The tibial plateau leveling osteotomy, or TPLO, is a means of stabilizing the canine stifle joint following rupture of the cranial cruciate ligament (provide same link to “Cranial cruciate ligament rupture” under conditions). It was initially developed many years ago by a brilliant veterinarian named Barclay Slocum and his wife, Theresa Divine Slocum. In my hands, it is the best that can be offered for management of a ruptured cranial cruciate ligament in most dogs.
Using this procedure, one essentially reconstructs or reconfigures the stifle joint such that it no longer needs a cranial cruciate ligament. When viewed from the side, the top of the canine tibia (also known as the tibial plateau) is sloped or canted backwards. Hence, when the cranial cruciate ligament is ruptured, the femur will touch the top of the tibia and then slide off of the back of the top of the tibia. By leveling the top of the tibia, the femur will no longer slide off of the back of the top of the tibia when the patient is bearing weight.
The plateau is leveled by making a cut from side-to-side all the way through the tibia just below the knee joint. Upon completion of the cut, one is able to rotate the top of the tibial along the arc of the cut. Once the top of the tibia is rotated sufficiently, it is then held in place using a bone plate and screws. There are different sizes of bone plates and screws that are used depending upon the size of the tibia.