TPLO Surgery for Dogs: What Pet Owners Need to Know

If you have heard of an ACL tear in people, you may picture a football player or skier with a sudden injury. Dogs have a similar structure, but their injury is usually very different. In dogs, it is called the cranial cruciate ligament (CCL), and it is the same stabilizing structure commonly called the ACL in people.

In most dogs, a CCL tear is degenerative. The ligament slowly wears out over time until it eventually ruptures. Degenerative does not imply an “old age” disease however, as we have seen it in dogs as young as seven months and as old as 16 years. There is a strong genetic component, which is also why about half of dogs that tear a CCL in one knee will experience the same problem in the other knee within two years.

Once the CCL tears, it cannot heal on its own. Scar tissue will develop around the knee, and once this happens arthritis will start to progress. The knee remains unstable, which will lead to progressive arthritis and ongoing discomfort. With surgery, we can restore stability, reduce the progression of arthritis, and help dogs return to excellent long-term function.

Why TPLO Is the Gold Standard

Tibial Plateau Leveling Osteotomy (TPLO) is widely considered the gold-standard treatment for CCL injury in dogs. It is preferred by 86% of board-certified veterinary surgeons in the United States and is the only surgical or non-surgical treatment proven with objective force-plate data to return dogs to normal walking and running function.

Rather than replacing the damaged ligament, TPLO changes the mechanics of the knee.

The problem: When the CCL tears, the femur can slide across the sloped top of the tibia, causing pain and instability.

The solution: Your surgeon makes a precise curved cut in the tibia, rotates the top of the bone to level the slope, and secures it with a specialized plate and screws.

The result: The knee becomes stable during weight-bearing movement without relying on the damaged ligament.

At Bentonville Veterinary Specialists, TPLO is the procedure we perform most often. Our surgeons have completed more than 4,000 successful TPLO procedures, with an approximately 98% success rate in our hands.

What to Expect on Surgery Day

Most dogs arrive for surgery between 7:00 and 8:00 a.m. after fasting as directed. Before surgery, we review your dog's health information and ensure we have blood work from within the previous 90 days. This helps us confirm that anesthesia and surgery are appropriate for your pet.

During the procedure, we use an epidural to reduce the amount of general anesthesia needed and provide strong pain control. Our team monitors oxygenation, blood pressure, end-tidal carbon dioxide, and EKG throughout anesthesia. Patients are supported with a ventilator during surgery for an added layer of safety. Epidural anesthesia and ventilator support are advanced safeguards more commonly available in specialty settings led by board-certified surgeons, rather than in a typical general-practice surgical environment.

A Facility Designed for Surgical Safety

A specialty surgery center is built around the needs of surgical patients. Dedicated anesthesia personnel, advanced monitoring equipment, and a sterile surgical suite give the team the tools to focus on your dog's safety from induction through recovery.

At BVS, our surgical environment is designed to the same specifications used for human operating rooms, including dedicated sterile spaces and infection-control practices intended to reduce the risk of surgical site infection. These facility-level safeguards — along with a team that works in surgery every day — are not replicated in a general-practice setting.

Once surgery is complete, your surgeon will call you with an update. Many dogs stay overnight so our hospital team can monitor their comfort and recovery through the night. They typically go home the following day.

The First Six Weeks: Strict Rest Is Essential

The first six weeks are the most important part of recovery. Your dog's bone needs time to heal in its new position, so activity must be carefully controlled.

During this period, your dog should have:

• No running, jumping, play, furniture access, or uncontrolled stairs.
• A crate or small room without furniture to jump on or off.
• Short, controlled leash walks only for bathroom breaks.
• An e-collar or lick sleeve at all times for the first 14 days, until stitches are removed.

We see patients at about two weeks to remove stitches and check the incision. We see them again at six weeks for X-rays to confirm that the bone is healing properly. Some dogs benefit from sedatives or anxiety medication during this phase to help them rest safely and comfortably.

Weeks Seven Through Twelve: A Gradual Return to Normal

After six weeks, and once X-rays confirm appropriate healing, your dog can begin a slow return to normal activity. They no longer need to be confined in the home, but exercise should still be structured and controlled.

Over the next six weeks, walks gradually become longer until your dog is building toward a 40-minute walk once daily. In total, recovery is about 12 weeks from surgery to a return to normal activity, but only the first six weeks require strict confinement.

Why Follow-Through Matters

The biggest risks after TPLO are often preventable. Licking at the incision can introduce infection or disrupt healing, which is why the e-collar or lick sleeve is essential until stitches come out. Too much activity too soon can interfere with bone healing, which is why strict rest and follow-up X-rays matter so much.

When dogs follow their recovery plan, the likelihood of returning to normal function is extraordinarily high.

The Bottom Line

A torn CCL can be painful and limiting, but TPLO offers a reliable path back to comfortable, active movement. If your veterinarian has recommended TPLO or you would like a specialist evaluation, our team is here to help. Contact Bentonville Veterinary Specialists at [email protected] or ask your family veterinarian about a referral.