TPLO was originally developed in the early 1990’s by a veterinary surgeon and his partner, Barclay and Therese Slocum. The theory behind TPLO was that by rotating the slope of the joint surface at the top of the tibia then the forces that are normally counteracted by the cranial cruciate ligament will be reduced or eliminated.
CBLO was developed as a refinement of the concepts of TPLO and addresses some of the issues that could cause complications with TPLO particularly in certain animals. One of the issues with TPLO is that in a lot of dogs the end result is that the load bearing axis of the tibia is moved further away from the anatomical axis of the tibia. CBLO addresses this by inverting the rotation which results in the weight bearing axis being brought into alignment with the anatomical axis.
Your pet is anaesthetised ready for surgery and the area clipped and prepared for sterile surgery. The stifle is approached through a medial incision (inside of the leg). The subcutaneous tissues are dissected and the stifle joint is entered. The joint and menisci are inspected. Damaged menisci are removed and the joint is then closed with high grade synthetic absorbable suture material. Once the joint is inspected the osteotomy is performed. The location of the radial cut is determined from pre operative planning radiographs and the cut made. The proximal segment is then rotated a set distance determined from pre operative radiographs. The rotated segment is then fixed in place with special screws and plates. The wound is closed and post operative radiographs are taken to ensure correct placement of all the implants.
What to expect from CBLO / TPLO surgery
Most studies and our clinical experience has been that over 95% of clients regard results of surgery as “excellent”. Obviously one persons assessment of excellent is different from anothers however our impressions are that there is a more normal function and better long term relief from symptoms achieved with this surgery compared with other treatment options including conservative (i.e. non surgical) management, graft repair or DeAngelis suture repair. Whilst TTA will often have a slightly faster recovery, long term studies indicate CBLO/TPLO has better long term results with fewer complications than TTA particularly in dogs over 30kg or with very steep tibial slopes.
We CANNOT CURE ARTHRITIS!! If your pet has significant arthritic changes in the joint then results will not be as good as if surgery was done earlier. Significant degeneration of the joint can occur in as little as 4-6 weeks! This is why we recommend surgery as soon as possible after injury.
Does my pet need any care after surgery?
We will usually keep your pet in overnight after surgery for monitoring. Your pet will go home the following day and will need to take antibiotics and pain relief medications for 10 to 20 days. To get the best results from the surgery your pet needs to have follow up visits weekly for 4 weeks. At these visits they will receive an injection (Cartrophen) to help the joint recover from surgery. Additionally they will have physiotherapy and you will be given exercises to do with them at home to help with recovery.
We typically expect your pet to be 20-30% weight bearing at 1 week post op, 40-50% weight bearing at 2 weeks post op, 60-70% weight bearing at 3 weeks post op and around 80% weight bearing at a walk 4 weeks post op. If there is meniscal damage then that will typically delay recovery by 1-2 weeks. We do not recommend off leash exercise until radiographs at 8-12 weeks post op show good healing of the osteotomy.
Our fee for CBLO / TPLO surgery is $3500 which includes all pre ad post operative radiographic assessments, post operative visits and physiotherapy program as well as treatment of any complications associated with the surgery. For dogs over 40kg there is an additional fee of $500 to cover the increased costs of medications and implants.