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Orthopedic Surgery

Here at the Grinnell Veterinary Clinic we offer multiple types of orthopedic surgeries that consist of:

 

TPLO (Tibial Plateau Leveling Osteotomy)

Fracture Repairs

Luxating Patella 

FHO (Femoral Head Ostectomy) 

Limb Deformities 

Amputations

If your pet is in need of any of these surgeries, please call us at 641-236-4461 and we can help you and talk you through the next steps! 

Tibial Plateau Leveling Osteotomy Procedure at the Grinnell Veterinary Clinic

Here at the Grinnell Veterinary Clinic we offer a surgery for torn Cranial Cruciate Ligaments (CCL) called a Tibial Plateau Leveling Osteotomy (TPLO) done by Michael Foley, DVM. This surgery is the gold standard treatment and is highly effective. It repairs, reshapes, levels and stabilizes the joint. Let's get a little more into it...

The Cranial Cruciate Ligament (CCL)

First let's talk about the ligament itself. The Cranial Cruciate Ligament (CCL) is the primary ligament that is responsible for limiting "cranial drawer" motion. It prevents the shin bone from sliding forward and stopping the knee from twisting abnormally or hyperextending. 

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What happens when the CCL tears?

Second, what happens when the CCL tears? When the CCL has a partial tear or ruptures completely it will cause instability in the joint itself. These tears are generally caused by chronic degeneration of the ligament or trauma.

Chronic degeneration of the CCL ligament is a slow and progressive weakening that happens overtime usually due to pet obesity, immune-mediated diseases or abnormal bone/limb shaping.

​Acute or traumatic cruciate rupture is caused by a sudden twisting injury to the knee joint. This twisting occurs most often when the dog is running and suddenly changes direction, placing most of the body weight on the knee joint.

However your dog tears their CCL, it is painful and left untreated will cause loss of cartilage in the knee joint and this can lead to osteoarthritis and chronic pain. Here is what the surgery consists of and how we can help your pet feel better!

Tibial Plateau Leveling Osteotomy (TPLO)

What is a TPLO and what does it consist of?

 

The TPLO procedure neutralizes the effect of the cranial drawer motion. A special bone cut is make in the top of the tibia and the bone fragment is rotated to reduce the slope of the tibia. This rotation changes the mechanics of the knee, eliminating the need for the cranial cruciate ligament (CCL). A special custom surgical grade titanium plate and locking screws are used to secure the bone fragment in place. Over time the bone segments will heal together to provide life-long stability.

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What can I expect recovery to look like?

Your pet will be on strict exercise restriction with no off-leash activity for 8 weeks post operatively if recovery goes well. Lack of compliance with this recommendation can result in decrease in effectiveness, or even partial or complete failure of the procedure. You will be provided with a recovery and rehabilitation schedule for physical therapy to be performed at home. This allows reintroduction of activity, as well as gradually increasing strength, balance and body awareness during the recovery period, to facilitate your pets return to normal activity after clearance. We will have a few progress visits after surgery to be sure recovery is going well and we will take radiographs of the leg the was operated on to ensure the bone is healing properly. These appointments will most likely be scheduled in 2 week intervals. (2 weeks post op & up to 8 weeks post op).

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What are some good ways that I can prepare my home?

  • A dog crate that is large enough that they can stand up and turn around​

  • A gated off area such as the kitchen

  • Confinement to a room - if surfaces are hardwood, tile, linoleum, etc. they can be very slippery, we suggest that you place some throw rugs with rubber backing or yoga mats on these surfaces to make it easier for your pet to walk around.

 

House Rules:

We don't mean to be sticklers but since recovery is SO important we do have some house rules to better the recovery and help your pet feel and heal the best way they can.

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- No jumping at all! No jumping on/off the bed, no jumping on/off the couch, no jumping on you! Overextension of the knee could compromise the repair of your dog's leg and delay the healing time.

- Stairs:  You will need to use a towel, blanket or belly sling for support on stairs 2-4 weeks after surgery. Your pet should be limited to short flights to get in/out of your house. They will need to be on a short leash and slowly guided up and down 2-3 stairs. If you have stairs in your home please limit your pets access by blocking with a baby gate or something similar. 

- No active play! Refrain from active play wit your pet and do not allow them to play with other animals until your veterinarian tells you otherwise.

What is done for pain control/how much pain will my pet be in?

A very large part of recovery is the pain medication protocol that we use after surgery. Uncontrolled pain can slow down the healing process and delay your pets recovery. We will supply medications to alleviate the post surgical pain. It is very important that you give all the medications as directed so that you r pet is most comfortable. This does not mean that they should have free reign because the "feel good". Your pet still needs to be restricted to avoid compromising the surgery which may lead to prolonged recovery and potentially additional surgeries. After the surgery, your pet is going to limp on the surgically repaired leg for a period of time. This is because your pet has lost muscle and the leg is weaker and may get sore from building muscle as you progress through your program. Your pet should be placing some weight on the surgical leg (even just touching toes to the floor) within 7 days from the date of the surgery. Over the course of the next few weeks the degree of limping should decrease. If your pet is too active during recover, their limp may become more severe. In this case, you should apply ice 3-4 times a day, allow 24 hours of rest and give any prescribed pain medication. Call us if there is no improvement after the 24 hour period.

Week by Week Recovery Program

We will go over a weekly recovery program when you pick your pet up from surgery. It is essential for ensuring your pets recovery. The physical therapy exercises should be started slowly and cautiously. It is best to time these approximately 30 minutes after administering your pets pain medications so they are more comfortable. Please watch for signs of discomfort such as struggling or significant resistance to the exercises. If your pet is stiff and reluctant to allow further manipulation you may need to reduce the amount of physical activity and/or request additional pain medications from us. Your pet may be tentative at first but their comfort level will increase as you progress. 

Rehabilitation Plan

Day 0-14 Post Surgery

The first 48-72 hours your pet may have a bandage on the affected leg, manual therapy can begin as soon as the bandage is removed: 2-3 day following surgery. The following routine should be done daily until your pet is consistently using their leg.

  • Massage and Passive Range of Motion (PROM)

  • Controlled Leash Walks

  • Ice Therapy

  • Heat Therapy

Rehabilitation Plan

Week 2-12 Post Surgery

​The intent of this program is to gradually increase strength, balance and body awareness so that your pet can return to normal activity.

  • Controlled Leash Walks

  • Weight Shifting Exercise

  • Exercises to increase body awareness

  • Cookie Stretches

  • Sit-to-Stand

  • 3 Legged Standing

  • Wading in water (after 2 weeks)

  • Walking in Deep Snow or Tall Grass

  • Swimming (After 8 weeks)

  • Tug

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