Understanding the Stifle Joint

The stifle is essentially your dog’s knee joint – it’s the equivalent of your knee, located on the back leg where the thigh bone (femur) meets the shin bone (tibia). Just like your knee, it’s a complex joint that allows your dog to bend and straighten their leg for walking, running, and jumping.

The stifle joint is made up of several important parts:

• The bones (femur above, tibia below)
• Cartilage that cushions the joint surfaces
• Two C-shaped pieces of cartilage called menisci that act like shock absorbers
• Several ligaments that hold everything together and provide stability

What Are the Cruciate Ligaments?

Think of the cruciate ligaments as strong rope-like structures inside the knee that cross over each other (that’s why they’re called “cruciate” – it means “cross-shaped”). There are two of them:

• The cranial cruciate ligament (CCL) – this is the one that most commonly causes problems. It runs from the back of the thigh bone to the front of the shin bone and prevents the shin bone from sliding forward.
• The caudal cruciate ligament – this runs the opposite direction and is much less likely to be injured.

What Is Cruciate Disease?

Cruciate disease occurs when the cranial cruciate ligament becomes damaged or tears. This is one of the most common orthopaedic problems we see in dogs. The ligament can either tear suddenly during activity, or more commonly, it gradually weakens and degenerates over time before finally giving way.

When this ligament is damaged, your dog’s knee becomes unstable. The shin bone can slide forward abnormally when weight is put on the leg, which is painful and makes normal movement difficult. This instability also puts extra stress on other parts of the joint, particularly the meniscal cartilages, which can become torn as a result.

What this means for your dog:

• Pain and lameness – your dog will likely be reluctant to put full weight on the affected leg
• Joint swelling – you may notice the knee appears larger than normal
• Muscle wasting – the thigh muscles may become smaller from lack of use
• Long-term arthritis – without treatment, the unstable joint will develop degenerative changes

What Is TPLO Surgery?

A Tibial Plateau Leveling Osteotomy (TPLO) has been recommended as the most appropriate method of surgical treatment for cranial cruciate ligament disease. Many surgical treatment options are available for managing CCL disease, but TPLO is recommended based on the shape and size of your dog’s tibia (shin bone).

How TPLO Works

Instead of replacing the torn ligament, the TPLO changes the way the knee works. During surgery, the veterinary surgeon:

• Makes a curved cut in the top of the shin bone (tibia)
• Rotates that top piece to change the angle of the joint surface (the “tibial plateau”)
• Secures the bone in the new position using a strong metal plate and screws

By changing the slope of the bone, the knee becomes stable when your dog bears weight, even without an intact ligament. During each surgery, a complete assessment of the joint is made to assess the damaged cruciate ligament and the joint menisci (shock-absorbing cartilage pads that provide rotational knee stability).

The goals of treatment are to relieve pain, improve function by stabilisation, and reduce the progression of arthritis. Surgery, in combination with post-operative care and rehabilitation, can significantly improve the outcome and prognosis for dogs with CCL disease.

What to Expect: Success Rates and Recovery

Excellent Long-Term Success Rates

Many studies report very high rates of improvement in limb function after TPLO. One summary article stated that while no technique returns every dog to perfectly normal, most dogs show “85% to 95% improvement” in lameness or comfort.

• Among dogs that compete in agility, one study found 20 of 31 (65%) returned to competition after TPLO; 16 of those (80% of the 20) did so within 9 months
• A long-term (3 year) study showed weight-bearing function improved within 6 months after TPLO and this improvement was maintained through 36 months

Return to Normal Activity

Timeline and Function:

• Most dogs achieve normal walking gait around 8-12 weeks post-surgery
• By 6 months, most dogs achieve full function and stability
• Dogs can return to running, hiking, and playing without significant limitations
• For agility dogs specifically, 65% returned to competition, with 80% returning within 9 months

Activity Progression:

• During days 61-90, dogs can return to normal activity with 30-45 minutes lead walks, off-lead time for 15 minutes, gentle ball games, and playing with other dogs
• From days 91-120, there is further strengthening and full return to normal activity

Long-Term Joint Health

TPLO can reduce the risk of arthritis progression by addressing joint instability early. Dogs treated with TPLO show less pain and mobility issues over time.

What’s Included in TPLO Surgery at Taylor Vets

At Taylor Vets, we ensure there are no hidden costs with our orthopaedic surgeries. Included in the cost of surgery is:

• Pre-anaesthetic blood screen
• Intravenous fluids during the anaesthetic and surgery
• General anaesthesia
• Surgery (including the implants)
• Post-operative medication that may be needed
• Cold pack for post-operative icing and surgical sleeve to keep the wound covered
• Discussion with a Veterinary Nurse on discharge to go through post-operative care
• Re-check at the practice 48 hours after surgery to perform a post-operative check and start post-operative exercises
• Ongoing post-op checks to check your dog’s progress
• Post-operative x-rays (usually 4 weeks after surgery)

Potential Complications

Studies show that approximately 11-20% of dogs experience some form of complication after cruciate surgery. The good news is that most of these are minor and resolve well with appropriate treatment.

Major Complications

Major complications (requiring additional surgery) occur in about 3-7% of cases. These might include:

• Surgical site infections requiring implant removal
• Implant failure or loosening
• Fractures around the surgical site

Minor Complications

Minor complications (managed without surgery) happen in approximately 8-13% of cases and typically include:

• Minor wound healing issues
• Small fractures that heal on their own
• Temporary swelling or bruising

Surgical site infections occur in about 8.5% of procedures, with the majority (about 80%) requiring some form of surgical treatment. However, with proper antibiotic treatment and sometimes implant removal, most infections resolve successfully.

Our Surgical Guarantee

At Taylor Vets we have a surgical guarantee. Should any complications arise, this will be included in the surgical price, if all post-operative care and advice was followed at home.

The Importance of Rehabilitation

We strongly advise rehabilitation before and after this surgery.

Pre-Operative Physiotherapy

Pre-op physiotherapy for TPLO helps ensure your dog enters surgery in the best possible physical condition with stronger muscles, better joint function, and improved comfort – all of which enhance recovery quality and speed after the operation. It aims to:

• Maintain muscle strength – prevents atrophy and weakness from reduced limb use
• Improve joint mobility – keeps the knee flexible and reduces stiffness
• Enhance balance and proprioception – retrains limb awareness before surgery
• Boost circulation and healing – promotes tissue health and reduces swelling
• Reduce pain – through gentle, controlled exercises and modalities like massage or laser
• Prepare dog and owner – familiarises both with handling and post-op rehabilitation exercises
• Provide a baseline – for tracking post-surgery progress

Post-Operative Physiotherapy

Post-operative physiotherapy is essential to ensure proper healing and restore normal limb function after the knee is surgically stabilised. It:

• Promotes safe healing – supports recovery of muscles, tendons, and bone while protecting the surgical site
• Reduces pain and swelling – using gentle movement, massage, cold therapy, and other modalities
• Restores range of motion – prevents stiffness and joint contracture
• Rebuilds muscle strength – progressive exercises help reverse muscle atrophy from pre-surgery lameness
• Improves limb use and gait – retrains normal walking patterns and balance
• Prevents secondary problems – reduces risk of compensatory issues in other limbs or the spine
• Speeds recovery and enhances outcomes – dogs regain function and comfort sooner, improving long-term success of the TPLO