The field of veterinary orthopedics has witnessed remarkable advancements over the years, particularly in the treatment of cranial cruciate ligament (CrCL) injuries in dogs. The development of the Tibial Plateau Leveling Osteotomy (TPLO) technique has transformed the management of this common orthopedic condition. To appreciate the significance of TPLO, it is essential to delve into its origins and the factors that led to its development.
TPLO (Tibial Plateau Leveling Osteotomy) - Dr. Slocum (Oregon, USA)
The TPLO technique was developed by Dr. Barclay Slocum, a veterinary surgeon, and was introduced in 1993. Dr. Slocum aimed to address the biomechanical issues associated with cranial cruciate ligament (CrCL) rupture in dogs, particularly large and active breeds. CrCL rupture is a common orthopedic problem in dogs, leading to lameness, joint instability, and osteoarthritis.
Traditional treatments for CrCL rupture, such as extracapsular suture techniques, often had limitations in providing long-term stability and preventing osteoarthritis progression. Dr. Slocum recognized the importance of addressing the abnormal biomechanics of the stifle joint caused by CrCL rupture, particularly the cranial tibial thrust.
The TPLO technique was developed to stabilize the stifle joint by altering the biomechanics of the tibial plateau. Unlike traditional treatments that attempt to recreate the function of the torn ligament, TPLO aims to neutralize cranial tibial thrust by altering the slope of the tibial plateau. This is achieved by performing a circular osteotomy in the proximal aspect of the tibia, rotating it to achieve a desired postoperative tibial plateau angle (TPA), typically around 5 degrees, and stabilizing it with a plate and screws.
Traditional treatments for CrCL rupture, such as extracapsular suture techniques, often had limitations in providing long-term stability and preventing osteoarthritis progression. Dr. Slocum recognized the importance of addressing the abnormal biomechanics of the stifle joint caused by CrCL rupture, particularly the cranial tibial thrust.
The TPLO technique was developed to stabilize the stifle joint by altering the biomechanics of the tibial plateau. Unlike traditional treatments that attempt to recreate the function of the torn ligament, TPLO aims to neutralize cranial tibial thrust by altering the slope of the tibial plateau. This is achieved by performing a circular osteotomy in the proximal aspect of the tibia, rotating it to achieve a desired postoperative tibial plateau angle (TPA), typically around 5 degrees, and stabilizing it with a plate and screws.
Initially, access to TPLO was restricted due to patents covering both the surgical procedure and the implants used.1 However, with the expiration of these patent rights, TPLO has become significantly more accessible. Over the years, refinements have been made to the surgical technique and implant designs, leading to improved outcomes and reduced complication rates.
Today, TPLO is considered one of the gold standard surgical treatments for CrCL rupture in dogs, particularly in large and active breeds. It has revolutionized the approach to managing this common orthopedic condition, offering a reliable and effective solution for restoring stability and function to the stifle joint.
Today, TPLO is considered one of the gold standard surgical treatments for CrCL rupture in dogs, particularly in large and active breeds. It has revolutionized the approach to managing this common orthopedic condition, offering a reliable and effective solution for restoring stability and function to the stifle joint.
Here is a video showing how TPLO works →
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