VPN Plus+ ExclusiveThe ABCs behind the challenges of TPLOJuly 19, 2023Ask any small animal veterinarians what they consider the "gold standard" approach for cranial cruciate ligament disease in dogs, and you will most likely hear, the "TPLO."1-7 From veterinary school forward, we hear from surgeons that the tibial plateau leveling osteotomy (TPLO) delivers a more rapid recovery and return to normal function, even when compared to other surgical techniques such as the tibial tuberosity advancement (TTA) and the triple tibial osteotomy (TTO).8 In contrast to other procedures, the TPLO supposedly causes fewer complications, less meniscal injury, and slower progression of osteoarthritis. For those who are unfamiliar with this procedure and its history, the TPLO is a traumatic procedure, involving severing the tibia, changing the angle of the tibial plateau, and then plating the two parts of the tibia back together. By altering the dog's anatomy, the veterinarian hopes to stop the proximal tibia from thrusting forward during weightbearing and locomotion for canine patients whose cranial cruciate ligament has failed.9 Proponents claim this "restores normal limb function," but this is an impossible claim to defend.10 Altering structural conformation does not and cannot restore "normal" function for that dog, breed, or species. Moreover, one year after …
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