What is TPLO Surgery in Dogs?
What is TPLO in dogs? A surgery to fix CCL injuries, restore mobility, and prevent arthritis. Learn the procedure, benefits, risks, and recovery timeline.

Tibial Plateau Leveling Osteotomy (TPLO) is a surgery used to treat cranial cruciate ligament (CCL) tears in dogs. Unlike traditional methods that try to replace or mimic the damaged ligament, TPLO changes how the knee joint works to restore stability.
The procedure involves cutting the top part of the tibia (shin bone) and rotating it to a flatter position. This change reduces the natural forward sliding motion of the femur over the tibia, removing the need for the CCL. A special bone plate and screws hold the new position, allowing the bone to heal over time.
TPLO is considered better than traditional extracapsular repairs, which use artificial sutures to mimic the ligament’s function. Those methods can fail in active or large dogs. TPLO offers better long-term stability, faster recovery, and a lower risk of complications, making it the preferred choice for many veterinarians treating CCL injuries.

Function of the Cranial Cruciate Ligament (CCL)
The Cranial Cruciate Ligament (CCL) is a key stabilizing part of a dog's knee (stifle) joint. It connects the femur (thigh bone) to the tibia (shin bone) and prevents excessive forward movement (tibial thrust) and rotation of the tibia when the dog walks, runs, or jumps. The CCL also helps distribute weight evenly across the joint, reducing stress on cartilage and minimizing wear over time.
When the CCL ruptures, the knee joint becomes unstable. Without this ligament, the femur slides abnormally over the tibia, causing pain, inflammation, and lameness. Dogs with a CCL tear may limp, have trouble bearing weight on the affected leg, and avoid activities like running or jumping. Over time, instability leads to arthritis, worsening discomfort and mobility.
CCL injuries greatly affect a dog's ability to move comfortably. Many dogs compensate by shifting weight to the opposite leg, increasing the risk of injuring the other knee. If left untreated, a torn CCL can cause chronic pain, muscle loss, and permanent joint damage. Surgical intervention, such as TPLO, is often the best option to restore knee function, relieve pain, and help dogs regain an active lifestyle.
Indications for TPLO Surgery: Which Dogs Need It?
TPLO surgery is most commonly recommended for large and active dog breeds, as they are more prone to cranial cruciate ligament (CCL) injuries due to their weight and activity levels.
Breeds like Labrador Retrievers, Golden Retrievers, Rottweilers, German Shepherds, and Boxers are at higher risk. However, TPLO can also be beneficial for medium-sized and small dogs, especially those with persistent knee instability.
Common Symptoms of a Torn CCL
- Limping or favoring one leg, especially after exercise
- Stiffness after resting, particularly in the morning
- Swelling and pain around the knee joint
- Difficulty rising, jumping, or using stairs
- Progressive worsening of lameness over time
When Is TPLO Surgery Necessary?
A veterinary evaluation is essential to determine the best treatment approach. TPLO is typically recommended if:
- The dog is large or highly active, where other repairs may fail
- There is significant knee instability affecting mobility
- Conservative management (rest, pain medication, and physiotherapy) has not improved symptoms
When Conservative Management May Work
For small dogs (under 30 lbs) or older, less active dogs, non-surgical options such as joint supplements, anti-inflammatory medications, weight management, and physical therapy may be considered. However, these methods do not fix the underlying instability, and arthritis will progress over time.
For high-energy or large dogs, TPLO remains the gold standard because it restores stability, allowing them to regain normal movement and minimize arthritis risk.
Mechanism of TPLO Surgery
Tibial Plateau Leveling Osteotomy (TPLO) is a surgery that aims to stabilize the knee joint by changing how the tibia (shin bone) works. Normally, when a dog walks, the femur (thigh bone) slides down the tibia because of the natural slope of the tibial plateau. The cranial cruciate ligament (CCL) stops this forward movement, keeping the knee stable.
How TPLO Alters the Tibial Plateau Angle
In TPLO, a curved cut (osteotomy) is made in the top portion of the tibia, allowing the surgeon to rotate the bone and reduce the tibial plateau angle (TPA) to nearly level (5-7 degrees from 20-30 degrees in most dogs). This new position eliminates the forward sliding motion (cranial tibial thrust) that occurs when the CCL is torn.
Why the CCL Is No Longer Needed
After TPLO, the knee no longer relies on the CCL for stability because the new bone alignment prevents abnormal movement. The femur rests in a neutral position, and weight-bearing forces are transferred evenly across the joint. The cut bone is then stabilized with a metal plate and screws, allowing it to heal in its new position.
Biomechanics in Simple Terms
Before TPLO, a torn CCL allows the tibia to slide forward with each step, causing pain and instability. After TPLO, the adjusted bone alignment prevents this sliding motion, making the knee function normally even without the ligament. This technique is particularly effective in large, active dogs, offering long-term stability and reducing the risk of arthritis progression.
TPLO Surgical Procedure Steps
Pre-Surgical Preparations
Before TPLO surgery, a veterinarian performs a thorough examination, including:
- X-rays of the knee to assess the tibial plateau angle and confirm CCL rupture.
- Blood tests to ensure the dog is healthy for anesthesia.
- Fasting for 8-12 hours before surgery to prevent complications.
- General anesthesia is administered, and the leg is shaved and disinfected.
Step-by-Step Breakdown
- Making the Curved Cut in the Tibia
- A semi-circular osteotomy (bone cut) is made in the upper tibia using a specialized saw. This allows the surgeon to reposition the tibial plateau.
- Rotating the Tibial Plateau
- The cut bone is rotated to reduce the tibial plateau angle from its natural slope (20-30 degrees) to a nearly level position (5-7 degrees).
- This prevents the femur from sliding forward, eliminating the need for the CCL.
- Fixing the New Position
- A metal plate and screws secure the rotated tibial plateau in place. These implants provide stability while the bone heals.
TPLO Surgical Duration and Hospital Stay
- TPLO surgery usually takes 60-90 minutes, depending on the dog's size and the complexity of the procedure.
- Most dogs stay in the hospital for 12-24 hours after surgery for pain management and monitoring.
- Full recovery takes 8-12 weeks, with limited activity and follow-up X-rays to ensure proper healing.
Why TPLO Surgery is Preferred Over Other Methods
TPLO surgery is considered the gold standard for treating cranial cruciate ligament (CCL) injuries, especially in large and active dogs. It provides superior joint stability and long-term success compared to other methods like Tibial Tuberosity Advancement (TTA), lateral suture stabilization, and conservative management.
Comparison with Other Techniques
- Tibial Tuberosity Advancement (TTA)
- Like TPLO, TTA alters knee mechanics but focuses on shifting the patellar tendon’s force rather than leveling the tibial plateau.
- Less effective for severe arthritis or extreme tibial slopes.
- Similar recovery time, but TPLO is often preferred for better long-term stability.
- Lateral Suture Stabilization (Extracapsular Repair)
- Uses an artificial suture outside the joint to mimic the CCL.
- Less reliable in large, active dogs, as the suture can stretch or break over time.
- Suitable for small dogs (<30 lbs) but not ideal for high-energy breeds.
- Conservative Management (Rest, Medication, Therapy)
- Does not restore knee stability, leading to progressive arthritis.
- May be an option for very small or senior dogs, but often results in chronic pain and reduced mobility.
Why TPLO is Preferred
- Higher success rate (~90-95%) with long-term joint stability.
- Faster recovery (dogs can bear weight within days, full recovery in ~12 weeks).
- Best suited for large and active dogs, as it withstands high physical demands better than other methods.
Benefits of TPLO Surgery
Restores Joint Stability for Normal Movement: TPLO surgery eliminates the instability caused by a torn cranial cruciate ligament (CCL) by changing the biomechanics of the knee. By leveling the tibial plateau, the femur no longer slides forward, allowing smooth, pain-free movement. This lets dogs return to normal activities like running, jumping, and playing after recovery.
Reduces Long-Term Arthritis Risk: A torn CCL leads to chronic joint instability, which accelerates cartilage damage and arthritis. TPLO provides permanent knee stability, significantly slowing down the degenerative changes that cause pain and stiffness. While arthritis can still develop, it progresses much slower compared to untreated or poorly repaired injuries.
Faster Recovery Compared to Traditional Repairs: Unlike lateral suture techniques, which rely on an artificial ligament that can weaken or break, TPLO stabilizes the knee through bone healing. Dogs start bearing weight within days after surgery, and most regain normal mobility within 8-12 weeks. This is faster and more reliable than other surgical methods, especially for large, active dogs.
Higher Success Rates and Better Long-Term Outcomes: Studies show TPLO has a 90-95% success rate, with fewer complications and a longer-lasting solution than alternative techniques. Dogs undergoing TPLO generally have a higher chance of returning to full activity, making it the preferred option for high-energy or working dogs.
Potential Risks and Complications of TPLO Surgery
While TPLO surgery has a high success rate, complications can still occur, including:
- Implant Failure (Plate or Screw Loosening) – If a dog is too active too soon, the metal implants can shift or break.
- Bone Fractures – The tibia is weakened during surgery, and excessive strain may cause small fractures, especially in high-energy dogs.
- Delayed Bone Healing – Some dogs, particularly older ones or those with underlying conditions, may take longer to recover.
Post-surgical infections are one of the biggest concerns in orthopedic surgeries, but many veterinary surgeons now use Simini Protect Lavage, a non-antibiotic surgical lavage solution. Simini reduces bacterial contamination and biofilms, lowering infection risks significantly. This makes TPLO surgery safer and helps prevent complications that could delay recovery.
How to Minimize Risks with Proper Post-Op Care
- Strict activity restriction for 8-12 weeks to prevent implant damage.
- Regular vet check-ups and follow-up X-rays to monitor healing.
- Wound care and infection prevention – Keeping the incision clean and using solutions like Simini helps reduce infection risk.
- Controlled physical therapy – Gentle exercises, under veterinary guidance, help regain mobility without stressing the joint.
With the right precautions and the use of advanced infection control methods like Simini Protect Lavage, most dogs recover successfully with minimal complications.
Success Rates and Long-Term Outcomes of TPLO Surgery
High Success Rate and Improved Mobility: TPLO surgery has a 90-95% success rate, making it one of the most reliable treatments for cranial cruciate ligament (CCL) injuries in dogs. Most dogs experience significant pain relief and restored joint stability within weeks. Studies show that 85-90% of dogs regain near-normal function, allowing them to walk, run, and play without limping or discomfort.
Long-Term Prognosis: Can Dogs Return to Normal Activity? For most dogs, TPLO provides a permanent solution, allowing them to return to normal activity levels once fully healed. Large, active, and working dogs particularly benefit from TPLO, as it withstands high-impact movement better than other surgical options. With proper post-op care, arthritis progression is slowed, and joint function remains strong for years.
Cases Where Additional Treatment May Be Needed
While TPLO is highly effective, some dogs may require further treatment, such as:
- Severe pre-existing arthritis – Some dogs may need joint supplements, weight management, or physical therapy for long-term comfort.
- Implant-related complications – Rare cases of plate or screw loosening may require revision surgery.
- Bilateral CCL injuries – If both knees are affected, a second TPLO may be needed once the first knee has healed.
With proper rehabilitation and veterinary follow-ups, TPLO surgery allows dogs to live pain-free, active lives with minimal long-term issues.
Also read more about:
Before and After TPLO Surgery: Dog Health Recovery Timeline
Common Myths About TPLO Surgery Explained
Post-Operative Infection in Dogs: Symptoms and Solutions
Conclusion
In conclusion, Tibial Plateau Leveling Osteotomy (TPLO) surgery is a highly effective treatment for cranial cruciate ligament (CCL) injuries in dogs, especially for large and active breeds. By changing the knee joint's biomechanics, TPLO offers better stability, lowers the risk of arthritis, and allows for quicker recovery compared to traditional repair methods.
Although there are possible risks and complications, proper post-operative care and advanced infection control can reduce these issues. With a high success rate and the ability to restore normal activity levels, TPLO remains the top choice for veterinarians looking to improve the quality of life for dogs with CCL injuries.
FAQs
How long does it take for a dog to recover from TPLO surgery?
Full recovery from TPLO surgery takes about 8-12 weeks. Most dogs start bearing weight within a few days, but strict activity restriction is necessary for proper healing. By 6-8 weeks, follow-up X-rays check bone healing. Gradual return to normal activity happens after 12 weeks, with complete muscle recovery taking up to 6 months in some cases.
Can a dog walk immediately after TPLO surgery?
Yes, most dogs can bear weight on the leg within 24-72 hours after TPLO surgery. However, their movement should be strictly limited to prevent complications. Short, controlled leash walks for bathroom breaks are allowed, but running, jumping, and stairs must be avoided for at least 8-12 weeks to ensure proper healing.
Does TPLO surgery prevent arthritis in dogs?
TPLO surgery does not completely prevent arthritis but significantly slows its progression. By stabilizing the knee joint, TPLO reduces abnormal wear on cartilage, which helps minimize long-term joint damage. However, some arthritis may still develop, especially if the injury was untreated for a long time before surgery.
Will my dog need physical therapy after TPLO surgery?
Yes, physical therapy helps speed recovery and improves mobility. Controlled range-of-motion exercises, underwater treadmill therapy, and strength training can reduce stiffness and rebuild muscle. While not always required, veterinary-supervised rehab improves outcomes, especially in large or highly active dogs.
Can a dog tear the CCL in the other leg after TPLO?
Yes, dogs that rupture one CCL have a 40-60% chance of tearing the other within two years. TPLO surgery helps restore stability in the operated leg, but increased weight-bearing on the opposite limb can strain the remaining CCL. Weight management, joint supplements, and controlled activity can help reduce this risk.
Is Bruising Normal After TPLO Surgery?
Yes, bruising after TPLO surgery is common and occurs due to tissue manipulation, blood vessel disruption, and surgical trauma. Mild to moderate bruising around the incision site typically fades within 1–2 weeks. However, excessive bruising, swelling, or warmth may indicate infection or complications. If bruising worsens or persists beyond two weeks, consult your veterinarian for further evaluation.
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Step #1
Getting Ready
Ensuring a clean surgical field starts with proper skin preparation. This video demonstrates the best practices for:
- Shaving the patient – Achieving a close, even shave while minimizing skin irritation
- The Dirty Scrub – The initial skin prep step to remove surface debris and reduce bacterial load before the sterile scrub.
Following these techniques helps reduce infection risk and improve surgical outcomes. Watch the video to see how it’s done effectively!
Step #2
Reduce Your Risks
Many surgeons are shocked to find out that their patients are not protected from biofilms and resistant bacteria when they use saline and post-op antibiotics.
That’s Where Simini Comes In.
Why leave these risks and unmanaged? Just apply Simini Protect Lavage for one minute. Biofilms and resistant bacteria can be removed, and you can reduce two significant sources of infection.
Step #3
Take the Course
Preventing surgical infections is critical for patient safety and successful outcomes. This course covers:
- Aseptic techniques – Best practices to maintain a sterile field.
- Skin prep & draping – Proper methods to minimize contamination.
- Antibiotic stewardship – When and how to use perioperative antibiotics effectively.
Stay up to date with the latest evidence-based protocols. Click the link to start learning and earn CE credits!
