Your dog has ruptured an anterior cruciate ligament (ACL) and the vet advises TPLO (Tibial Plateau Leveling Osteotomy) surgery. But this procedure involves cutting bone and you're worried. Is there something less invasive and is there a cruciate ligament dog alternative to surgery?
Is there an alternative to TPLO surgery, which is to do nothing?
In truth, to do nothing is not recommended. However, there are a few rare exceptions, such as the dog with health problems that mean a long anaesthetic is a big risk. Also, small light dogs may get away with no surgery, but risks arthritis down the line.
What dog owners need to know is that left untreated, the lame dog will eventually improve. This happens because scar tissue forms inside the knee, which helps the dog use the leg to some extent. But this comes with several downsides.
The non-surgical alternatives to TPLO surgery include:
There might be specific aspects of TPLO surgery that worry you, and you might consider surgery if it avoids cutting bone.
Actually, TPLO surgery is a relatively new technique and there are other, older procedures which were used prior to TPLO being available..
This is the least invasive surgery because it doesn't enter the knee joint. This procedure involves the surgeon incising the skin on the outside of the knee. They place a 'figure-of-8' suture outside the joint, in such a way that it stabilizes the joint.
This is a temporary fix that stops the knee slipping long enough for scar tissue to form.
This procedure falls in the middle, when it comes to invasive surgery. It is similar to the extracapsular repair because it involves placing a strong suture outside the knee joint to stabilise it. The difference is the surgeon drills a small hole through the crest of the shin bone, through which the suture is passed. This acts as a strong anchor, giving good stability
This is an older procedure where the surgeon harvests a ligament graft from tissue of the thigh muscle, opens the knee joint, passes the graft through, and sutures it in its new position. The idea here is to replicate the path of the broken cruciate, and stabilize the knee that way.
In truth, the OTT once was the main technique for repairing ruptured cruciates. But now it has fallen out of favour, because TPLO surgery gives better, more reliable results.
And last but not least, similar to TPLO surgery is TTA. This technique is used in large dogs, and does involve cutting bone in order to remodel the knee joint. In truth, the difference between choosing TTA or TPLO surgery is often due to preference of the individual surgeon, with the risks and benefits of both procedures being similar.
So for owners looking for TPLO surgery alternatives, then TTA probably isn't it.
Long story short, TPLO surgery is a major procedure but it's popular for a reason. Once healed the dog has a strong leg and the risk of arthritis is reduced. Whilst there are dog ACL surgery alternatives, these also come with pros and cons. If in doubt, talk to your vet about any concerns as they may be able to either reassure you or suggest an alternative treatment.