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Dog's titanium TPLO implant [1]. TPLO, or tibial-plateau-leveling osteotomy, is a surgery performed on dogs to stabilize the stifle joint after ruptures of the cranial cruciate ligament (analogous to the anterior cruciate ligament [ACL] in humans, and sometimes colloquially called the same).
There are around 200,000 ACL tears each year in the United States. ACL tears newly occur in about 69 per 100,000 per year with rates in males of 82 per 100,000 and females of 59 per 100,000. [65] When breaking down rates based on age and sex, females between the ages of 14 and 18 had the highest rates of injury with 227.6 per 100,000.
Tibial tuberosity advancement (TTA) is an orthopedic procedure to repair deficient cranial cruciate ligaments in dogs. It has also been used in cats. This procedure was developed by Dr. Slobodan Tepic and Professor Pierre Montavon at the School of Veterinary Medicine, University of Zurich, in Zurich, Switzerland beginning in the late 1990s.
Anterior Cruciate Ligament Reconstruction (ACL) surgery is a common intervention. 1 in every 3,000 American ruptures their ACL and between 100,000 and 300,000 reconstruction surgeries will be performed each year in the United States.
There are several ways a dog can tear or rupture the cruciate ligament. Young athletic dogs can be seen with this rupture if they take a bad step while playing too rough and injure their knee. Older dogs, especially if overweight, can have weakened ligaments that can be stretched or torn by simply stepping down off the bed or jumping. [7]
Most PLC injuries accompany an ACL or PCL tear, and can contribute to ACL or PCL reconstruction graft failure if not recognized and treated. [ 47 ] [ 48 ] A study by LaPrade et al. in 2007 showed the incidence of posterolateral knee injuries in patients presenting with acute knee injuries and hemarthrosis (blood in the knee joint) was 9.1%.
Additionally, with the knee in full extension, if valgus stress testing reveals more than 1–2 mm of medial compartment gapping present, a concomitant anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) injury is suspected. [4] [5]
The main goals to achieve during rehabilitation (rehab) of an ACL tear is to regain sufficient functional stability, maximize full muscle strength, and decrease risk of reinjury. [ citation needed ] Typically, three phases are involved in nonoperative treatment - the acute phase, the neuromuscular training phase, and the return to sport phase.