Procedure Guide
TPLO (Tibial Plateau Leveling Osteotomy)
The gold-standard surgical repair for cranial cruciate ligament rupture in dogs.
TPLO is the most commonly performed surgical treatment for cranial cruciate ligament (CCL) rupture in dogs — the canine equivalent of an ACL tear. Rather than replacing the torn ligament, the surgeon changes the geometry of the tibia so the joint becomes stable without it.
What it is
A TPLO (Tibial Plateau Leveling Osteotomy) involves making a curved cut in the top of the tibia, rotating the bone fragment to level the joint surface, and fixing it in place with a stainless steel or titanium plate and screws. Once healed, the dog can bear weight on the leg without the ligament — the joint biomechanics no longer require it.
When it's needed
- Confirmed cranial cruciate ligament rupture (partial or complete)
- Persistent hind-limb lameness after 4–6 weeks of rest
- Positive drawer sign or tibial thrust on orthopedic exam
- Medium-to-large breed dogs (TPLO is particularly favored for dogs >15 kg)
- Active dogs where rapid return to function matters
Procedure summary
Under general anesthesia, the surgeon performs an arthroscopy or arthrotomy to assess and treat the meniscus, then completes the osteotomy and fixes the bone with a locking plate. The procedure typically takes 90–150 minutes and most dogs are discharged the next day.
Recovery
Strict rest for 8 weeks with controlled leash walks only. Weight-bearing usually returns within days. Radiographic bone healing is confirmed at the 8-week recheck, after which a graduated return to full activity over 4–8 weeks is supervised by the surgical team.
Common questions
How long does a dog take to recover from TPLO?
Most dogs bear weight within days and complete bony healing by 8 weeks. Return to full off-leash activity typically takes 3–4 months with a controlled rehabilitation plan.
Is TPLO better than TTA or lateral suture?
For most medium-to-large active dogs, TPLO has the best long-term outcome data — particularly for return to athletic function and lowest progression of osteoarthritis. Surgeon experience matters more than the technique label, however.
Can both knees be done at the same time?
Bilateral TPLO is offered by some specialist centers when both ligaments are torn, but it significantly extends recovery and is not appropriate for every patient. A specialist can advise.
Find a Specialist
Royal Veterinary College (RVC)
London, United Kingdom
Wear Referrals
Bradbury, County Durham, United Kingdom
Cave Veterinary Specialists
West Buckland, Somerset, United Kingdom
Anderson Moores Veterinary Specialists
Winchester, United Kingdom
Tierklinik Hofheim
Hofheim am Taunus, Germany
Tierklinik Rostock
Rostock, Germany
Vetsuisse Faculty — University of Zurich
Zurich, Switzerland
University of Missouri Veterinary Health Center
Columbia, MO, United States
Global Veterinary Specialists
Houston, TX, United States
Purdue University Veterinary Hospital
West Lafayette, IN, United States
Michigan State University Veterinary Medical Center
East Lansing, MI, United States
Washington State University Veterinary Teaching Hospital
Pullman, WA, United States