Tibial-Plateau-Leveling Osteotomy (TPLO)

A tibial-plateau-leveling osteotomy (TPLO) is an advanced surgical procedure performed on dogs to repair the cranial cruciate ligament (CCL). Similar to an ACL in humans, this ligament supports the knee by continuously bearing the dog’s body weight and preventing the femur from sliding against the tibia. This constant tension leaves the CCL highly vulnerable to injury, resulting in one of the most common orthopedic injuries in dogs, particularly in large breeds.

When the ligament is ruptured, the knee is almost completely destabilized, severely reducing mobility and leading to pain and inflammation. Dogs are unable to put weight on the affected leg and will walk with a pronounced limp. If left untreated, this injury dramatically increases the probability of arthritis and further damage to the meniscus.

How TPLO Surgery Works

A TPLO procedure works by restructuring the bone interaction within the knee to stabilize the joint. This innovative surgery alters the slope of the tibia to allow the femur to rest directly on the bone. The surgeon cuts the upper section of the tibia and rotates the bone it until the plateau is level. Upon achieving the desired angle, a steel plate is attached to the bone to hold it in place and allow the surgery to heal correctly. By leveling the tibial plateau, the femur is no longer able to slide against the bone and cause damage, creating a load bearing, stable joint without the cranial cruciate ligament.


Tibial-plateau-leveling osteotomy is a major surgical procedure that requires an initial recovery period of 12 weeks. Painkillers, anti-inflammation and antibiotics are prescribed in the critical period following the procedure to manage discomfort and prevent infection of the surgical site. Pets that are prone to licking the wound must wear a collar to prevent oral bacteria from entering the bloodstream.

Exercise must be severely limited for the first few weeks to allow the bone and soft tissues to heal. Pets should be confined to a small area in the home to restrict unnecessary movement and prevent strenuous activity. Regular veterinary checkups (including x-rays) will monitor your pet’s recovery, assessing limb and joint function, as well as general mobility. As your dog heals, exercise may be gradually increased based on individual evaluation.

Physical therapy is often recommended to maximize recovery. Rehabilitation may include strength training, range of motion techniques, and aquatic therapy to help strengthen the joint and restore mobility.