What is the TPLO surgical technique, expected recovery timeline, and reported outcome rates?

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TPLO neutralizes cranial tibial thrust by leveling the tibial plateau via a radial osteotomy, with the proximal segment subsequently stabilized using a TPLO plate and screws to maintain the corrected tibial plateau angle (TPA). The procedure is the most commonly performed and most preferred technique among veterinary surgeons for cranial cruciate ligament (CCL) disease in dogs, with surgeon satisfaction reported at 97.2% in a Veterinary Orthopedic Society survey.6 The core surgical objective is to rotate the proximal tibial segment until the tibial plateau is leveled, eliminating the cranial tibial thrust force generated during weight-bearing. A temporary fixation pin is placed to stabilize the osteotomy segment during rotation; mal-positioning of this pin is a recognized risk factor for tibial tuberosity fracture.3 The absolute tibial tuberosity width (ATTW) — the narrowest mediolateral width of the tibial tuberosity cranial to the osteotomy at the patellar ligament insertion — is a key anatomic variable influencing tibial tuberosity fracture risk.3 Tibial tuberosity fracture occurs in 0.4% to 9% of TPLO cases and frequently necessitates revision surgery.3 In dogs with concurrent medial patellar luxation (MPL) and CCL rupture weighing less than 15 kg, a modified TPLO incorporating medial translation of the proximal tibial segment simultaneously levels the tibial plateau and realigns the quadriceps mechanism. The overall complication rate with this modified technique is 18.4%, compared with 28.9% for traditional repair in the same population, with patellar reluxation occurring in 6.6% versus 8.8%, respectively.1 Healing time does not differ significantly between the two approaches.1 A spherical osteotomy blade variant (S-TPLO) provides three rotational degrees of freedom and can address some tibial deformities that standard TPLO cannot correct, with outcomes reported as comparable to conventional TPLO.4 Overall TPLO complication rates range from 10% to 34%, with low