.

TopDog Helps Guide You Though the Process… Established in 2004, TopDog Health and Rehabilitation has been a leader in educating, motivating and guiding pet owners through this difficult period of surgery and recovery. Our mission statement sums it all up. We help you “Get your dog back to 100% and maintain a lifetime of healthy joints.”

At TopDog We Like to Keep Things Simple:

  1. Learn: Educate yourself on how you can personally help your dog recovery safely and successfully after surgery.
    • Click here to download: TopDog’s Home Rehabilitation Guide for TPLO Surgery
    • Click here to find a canine rehabilitation facility in your area
  2. Nurture: Provide them with the essential nutrients their joints need (ie. A high quality joint supplement)
    • Click here for TopDog’s Joint Supplement for Post Surgery Dogs
    • Click here to find other veterinary brands of joint supplements
    • **Warning** When if comes to joint health supplements…buyers beware….when it comes to the health of your dog make sure to use only top veterinary trusted products.
  3. Patience: Understand that FULL recovery takes time (often upwards of 6 months), therefore be patient and consistent
  4. Feel: Know when they are ready to run (meaning learn how to evaluate your dog. If you let them free to early they are most likely going to injury another leg or joint)

Remember that like humans, not all dogs recover at the same speed. It is best to be conservative and consistent. Do not force your dog to do certain exercises if they are unwilling. It is always best to seek professional guidance if available.

Click Here to Download Your Free Guide to TPLO Surgery & Recovery: Recommended by top Orthopedic Veterinary Surgeons

TPLO Complications

Hands down the number one complication of TPLO surgery is infection. The source of infection most of the time is when the pet owner allows the dog to lick at the surgery site. It is well understood that all pet owners absolutely hate the E-Collar ie. lampshade, that is put on dogs after surgery. Often we feel bad for the dog and therefore remove it at times where we are “watching” them. The fact of the matter is…it only takes seconds for them to infect the wound.

The second most common complication is due to over-activity to early. Often with the TPLO surgery the dogs “feel” good. Whatever you do…don’t be one of these statistics. Over-activity can be devastating with regards to the TPLO. Remember this surgery involves cutting bone, therefore essentially there is a broken bone that needs to heal. Primary healing takes a minimum 8 weeks.

Click Here to Download Your Free Guide to TPLO Surgery & Recovery: Recommended by top Orthopedic Veterinary Surgeons

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