Tibial Plateau Leveling Osteotomy, otherwise known as TPLO surgery, is a common orthopedic procedure used to treat cranial cruciate ligament (CCL) rupture in dogs. Similar to the human ACL, the cranial cruciate ligament (CCL) plays a vital role in stabilizing a dog's knee joint. To find out if the CCL needs surgical repair, the vet will take an X-ray of a specific position of your doggo's knee while under sedation.
This surgery has a high success rate, and some dogs may experience limping or lameness one year or more after surgery. Here are some potential causes for limping after surgery and what you can do to help your doggo.
Timeline Of Recovery
The timeline for repair surgery recovery can vary depending on several factors, including the size, age, and health of the dog, the severity of the CCL rupture, and any concurrent medical conditions. In general, the recovery process can be divided into three phases: the immediate postoperative period, the early recovery phase, and the late recovery phase.
Immediate Post-Operative Period
The immediate post-operative period usually lasts for 24-48 hours, during which the dog is closely monitored in the veterinary hospital. The dog is typically kept in a quiet, warm, and comfortable area with minimal disturbance. Pain medication and anti-inflammatory drugs are administered to help manage pain and reduce swelling.
The dog's leg is usually bandaged, and a protective collar may be fitted to prevent the dog from chewing or licking the incision site. It is important to keep the bandage clean and dry to prevent infection and to check the bandage regularly for any signs of bleeding or oozing.
The veterinary team will typically provide instructions on how to care for the dog during the immediate postoperative period, including the administration of medications, monitoring for any signs of discomfort or distress, and arranging a follow-up appointment.
Early Recovery Phase
The early recovery phase usually lasts for four to six weeks after surgery. During this phase, the dog's activity level is severely restricted to allow the surgical site to heal properly. The dog should be kept in a small, confined space, such as a crate or playpen, to prevent excessive movement.
The dog may require assistance with basic activities such as eating, drinking, and going to the bathroom. It is important to limit the dog's movement to short, controlled leash walks for bathroom breaks only. Any running, jumping, or playing should be avoided entirely.
Pain meds and anti-inflammatory drugs are usually continued during the early recovery phase, and the incision site should be monitored regularly for any signs of infection, such as redness, swelling, or discharge.
Late Recovery Phase
The late recovery phase typically begins around six to eight weeks after surgery, depending on the dog's progress. During this phase, the dog's activity level can gradually be increased under the guidance of the veterinary team.
Short leash walks can be gradually extended to longer walks, and low-impact activities such as swimming or controlled treadmill exercises may be introduced. However, any high-impact activities such as running, jumping, or rough play should still be avoided.
The dog's medication for pain and anti-inflammatory drugs may be gradually reduced or discontinued, depending on the dog's response to therapy. The incision site should continue to be monitored regularly, and any signs of infection or discomfort should be reported to the veterinary team immediately.
Causes of Limping One Year After Surgery
Your veterinarian will take an X-ray at 4 and 8 weeks to make sure the bone is healing correctly, but here are some things that may impede progress and make your doggie limp.
Arthritis
Arthritis is a common complication following surgery. While the surgery itself addresses the ruptured CCL, it does not prevent the development of arthritis in the affected joint. Arthritis is a degenerative joint disease that can cause pain, stiffness, and reduced mobility in affected joints.
Dogs may experience arthritis in the affected joint 12 months or more after surgery, leading to limping or lameness. Arthritis can be diagnosed through X-rays or other imaging tests, and treatment may include medication, supplements, weight management, and physical therapy.
Implant Failure
CCL repair surgery involves the use of implants, such as plates and screws, to stabilize the joint while it heals. While these implants are designed to be long-lasting, they can fail or loosen over time. If an implant fails, it can cause instability in the joint, leading to limping or lameness.
Implant failure can be diagnosed through X-rays or other imaging tests, and treatment may involve the removal or replacement of the failed implant. In some cases, revision surgery may be necessary.
Meniscal Tear
The meniscus is a cartilage structure that helps to cushion and stabilize the knee joint. During surgery, the meniscus may be partially or completely removed to address any damage that may have occurred due to the CCL rupture.
However, even after surgery, the meniscus can be susceptible to injury or tearing, leading to limping or lameness. One of these tears can be diagnosed through imaging tests, and treatment may include surgical repair or removal.
Infection
Infection is a potential complication of this surgery. While infections are typically treated with antibiotics, if left untreated, they can cause significant damage to the joint and surrounding tissue. Infection can cause inflammation, pain, and swelling, leading to limping or lameness.
Infection can be diagnosed through physical examination, imaging tests, or laboratory tests, and treatment may include antibiotics, wound care, or surgical intervention.
Compensatory Issues
After surgery, dogs may compensate for the affected joint by overusing other joints or muscles. This can lead to secondary issues, such as strains, sprains, or muscle soreness. Overcompensating can also lead to altered gait or movement patterns, leading to limping or lameness.
Compensatory issues can be diagnosed through physical examination and gait analysis, and treatment may involve PT or rehabilitation exercises to address any muscle weakness or imbalance.
Swelling
Swelling is a normal part of the healing process after surgery, but excessive swelling can cause discomfort and delay recovery. Swelling can occur around the surgical site, as well as in the surrounding tissues and joints. It is important to monitor swelling closely and to report any excessive swelling or signs of discomfort to the veterinary team.
To manage swelling, the dog may require ice therapy or cold compresses applied to the surgical site, as well as elevating the affected leg. Anti-inflammatory drugs can also help to reduce swelling and pain.
Complications Related To Anesthesia
TPLO surgery requires general anesthesia, which carries some risks, including complications related to the heart, lungs, or other organs. Older dogs, dogs with underlying medical conditions, and dogs undergoing lengthy surgeries may be at higher risk of anesthesia-related complications.
To minimize the risk of anesthesia-related complications, it is important to disclose any pre-existing medical conditions to the veterinary team and to follow their instructions for pre-operative fasting and medication.
If Your Dog Is Limping One Year After Surgery
If your dog is limping one year after surgery, it is important to seek medical care promptly. The first step will be to determine the underlying cause of the limping, which may involve a physical examination, imaging tests, or laboratory tests.
Depending on the cause of the limping, treatment may involve medication, supplements, PT, or surgery. In some cases, a combination of these treatments may be necessary.
It is important to follow your vet's instructions closely, particularly with regard to any rehabilitation exercises or PT. These exercises can help to strengthen the affected joint and prevent future issues.
Preventing Limping After Surgery
While limping eight months to one year after the surgery can occur, there are steps that can be taken to reduce the risk of complications and promote a successful recovery.
Some dogs bounce right back after surgery, but others have different degrees of intermittent limping for some time afterward.
Follow Post-Operative Care Instructions
Following the post-operative care instructions provided by your veterinary surgeon is essential to ensuring a successful recovery after surgery. These instructions may include wound care, medication administration, and rehabilitation exercises. Some pet parents have a room just for their furry loved ones to keep them from jumping or trying to walk too much while they heal; others who don't have an extra room confine their doggos to small areas using furniture or baby gates.
It is important to follow these instructions closely, even if your dog appears to be feeling better. Skipping or altering any of these instructions can lead to complications or delay the healing process.
Managing Pain, Swelling, and Mobility
Effective pain management is essential during surgery recovery, as it can help to reduce discomfort and promote healing. Pain medication, such as opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local anesthetics, can be used to manage pain during the immediate postoperative period and throughout the recovery process.
Medical management to manage swelling includes ice therapy, cold compresses, or elevating the affected leg can be effective. It is important to follow the veterinary team's instructions for using these techniques to avoid damaging the surgical site or causing discomfort to the dog.
Monitor Your Dog's Weight
Maintaining a healthy weight is important for reducing the risk of complications after surgery. Excess weight is one of the things that can put additional strain on the affected joint, leading to increased pain and a slower recovery.
Your veterinarian can provide guidance on managing your dog's weight, including dietary changes and exercise recommendations.
Provide Joint Supplements
Joint supplements, such as glucosamine and chondroitin, can help to support joint health and reduce the risk of arthritis after Tibial Plateau Leveling Osteotomy surgery. Your vet can recommend a high-quality joint supplement and provide guidance on dosing.
Consider Physical Therapy
PT and rehabilitation exercises can help to strengthen the affected joint and reduce the risk of compensatory issues. Your veterinarian can provide guidance on exercises to perform at home or refer you to a veterinary rehabilitation specialist.
Rehabilitation Exercises
Rehabilitation exercises are an essential part of surgery recovery, as they can help to strengthen the affected leg and prevent the development of compensatory issues. Rehabilitation exercises should only be performed under the guidance of a qualified veterinary professional, as improper techniques or excessive force can cause further injury or delay healing.
Some of the most common rehabilitation exercises used during surgery recovery include:
Passive range of motion exercises
Passive range of motion exercises involves gently moving the affected leg through a range of motion without using the dog's own muscles. These exercises can help to maintain joint flexibility and prevent stiffness.
Active range of motion exercises
Active range of motion exercises involves using the dog's own muscles to move the affected leg through a range of motion. These exercises can help to strengthen the muscles and improve joint stability.
Weight-bearing exercises
Weight-bearing exercises involve gradually increasing the amount of weight that the dog places on the affected leg, such as by standing or walking on an incline or decline surface. These exercises can help to improve muscle strength and promote healing.
Hydrotherapy
Hydrotherapy involves exercising in a water-based environment, such as swimming or using an underwater treadmill. Hydrotherapy can provide a low-impact workout that can help to improve muscle strength and mobility.
TPLO surgery is a highly successful orthopedic procedure that can provide long-term relief for dogs with CCL rupture. However, it requires a significant commitment to post-operative care and rehabilitation to ensure a successful recovery. By following the veterinary team's instructions for wound care, pain management, and rehabilitation exercises, owners can help their dogs to heal quickly and comfortably after surgery.
Schedule Regular Check-Ups
Regular check-ups with your veterinarian can help to identify potential issues before they become serious. They can monitor your dog's progress by taking an X-ray and adjusting their treatment plan as necessary.
Limping a year after surgery can occur due to a variety of factors, including arthritis, implant failure, meniscal tears, infection, or compensatory issues. Prompt medical care is essential to determining the underlying cause and developing an appropriate treatment plan.
By following post-operative care instructions, monitoring your dog's weight, providing joint supplements, considering PT, and scheduling regular check-ups, you can help to reduce the risk of complications and promote a successful recovery after the surgery.
Mobility can be a significant challenge during surgery recovery, especially during the early recovery phase when the dog is restricted to a small, confined space. To help maintain mobility and prevent muscle wasting, the dog may require PT or rehabilitation exercises.
It is important to remember that surgery recovery is a gradual process that requires patience and dedication. Dogs may experience setbacks or require additional treatment, and it is important to stay in close communication with the veterinary team throughout the recovery process.
With proper concern, care, and attention, most dogs can return to their normal activities within six months of surgery, including running, jumping, and playing. By working closely with the veterinary team and providing attentive care, owners can help their dogs to regain their mobility and enjoy an active, pain-free life after the surgery.
Contact Laveen Veterinary Center Today
Are you concerned that your dog is suffering from a CCL tear or injury? If so, don't hesitate to contact the Laveen Veterinary Center. If you are looking to extend mobility and improve the well-being of your furry friend, visit our website to make an appointment today. Serving Laveen and the South Phoenix area, we are committed to providing animal care and pride ourselves on treating our animal patients with love, care, and compassion.