How to Keep a Dog Calm After TPLO Surgery
TPLO
X min read
Owners
Learn how to keep your dog calm after TPLO surgery using rest, crate training, and soothing techniques for safe, stress-free recovery.

Why Keeping Your Dog Calm After TPLO Surgery Is So Important
After TPLO surgery, keeping your dog calm is one of the most critical parts of recovery. The bone, plate, and screws need several weeks to heal securely, and any sudden movement or overactivity can disrupt that process. Rest allows tissues to rebuild and the surgical site to stabilize without extra strain.
- Prevents Implant Failure: The metal plate and screws hold the bone in position during healing. Jumping or running too early can loosen or shift these implants, leading to painful setbacks or revision surgery.
- Reduces Swelling and Inflammation: Controlled rest limits joint stress and prevents excess fluid buildup that delays bone fusion.
- Supports Safe Bone Healing: The tibia needs time for callus formation and proper alignment. Calm, limited movement ensures consistent recovery.
- Avoids Reinjury: Dogs often feel better before the bone fully heals, making them eager to move. Restricting activity keeps them from damaging soft tissue or undoing surgical repairs.
- Promotes Mental Stability: A calm environment lowers stress hormones, which supports both physical and emotional healing.
Maintaining your dog’s calm behavior after TPLO surgery is not just about obedience — it’s about protecting the repair and ensuring a smooth, complication-free recovery.
How Long Dogs Need to Stay Calm After TPLO Surgery
The healing process after TPLO surgery requires strict control of movement. Dogs typically need 6–8 weeks of restricted activity before returning to light exercise, though this can vary depending on size, age, and overall health. Remaining calm during this period ensures the bone plate stabilizes and heals properly.
- Initial Rest Period (Weeks 0–6): Dogs should stay confined to a crate or pen with only brief, supervised leash walks for bathroom breaks.
- Gradual Activity Increase (Weeks 6–10): Once X-rays confirm bone healing, your vet may approve gentle walking or light physical therapy.
- Long-Term Transition (After 10 Weeks): Controlled movement replaces full restriction. Activities like swimming or slow leash walks promote strength safely.
- Recovery Variations: Large or older dogs may need longer rest, while smaller breeds often heal faster due to lower joint stress.
- Vet-Guided Plan: Always follow your veterinarian’s recovery schedule and delay activity until your dog’s gait and confidence improve.
Patience during the calm phase prevents reinjury and ensures the surgical repair remains stable throughout the healing process.
Preparing a Safe Recovery Space Before Bringing Your Dog Home
Setting up a calm, controlled environment before your dog returns home is key to a smooth recovery. A secure space prevents accidental slips, jumping, or overexcitement while your dog adjusts to limited movement.
- Choose a Confined Area: Use a crate, playpen, or small gated room to limit running or climbing. Ensure there’s enough room to lie down comfortably.
- Provide Non-Slip Flooring: Mats or rugs prevent your dog from slipping on tiles or hardwood, reducing strain on the surgical leg.
- Use Soft Bedding: Thick, supportive bedding cushions the joint and prevents pressure sores during long rest periods.
- Keep Essentials Close: Place food, water, and toys within easy reach so your dog doesn’t need to move around unnecessarily.
- Minimize Noise and Distractions: Keep the space quiet and away from household traffic to maintain calm behavior.
A well-prepared environment helps your dog feel secure and relaxed, supporting both emotional and physical healing after surgery.
Crate Rest and Confinement Tips After TPLO Surgery
Crate rest is one of the safest ways to control your dog’s activity after TPLO surgery. When used correctly, it supports proper bone healing while reducing stress and the temptation to move too much.
- Purpose of Crate Rest: It restricts movement, preventing your dog from jumping, twisting, or running, which could damage the surgical site.
- Make the Crate Comfortable: Add soft bedding, a familiar blanket, and safe chew toys to make the space relaxing.
- Reduce Stress: Use calming scents or gentle music near the crate to create a peaceful environment.
- Positive Association: Feed meals or offer treats inside the crate so your dog views it as a safe, comforting space.
- Gradual Out-of-Crate Time: Once cleared by your vet, increase supervised movement slowly—starting with short walks or passive exercises.
Proper crate management helps your dog stay calm, safe, and comfortable throughout recovery without feeling isolated.
Using Calming Techniques and Tools After TPLO Surgery
Keeping your dog emotionally calm is as important as restricting physical activity. Calming tools and consistent routines help reduce anxiety during recovery.
- Soothing Sounds: Soft music or white noise masks outside distractions and helps anxious dogs relax.
- Natural Calming Aids: Pheromone diffusers, herbal sprays, or vet-approved supplements can reduce restlessness naturally.
- Predictable Routine: Regular feeding, potty breaks, and gentle interactions give structure and reassurance.
- Gentle Reassurance: Stay near your dog, speak calmly, and avoid sudden handling that could trigger anxiety or pain.
- Avoid Overstimulation: Limit visitors, children, or other pets from crowding your dog during recovery.
Combining environmental control with emotional support keeps your dog relaxed, promoting steady healing and preventing stress-related complications.
Managing Pain and Discomfort to Keep Dogs Calm
Unmanaged pain can make even the calmest dog restless after TPLO surgery. Pain relief not only promotes comfort but also prevents agitation and unwanted movement that could slow recovery.
- Follow Medication Instructions: Administer pain relievers and anti-inflammatories exactly as prescribed by your veterinarian.
- Watch for Signs of Pain: Whining, panting, or licking the surgical site may signal discomfort or medication wearing off.
- Monitor Activity Levels: A calm, comfortable dog rests easily; pacing or agitation may mean dosage adjustment is needed.
- Communicate with Your Vet: If pain persists despite medication, contact your vet before changing any drug schedule.
- Comfort Measures: Provide soft bedding, maintain room temperature, and ensure your dog rests undisturbed.
Consistent pain control encourages relaxation and speeds up healing by keeping stress levels low and mobility safe.
Mental Stimulation Without Physical Strain After TPLO Surgery
A calm mind leads to a calmer body. Mental enrichment keeps your dog engaged during rest without risking physical strain on the operated leg.
- Puzzle Feeders: Interactive feeding toys make mealtime mentally stimulating and extend eating time for restless dogs.
- Low-Impact Toys: Offer safe chew toys that keep your dog occupied without encouraging jumping or chasing.
- Gentle Obedience Training: Teach stationary cues like “stay,” “touch,” or “watch me” using treats and calm praise.
- Scent Games: Hide treats within reach to engage your dog’s nose and brain while keeping activity minimal.
- Supervised Interaction: Spend time nearby to provide emotional comfort and prevent boredom-related anxiety.
Mental stimulation helps reduce frustration during confinement and keeps your dog emotionally balanced throughout recovery.
Walking and Potty Breaks During the Recovery Period
Bathroom breaks must be short, calm, and strictly supervised during TPLO recovery. Controlled leash walks prevent slips, overexcitement, or sudden pulling that could harm the healing leg.
- Use a Short Leash and Harness: A well-fitted harness offers better control without straining the neck or back.
- Keep Walks Brief: Limit outings to 3–5 minutes, just long enough for your dog to relieve itself.
- Stable Ground: Choose grass or rubber mats over slippery concrete or tile surfaces.
- Avoid Stimulation: Steer clear of other dogs, loud noises, or distractions that might trigger sudden movement.
- Assist with Support: Some dogs benefit from a rear-end support sling during early recovery to maintain balance.
Calm, structured potty breaks maintain consistency while protecting the joint from unnecessary stress.
When to Seek Help for Restlessness After TPLO Surgery
Even with care, some dogs may struggle to stay calm during recovery. Persistent anxiety, restlessness, or agitation can interfere with healing and should not be ignored.
- Signs of Anxiety: Constant whining, pacing, or trying to escape confinement may indicate emotional distress.
- Excessive Movement: If your dog repeatedly gets up, circles, or limps after short walks, contact your vet for evaluation.
- Pain-Related Restlessness: Discomfort often shows as panting, licking the leg, or refusing to settle. Pain management adjustments may be necessary.
- Sedation Support: Vets can prescribe mild sedatives or calming medications for dogs who remain overly anxious.
- Separation Anxiety: If your dog becomes distressed when left alone, consider gradual desensitization or temporary companionship support.
Prompt veterinary guidance ensures your dog stays comfortable, safe, and mentally at ease throughout recovery.
Conclusion
Keeping your dog calm after TPLO surgery is just as important as the surgery itself. Controlled rest allows the bone, joint, and surrounding tissues to heal without stress or strain.
- Patience and Structure: A calm, predictable routine reduces anxiety and prevents sudden movements that can harm recovery.
- Balanced Care: Combine physical confinement with emotional comfort—soft bedding, quiet space, and gentle reassurance.
- Veterinary Support: Regular check-ins ensure pain and stress are properly managed throughout the healing period.
By creating a structured, peaceful recovery environment, you’ll help your dog heal faster, stay comfortable, and return to normal activity safely and confidently.
Would you like me to create the meta title, meta description, and SEO slug next for this article, brother?
FAQs
How long should my dog stay confined after TPLO?
Most dogs need to remain confined for 6–8 weeks following TPLO surgery. During this time, movement should be limited to short, supervised leash walks for potty breaks. Your vet will confirm when it’s safe to expand your dog’s space or start physical therapy based on bone healing progress.
Can I leave my dog alone after TPLO surgery?
It’s best to avoid leaving your dog alone for long periods during the first few weeks. Dogs recovering from surgery can become anxious, restless, or try to move too much. If you must step out, keep your dog securely crated or in a small, safe area and use calming aids if recommended.
What if my dog keeps trying to run or jump?
Sudden movements can damage the surgical repair. Redirect energy through mental stimulation—like puzzle feeders or scent games—and keep your dog leashed when outside the crate. If restlessness continues, ask your vet about temporary calming supplements or mild sedatives to prevent setbacks.
Are sedatives safe to help my dog rest?
Yes, but only under veterinary supervision. Your vet may prescribe mild sedatives or anxiety-relief medications for dogs that struggle with confinement. These drugs are safe when dosed correctly and can prevent harmful overactivity that delays recovery.
How can I tell if my dog is in pain or anxious?
Signs include panting, whining, trembling, excessive licking of the incision, or refusing food. Pain and anxiety can look similar, so if you notice these behaviors, contact your vet. They can adjust pain medication or suggest additional calming support to help your dog relax.
Get a Free Poster
Enhance your workspace with a high-quality radiographs reference poster, designed for veterinary professionals. This free physical poster will be shipped directly to you—just fill out the form to request your copy.
Related posts

How to Confine Your Dog Post-TPLO Surgery
Why Confinement Matters After TPLO Surgery
Confinement is one of the most important parts of TPLO recovery. After surgery, your dog’s knee is healing and not yet stable. Limiting movement protects the surgical site and gives the bone, soft tissues, and implant time to settle and heal properly.
Without proper confinement, your dog may jump, run, or twist the leg—movements that can cause serious problems. These actions can lead to re-injury, implant failure, or delayed healing. Even a short burst of energy during the early weeks can undo the surgical repair.
Use a crate, pen, or small room with non-slip flooring to keep your dog calm and safe. Always use a leash when outside, even for bathroom breaks. Proper confinement supports faster healing, reduces pain, and lowers the risk of complications, helping your dog return to normal life sooner.
Choosing the Right Confinement Setup
Crate or Small Room
A crate is one of the safest ways to confine your dog after TPLO surgery. It limits movement while allowing rest in a cozy, secure space. Crates help prevent jumping, running, or sudden twisting that can damage the healing leg.
Choose a crate that’s large enough for your dog to stand, turn around, and lie down comfortably, but not so big that they can run inside it. Use soft bedding and avoid wire flooring. A small, quiet room can also work if the crate feels too restrictive for your dog.
Exercise Pen (X-pen) as an Alternative
An exercise pen (X-pen) is a good option for dogs who don’t do well in crates. It allows more room to stretch while still limiting unsafe movement. Use it only if your dog is calm and not likely to jump or push against the sides.
To make it secure, place it on non-slip flooring and anchor the panels so they don’t move. Avoid putting toys that may cause too much excitement inside. An X-pen works best when placed in a quiet corner of the home, away from distractions.
Baby Gates and Physical Barriers
Baby gates or other barriers can help block off areas like stairs, hallways, or rooms where your dog may try to run or jump. They’re useful when using a small room as a recovery space or to limit access within your home.
Make sure gates are tall enough and securely installed to prevent your dog from pushing them over. Combine gates with closed doors or blocked furniture to create a safe recovery zone that’s quiet, has soft bedding, and keeps your dog close to you while staying confined.
Making the Space Safe and Comfortable
Use Non-Slip Floors
Slick floors like tile or hardwood can be dangerous after TPLO surgery. Dogs recovering from surgery may slip easily, which can strain the healing leg or even damage the implant. To prevent falls, cover the floor with non-slip rugs, yoga mats, or rubber-backed runners.
These give your dog better grip when walking or shifting positions. Make sure mats lie flat to avoid tripping. A stable, slip-free surface gives your dog more confidence to move safely and supports better recovery during the early healing stages.
Remove Hazards and Obstacles
To keep your dog’s recovery area safe, remove anything that could cause injury or discomfort. Take away slippery throw rugs, which can slide underfoot. Watch out for sharp corners, unstable furniture, or clutter your dog could bump into or trip over.
Keep electrical cords out of reach and make sure the area is free from chewable or breakable items. A hazard-free zone gives your dog a calm, injury-free space to rest and heal without the risk of accidents or stress.
Prevent Access to Furniture and Stairs
Jumping on or off furniture and climbing stairs is risky after TPLO surgery. These movements can place too much pressure on the healing leg and lead to setbacks. Use baby gates or closed doors to block off stairs and rooms with couches or beds.
If your dog must use stairs to access the outdoors, consider using a ramp or carry them with proper support. Keeping your dog grounded and away from heights protects the surgical site and helps prevent reinjury.
Add Soft Bedding and Essentials
Comfort is key during recovery. Use soft, supportive bedding to cushion your dog’s joints and help them relax. Orthopedic dog beds or thick blankets work well. Place food and water bowls within easy reach, so your dog doesn’t need to walk far.
Keep the area clean by washing bedding often and wiping up spills. Good hygiene prevents infections and keeps the recovery space fresh. A comfortable, well-stocked setup reduces stress, supports healing, and helps your dog feel calm and cared for.
Managing Daily Routines in Confinement
Always Use a Leash Outside the Confinement Area
After TPLO surgery, always keep your dog on a short leash, even indoors, when outside the recovery space. This includes bathroom breaks or short walks across the house. Dogs can get excited quickly and make sudden movements that may harm the healing leg.
Using a leash helps you control their speed and direction. It also prevents jumping, running, or slipping on smooth floors. Calm, guided movement keeps your dog safe and reduces the risk of re-injury during recovery.
Stick to a Strict Potty Schedule
Maintaining a consistent potty routine helps reduce stress for both you and your dog. Take your dog out at the same times each day using a leash. Always go to the same spot, so they recognize it as their bathroom area. Avoid long walks or distractions.
A set schedule helps regulate their body, keeps outings short, and makes it easier to control their movement. Staying consistent also reduces the chances of indoor accidents and supports a calm recovery environment.
Supervise Whenever Out of Confinement
Your dog should never be out of the recovery area without supervision, even for short periods. No off-leash time is allowed during the early weeks. Watch closely for signs of restlessness, like pacing, whining, or sudden bursts of energy.
These can lead to unsafe movement that may damage the healing leg. Always stay nearby and use a leash to guide them. Close supervision ensures your dog stays calm and safe, giving the surgery site time to heal properly.
Final Tips for a Smooth Recovery
A calm mind is just as important as a healing body. Keep your dog mentally calm by creating a peaceful environment with limited noise and stimulation. If needed, you can introduce safe mental enrichment later in recovery, like puzzle toys or slow feeders, but only with your vet’s approval.
If you have concerns about confinement, such as anxiety or restlessness, talk to your vet. They can suggest calming aids, safe adjustments, or behavior tips to help your dog settle.
As your dog heals, you may need to adjust the recovery space. For example, you can allow more room to stretch or reposition food and water bowls as mobility improves. Always make changes based on your vet’s guidance. Recovery takes time, but with patience, proper care, and the right setup, your dog will be on the path to a healthy, active life again.
Read more about:
- TPLO failure symptoms
- Long-term outcomes of TPLO surgery
- Common causes of limping in dogs post-TPLO surgery
- Preparing for your dog’s TPLO surgery
FAQs
How to keep a dog calm after TPLO surgery?
Keep your dog in a quiet, confined space like a crate or small room. Avoid visitors, loud noises, and playtime. Use soft bedding and stick to a calm routine. If needed, ask your vet about safe calming aids or anxiety support during the early recovery period.
Can I leave my dog alone after TPLO surgery?
Yes, but only if your dog is safely confined in a crate or pen where they can’t jump or move around too much. Make sure they have food, water, and can’t reach the incision. Avoid leaving them alone for long periods, especially during the first week.
Can my dog walk around the house after TPLO?
No, free movement around the house is not safe during early recovery. Your dog should only walk on a leash for short bathroom breaks. Letting them walk freely can risk injury, implant damage, or slower healing. Always supervise and limit movement as advised by your vet.
How long is a dog in pain after TPLO?
Most dogs experience some pain or discomfort for the first 7–10 days after surgery. Pain is usually well managed with vet-prescribed medications. If your dog seems uncomfortable beyond that or shows signs of distress, contact your vet for a recheck or medication adjustment.
X min read

TPLO Surgery for Older Dogs: Is It a Worthwhile Option?
As dogs get older, joint health often becomes a major concern, especially when issues like a torn cranial cruciate ligament (CCL) affect their movement and quality of life. Tibial Plateau Leveling Osteotomy (TPLO) surgery is commonly recommended to treat CCL injuries by stabilizing the knee and restoring function.
For senior dogs, choosing invasive surgery is tough. Consider recovery time, risks, and benefits. Alternatives like therapy, braces, or pain management may not offer the same long-term results. Can older dogs benefit from TPLO surgery, or is a less invasive approach better? Understanding their challenges helps owners decide.
In this article, we will explain why your older dog might need TPLO surgery and why it might not.
What Is TPLO Surgery and How Does It Work?
Tibial Plateau Leveling Osteotomy (TPLO) is a surgery used to treat cranial cruciate ligament (CCL) injuries in dogs. The CCL is crucial for keeping the knee joint stable and preventing the tibia (shinbone) from moving forward relative to the femur (thighbone). When this ligament tears, it leads to instability, pain, and difficulty moving.
In TPLO surgery, the angle of the tibial plateau is adjusted to remove the knee's dependence on the damaged ligament. This involves making a precise cut in the tibia, rotating it to a more stable position, and securing it with metal plates and screws. By realigning the bone, the forces within the joint are spread out, allowing the knee to work properly without causing further damage or pain.
Now let's take a look at some benefits of TPLO.
Benefits of TPLO Surgery for Older Dogs
For older dogs, TPLO surgery provides several life-enhancing benefits, even in their senior years. While age can bring unique challenges, the advantages of this procedure often outweigh the concerns when carefully considered.
1. Improved Mobility and Reduced Pain
TPLO surgery stabilizes the knee joint, significantly reducing the pain caused by a torn cranial cruciate ligament (CCL). For senior dogs, regaining stable and pain-free movement can be transformative. Many older dogs return to activities like walking, climbing stairs, and playing within weeks of recovery, giving them a new lease on life.
2. Prevention of Arthritis Progression
Untreated CCL injuries often lead to arthritis in the knee due to ongoing instability and inflammation. By restoring joint stability, TPLO surgery helps slow or even stop the progression of arthritis. This is especially important for senior dogs, as arthritis can greatly affect their comfort and ability to move.
3. Enhanced Quality of Life
Even for older dogs, maintaining an active lifestyle is crucial to their overall health. TPLO surgery allows them to stay mobile and engaged with their families, improving their mental well-being along with their physical health. Owners often report that their senior dogs show renewed energy and enthusiasm after recovery.
Potential Risks and Complications for Older Dogs
While TPLO surgery provides significant benefits, it's important to consider the potential risks, especially for senior dogs. Understanding these challenges helps us make informed decisions that are tailored to the unique needs of older pets.
Surgical Risks
As with any major surgery, TPLO carries certain risks:
- Infection: The surgical site can get infected. To reduce this risk, many surgeons use advanced techniques like Simini Protect Lavage, a non-antibiotic solution that helps control infection without causing antibiotic resistance.
- Anesthesia Complications: Older dogs are more prone to anesthesia-related issues because of underlying health conditions like heart, liver, or kidney disease. Pre-surgical screenings help reduce these risks.
- Implant Issues: In rare cases, the metal plates and screws used to stabilize the bone might loosen or cause irritation, which may require further treatment.
Post-Surgical Risks
- Stiffness and Reduced Range of Motion: Older dogs might feel stiff after surgery, which can slow down their return to full movement.
- Prolonged Recovery: Healing can take longer in senior dogs due to slower tissue regeneration and age-related issues like arthritis or obesity.
- Age-Related Complications: Conditions like diabetes or chronic inflammation can affect recovery and may need more intensive care.
Slower Recovery Compared to Younger Dogs
Senior dogs often need a longer recovery time, with extra monitoring and rehabilitation. Physical therapy and a controlled exercise plan can help improve results, but patience is essential. Adjusting expectations for the recovery timeline is important to ensure a positive post-surgical experience.
By carefully evaluating these risks and collaborating closely with a veterinary team, we can help older dogs go through surgery and recovery safely, enhancing their quality of life in the long run.
Recovery Expectations and Timeline for Older Dogs
Recovery from TPLO surgery can take longer for older dogs than for younger ones. Understanding the process and setting realistic expectations are important for a successful outcome.
Typical Recovery Stages
- Initial Rest (Weeks 1–2): In the first two weeks, strict rest is crucial to help the bone and surgical site start healing. Dogs may need to be kept in a confined space, like a crate, to prevent too much movement. Swelling and mild discomfort are normal but can be managed with prescribed pain relief and anti-inflammatory medications.
- Controlled Mobility (Weeks 3–6): Gradually reintroduce activity with short, leash-controlled walks. Older dogs might need more encouragement and patience during this stage, as stiffness can make moving difficult at first.
- Strengthening and Full Recovery (Weeks 7–12): By this time, dogs usually regain better mobility. Physical therapy, including range-of-motion exercises, is very helpful for older dogs to rebuild strength and flexibility.
Tips for a Smooth Recovery
- Maintain a Safe Environment: Use non-slip mats and remove obstacles to prevent slips and falls.
- Support Mobility: Ramps and orthopedic beds can help reduce joint strain during recovery.
- Limit Movement: Leash walks and avoiding stairs are crucial to prevent stress on the healing joint.
With proper care and by following the recovery plan, many older dogs can greatly improve their mobility and comfort after TPLO surgery.
Cost of TPLO Surgery: Is It Justified for Older Dogs?
TPLO surgery is a significant financial investment, but it is especially beneficial for active older dogs or those with manageable pre-existing conditions.
Average Costs
The cost of TPLO surgery usually ranges from $3,000 to $6,000, depending on factors like the surgeon’s experience, location, and included services. This cost often includes pre-surgical diagnostics, anesthesia, surgical materials, hospitalization, and follow-up appointments.
Comparing Costs: Surgery vs. Long-Term Alternatives
While non-surgical treatments like braces, medications, or physical therapy might seem cheaper at first, their long-term costs can add up. Managing chronic pain with medications alone can cost $500–$1,000 annually, and braces may require frequent replacements or adjustments.
For dogs with severe CCL injuries, surgery often offers a better cost-benefit ratio. TPLO addresses the root cause of knee instability, potentially removing the need for ongoing medical management and improving the dog’s quality of life.
Success Rates and Real-Life Outcomes
TPLO surgery has high success rates, even for senior dogs. Studies estimate that 85–90% of dogs who undergo TPLO surgery regain near-normal or improved limb function, including senior pets. Although older dogs might take longer to recover, their overall surgical outcomes are similar to those of younger dogs when given proper post-operative care.
We have observed that while younger dogs tend to heal faster, older dogs can achieve similar success rates if conditions like arthritis are managed well. The key is to customize recovery plans to fit each dog's specific needs and abilities.
Signs TPLO Surgery Might Not Be Suitable for an Older Dog
While TPLO surgery can greatly improve mobility for many dogs, it might not be the best choice in certain situations. Recognizing these signs helps us select the safest and most suitable option for older pets.
Indicators Surgery May Not Be Suitable
- Advanced Arthritis: Severe arthritis in the affected joint can limit the benefits of TPLO surgery, as the underlying degenerative changes may still cause discomfort even after stabilization.
- Significant Health Issues: Chronic conditions like heart disease, kidney failure, or uncontrolled diabetes can increase surgical risks and prolong recovery.
- Limited Mobility: If a dog is already frail and has difficulty moving due to age or other conditions, surgery might place unnecessary strain on their overall health.
- Shortened Life Expectancy: In cases where a dog’s life expectancy is significantly reduced due to age or illness, less invasive options may be more humane and practical.
Alternatives to TPLO Surgery for Older Dogs
When surgery isn’t suitable for an older dog, there are several non-invasive alternatives to consider. These options focus on managing pain, improving stability, and enhancing quality of life.
Rest and Physical Therapy
Conservative management often begins with rest, combined with specific physical therapy exercises. These therapies can strengthen the surrounding muscles, improve joint stability, and reduce pain. Hydrotherapy is particularly helpful, as it allows dogs to build strength with minimal strain on their joints.
Braces and Supportive Devices
Knee braces can help stabilize the joint, reducing the sliding motion that causes pain. While braces don’t fix the underlying injury, they can provide immediate relief and are a cost-effective option for less active dogs.
Injections and Medications
- Pain Management: Nonsteroidal anti-inflammatory drugs (NSAIDs) and other pain relievers can reduce inflammation and improve mobility, as prescribed by a surgeon.
- Joint Injections: Treatments like hyaluronic acid or platelet-rich plasma (PRP) injections may help alleviate joint pain and slow degenerative changes. This should be decided by your vet after assessing your dog's health.
Choosing the right approach depends on the dog’s overall health, activity level, and long-term needs.
Conclusion
TPLO surgery can offer significant benefits for many older dogs, including better mobility, less pain, and an improved quality of life. However, it does carry risks, especially for dogs with severe arthritis, major health problems, or limited mobility.
For dogs that aren't good candidates for surgery, alternatives like physical therapy, braces, and pain management can still provide comfort and stability, though with some limitations. Each option has its own considerations regarding effectiveness, cost, and long-term effects.
Ultimately, every dog is unique, and the most important thing is to choose the approach that best supports your pet's health and happiness. Consult your veterinarian to create a plan tailored to your dog's needs and situation, ensuring their later years are as comfortable and fulfilling as possible.
Sources:
X min read

10 Essential TPLO Recovery Tips for Pet Owners
What to Expect After TPLO Surgery
TPLO (Tibial Plateau Leveling Osteotomy) is a surgery used to treat a torn cranial cruciate ligament (CCL) in a dog’s knee. It involves cutting and rotating the top of the tibia to stabilize the joint without needing the ligament.
In the first few days, your dog may have swelling, mild pain, and limited movement. Strict rest is needed during this time. Your vet may also provide pain medication and antibiotics.
In the first few weeks, your dog will start putting more weight on the leg. Short, slow walks and controlled exercises may begin under vet guidance.
By 8 to 12 weeks, most dogs show good improvement, though full bone healing may take up to 4 months.
Every dog heals differently, so regular vet check-ups and follow-up X-rays are important to make sure everything is on track.
Week 1: The Critical Rest Period
1. Keep Your Dog Rested and Safe
The first week after TPLO surgery is all about strict rest. Your dog’s body needs time to start healing the bone and soft tissues. Keep your dog in a crate or a small room with soft bedding to prevent movement.
Avoid stairs, running, or jumping on and off furniture, as these can damage the surgical site. Calm, quiet surroundings help lower stress and reduce the chance of injury. Limiting movement now supports a stronger, smoother recovery later.
2. Manage Pain and Swelling
Your vet will prescribe pain and anti-inflammatory medications—give them exactly as directed to keep your dog comfortable. Never skip doses, even if your dog seems fine. To reduce swelling, use a cold pack wrapped in a towel and gently apply it to the surgical area for 10–15 minutes, 2–3 times a day during the first 48–72 hours.
This helps ease inflammation and supports healing. Always monitor your dog’s response and stop if discomfort increases.
3. Help Your Dog Walk Safely
Only allow your dog to walk when absolutely needed, such as going outside for bathroom breaks. Always use a short leash and walk slowly. You can support your dog’s rear end using a towel or sling under the belly, especially for larger dogs.
This reduces strain on the healing leg. Avoid any sudden movements, pulling, or distractions during walks. Controlled support prevents accidents and keeps pressure off the surgical site while your dog gains confidence in using the leg again.
4. Protect the Surgical Site
To protect the incision, your dog should wear an E-collar (cone) at all times. Licking or chewing at the stitches can lead to infection or wound opening. Check the surgical site daily. Signs of infection include redness, swelling, warmth, discharge, or a bad smell.
If you notice any of these symptoms, contact your vet right away. Keep the area clean and dry—don’t bathe your dog or allow the wound to get wet during this week. Healing starts with protection.
Weeks 2–4: Keeping Recovery on Track
5. Stick to a Calm Routine
During weeks 2 to 4, your dog may start feeling better—but they still need to stay calm. Keep them confined to a crate or small room and always use a leash when taking them outside. Even small bursts of excitement or sudden movements can stress the healing joint.
Try to keep daily routines predictable. Calm, steady days help your dog stay relaxed and reduce the risk of re-injury while the bone and tissues continue to heal.
6. Keep Their Mind Busy
Your dog’s body needs rest, but their brain still needs activity. Use safe, vet-approved chew toys or treat puzzles to keep them mentally engaged. Gentle training with simple commands can also help. Mental stimulation reduces boredom, lowers stress, and can prevent behaviors like barking, whining, or trying to escape confinement.
A mentally calm dog is less likely to make sudden movements, helping their body heal more smoothly during the recovery process.
7. Feed a Healthy Diet
Since your dog’s activity is limited, weight gain can happen quickly. Extra weight puts stress on the healing leg and can slow recovery. Feed a balanced, healthy diet and avoid giving too many treats. Use portion control based on your vet’s advice, and consider switching to a lower-calorie or recovery-specific food if recommended.
Fresh water should always be available. Keeping your dog at a healthy weight supports joint health and makes walking easier as they recover.
8. Create a Healing Environment
Set up a quiet, cozy space for your dog that supports healing. Use soft bedding to cushion their joints and prevent pressure sores. Keep this space away from slippery floors, loud noises, or other pets that may cause stress or excitement.
Avoid busy areas of the home where your dog might feel the need to move around or follow you. A peaceful environment keeps your dog calm, safe, and focused on healing.
After Week 4: Slowly Getting Back to Normal
9. Gradually Increase Movement
After week 4, your dog may start gentle movement, but only with your vet’s approval. Short leash walks and light exercises can begin once healing is confirmed. Signs your dog may be ready include steady walking, good weight-bearing on the leg, and no signs of pain.
Always go slow—avoid running, stairs, or off-leash activity. Controlled movement helps build strength and balance without risking damage to the healing bone or implant. Your vet will guide the right pace.
10. Follow-Up Appointments Matter
Follow-up vet visits are key to a safe recovery. These appointments usually include a physical exam and sometimes X-rays to check how well the bone is healing and if the implant is stable. Your vet will look for signs of infection, swelling, or joint issues like meniscus damage.
They’ll also assess how your dog moves and how much weight they put on the leg. These checkups help decide when to safely increase activity or start physical therapy.
Also read about:
- Common Myths About TPLO Surgery Explained
- TPLO Surgery for Older Dogs: Is It a Worthwhile Option
- Post-Operative Infection in Dogs: Symptoms and Solutions
Conclusion
Recovery after TPLO surgery takes time, patience, and care—but you’re not alone in this journey. The clicking sound you hear may seem worrying, but in most cases, it’s a normal part of healing. With proper rest, safe movement, and regular vet checkups, your dog has a strong chance of making a full recovery.
By following the tips in each stage—from strict rest in week 1 to gentle activity after week 4—you’re giving your dog the best support possible. Watching their behavior, protecting the surgical site, and keeping their mind and body healthy all play a role in a smooth recovery.
Stay consistent, stay observant, and don’t hesitate to reach out to your vet with any questions. With time and the right care, your dog can return to a happy, active life—stronger and healthier than before.
FAQs
How long does TPLO recovery take for most dogs?
Most dogs take about 8 to 12 weeks to recover from TPLO surgery. Full bone healing can take up to 4 months. During this time, rest, follow-up vet visits, and slow return to activity are important to ensure the leg heals properly and gains strength.
Can I leave my dog alone during recovery?
Yes, but only if your dog is safely confined in a crate or small room. Avoid leaving them unsupervised in open spaces where they might jump or move too much. Keep their environment calm and secure to prevent injury during the critical healing period.
What if my dog refuses to rest or stay confined?
If your dog is restless, use calming toys, puzzle feeders, or light training to keep them busy without moving much. Speak to your vet about safe calming aids if needed. Rest is key, so finding ways to reduce energy and stress will help healing.
Is physical therapy needed after TPLO surgery?
Physical therapy isn’t always required but can help many dogs regain strength and movement faster. Gentle exercises, guided walks, or professional rehab sessions improve recovery. Ask your vet if therapy is right for your dog’s age, size, and healing progress.
What signs of infection should I watch for at home?
Watch for redness, swelling, warmth, discharge, or a bad smell at the incision site. Other signs include licking the area, limping, or changes in behavior. If you notice any of these symptoms, contact your vet right away for treatment. Early care prevents bigger issues.
X min read

Preparing for Your Dog’s TPLO Surgery
Schedule a Vet Check-up and Pre-surgery Tests
Before TPLO surgery, your dog needs a full health check-up to make sure they’re strong enough for anesthesia and recovery. This exam helps your vet spot any hidden health issues, such as heart problems or infections, that could increase the risk during surgery.
Your vet will also recommend pre-surgery blood tests. These usually include a complete blood count (CBC) and blood chemistry panel to check for anemia, kidney or liver problems, and signs of infection. These tests help confirm that your dog’s organs are functioning well and can safely handle anesthesia and healing.
In some cases, additional tests like a urinalysis or chest X-rays may be needed, especially for older dogs or those with ongoing health conditions. A thorough pre-surgery check helps avoid complications and gives your dog the best chance for a smooth, successful recovery.
Adjust Your Dog’s Lifestyle Before Surgery
In the weeks before TPLO surgery, it’s important to limit your dog’s movement. Avoid running, jumping, or long walks to prevent further injury to the damaged knee. Too much activity can make the joint more unstable and harder to repair.
Also, focus on managing your dog’s weight. Extra weight puts more stress on the joint and can increase surgical risks. Feed a balanced diet, avoid treats, and follow portion guidelines from your vet. A lighter, calmer dog will have a smoother surgery and faster recovery.
Set Up a Comfortable Recovery Space
Before your dog comes home from TPLO surgery, prepare a safe and quiet recovery space. A crate or small room with limited movement is ideal. Make sure it has soft bedding, good airflow, and is away from stairs or slippery floors.
Keep your dog’s food, water, and any needed supplies within easy reach. Remove furniture or objects they might try to jump on. The goal is to create a calm, low-stress area where your dog can rest, heal, and avoid reinjury during the early recovery weeks.
Read more about:
Safety-Proof Your Home
After TPLO surgery, your dog’s movement will be limited and unsteady, so it’s important to safety-proof your home. Place non-slip rugs or mats on smooth floors like tile or hardwood to prevent slipping and falling. These provide traction and reduce the risk of injury.
Also, remove household hazards such as toys, loose cords, or clutter in walking paths. Block access to stairs using baby gates or closed doors. Creating a safe, simple environment helps your dog move around with less risk and supports a smooth recovery.
Essential Supplies for TPLO Surgery Recovery
Having the right supplies ready can make recovery after TPLO surgery much smoother. A supportive dog harness with a handle helps you safely guide your dog during short walks or bathroom breaks without putting stress on the healing leg.
An Elizabethan collar (cone) is essential to stop your dog from licking or chewing the surgical site, which helps prevent infection.
To keep your dog mentally engaged, use interactive toys like treat puzzles or slow feeders. These keep their mind busy while their body rests, reducing boredom and stress during recovery.
The Night Before Surgery
The night before TPLO surgery, follow your vet’s feeding instructions carefully. Most dogs should not eat for 8–12 hours before surgery to prevent vomiting under anesthesia. However, water is usually allowed up until a few hours before—ask your vet for exact timing.
Prepare any medications your dog will need after surgery, such as pain relievers or antibiotics. Having them ready at home saves time and stress. Make sure your dog’s recovery space is set up, and double-check your appointment time to ensure a smooth, calm start to surgery day.
Planning for Post-surgery Care
Proper planning makes a big difference in your dog’s TPLO recovery. Start by scheduling follow-up vet visits—these are key to tracking healing, checking the surgical site, and adjusting the care plan if needed.
Follow all medication instructions carefully. Giving pain meds and antibiotics on time helps manage discomfort and lowers the risk of infection.
Also, restrict your dog’s activity strictly. No jumping, running, or climbing stairs for several weeks. Always use a leash outside and keep your dog in a confined space indoors to protect the healing knee.
Read more about:
FAQs
How soon can my dog walk after TPLO surgery?
Most dogs can take short, controlled bathroom walks within 24–48 hours after surgery. Always use a leash and follow your vet’s instructions. Avoid free movement, running, or long walks during the first several weeks to protect the healing joint.
Can my dog sleep without the Elizabethan collar?
Only if your dog cannot reach or lick the surgical site. In most cases, the collar should stay on at all times, even during sleep, for at least 10–14 days. Removing it early can lead to licking, which increases the risk of infection.
When should I call my vet after TPLO surgery?
Call your vet if you notice swelling, discharge, foul odor, loss of appetite, vomiting, or signs of pain like whining or limping. Also contact them if your dog stops using the leg completely or if the incision looks red, warm, or irritated.
How long does full TPLO recovery typically take?
Most dogs recover well within 8–12 weeks. However, full bone healing and return to normal activity may take up to 4 months. Follow-up visits and a gradual increase in activity are key to a successful, long-term recovery.
X min read

Bilateral TPLO Surgery Explained
What Is Bilateral TPLO Surgery?
Tibial Plateau Leveling Osteotomy (TPLO) is a surgical procedure used to treat cranial cruciate ligament (CCL) rupture in dogs. Instead of replacing the torn ligament, TPLO alters the tibial plateau angle, stabilizing the knee joint and reducing abnormal movement.
Bilateral TPLO surgery is performed when both knees require correction. Some dogs suffer CCL injuries in both hind limbs, either simultaneously or within a short period. In such cases, a surgeon may recommend performing TPLO on both knees in a single procedure or as staged surgeries.
Large, active breeds like Labrador Retrievers, Rottweilers, Golden Retrievers, and German Shepherds are more prone to CCL injuries due to their size and activity level. Obesity, genetics, and structural predisposition also contribute to ligament degeneration, making bilateral TPLO necessary for some dogs. Early intervention helps restore mobility and prevent long-term joint damage.
When Is Double or Bilateral TPLO Surgery Necessary?
Some dogs develop cranial cruciate ligament (CCL) injuries in both knees, either at the same time or within a few months. This often occurs due to genetic factors, excessive strain on the healthy limb after an initial injury, or progressive ligament wear in both knees. When both knees are unstable, bilateral TPLO surgery is necessary to restore mobility and prevent further joint damage.
Dogs needing bilateral TPLO often show signs like severe limping, difficulty standing up, reluctance to walk or play, and an unusual sitting posture. They may shift their weight excessively, struggling to support themselves on either leg.
Veterinarians determine the need for bilateral TPLO through a detailed orthopedic exam, gait analysis, and imaging tests like X-rays. If both knees are significantly unstable, vets may recommend simultaneous TPLO to correct both knees in one procedure.
However, for older dogs or those with other health issues, a staged approach—operating on one leg first and the other after recovery—may be safer to reduce surgical risks.
Simultaneous vs. Staged TPLO Surgery: What’s the Best Choice?
When a dog needs TPLO on both knees, veterinarians consider two approaches: simultaneous TPLO (operating on both legs at once) or staged TPLO (operating on one leg first and the other after recovery).
Simultaneous TPLO
Simultaneous TPLO offers the advantage of a single anesthesia event and a shorter overall recovery period. Dogs regain balanced mobility faster since both knees heal together.
However, post-surgical care is more challenging because the dog cannot rely on a strong leg for support, requiring owners to provide intensive assistance. Risks include increased surgical stress and a higher chance of post-operative complications like swelling or infection.
Staged TPLO
Staged TPLO involves operating on one knee first, allowing recovery before addressing the second leg. This approach reduces surgical risk, making it ideal for older dogs, those with other health issues, or those struggling with post-surgical pain. However, the overall treatment period is longer, and the dog may continue to experience discomfort in the untreated leg during the recovery phase.
Veterinarians decide the best approach based on factors like the dog’s overall health, weight, pain tolerance, and the owner’s ability to manage post-surgical care.
Large dogs with strong front limbs may handle simultaneous TPLO better, while smaller or weaker dogs may benefit from a staged approach.
Benefits of Doing Bilateral TPLO Surgery at Once
For dogs needing TPLO on both knees, opting for simultaneous bilateral TPLO surgery has several advantages compared to staging the procedures months apart.
- One major benefit is a faster overall recovery period. When both knees are corrected in a single surgery, the dog undergoes just one healing phase rather than two separate ones. This means they can return to normal activity sooner compared to waiting for two rounds of surgery and rehabilitation.
- Another advantage is lower long-term costs. While simultaneous TPLO may have a higher upfront expense, it often reduces overall costs by avoiding duplicate anesthesia, hospitalization, and post-operative care fees associated with two separate surgeries. Pet owners also save on pain medications and follow-up appointments.
- Bilateral TPLO also helps prevent excessive strain on the unoperated leg. When only one knee is repaired first, the dog must rely heavily on the untreated leg, which can worsen ligament damage or lead to muscle imbalances. Simultaneous TPLO eliminates this risk by addressing both knees at once, ensuring balanced weight distribution during recovery.
- Lastly, dogs who undergo bilateral TPLO often experience better mobility post-recovery. When both knees heal together, they regain strength and stability more evenly, allowing for a smoother transition back to normal activities. This approach minimizes long-term joint issues and improves overall quality of life.
For young, healthy, and active dogs, bilateral TPLO surgery can be the best option for a quicker and more effective recovery.
Read more about - Long-Term Outcomes of TPLO Surgery
How Double TPLO Surgery Is Performed
Step 1: Pre-Surgery Preparation
Before bilateral TPLO surgery, veterinarians perform a thorough evaluation, including X-rays to assess the tibial plateau angle and confirm the need for surgery.
Bloodwork ensures the dog is healthy enough for anesthesia. The dog is then sedated, intubated, and placed under general anesthesia. The surgical area on both knees is shaved and disinfected to minimize infection risk.
Step 2: Surgical Process
During the procedure, the surgeon makes an incision over each knee to access the tibia. A specialized oscillating saw is used to cut and rotate the tibial plateau, adjusting its angle to stabilize the joint and eliminate abnormal motion caused by cranial cruciate ligament (CCL) rupture. Once repositioned, a metal plate and screws are secured to hold the bone in place, ensuring proper healing and function.
To reduce the risk of biofilm formation and post-surgical infections, many surgeons use advanced solutions like Simini Protect Lavage. This non-antibiotic lavage solution helps flush out bacteria and prevent biofilm development, significantly lowering the chances of infection and promoting a safer recovery.
Combined with sterile surgical techniques and post-operative antibiotics, these measures enhance healing outcomes and minimize complications.
Step 3: Post-Surgical Stabilization and Suturing
Once both knees are stabilized, the surgeon checks for proper alignment. Soft tissues and muscles are carefully repositioned before closing the incision with sutures or staples. A sterile bandage may be applied to protect the area.
Step 4: Immediate Post-Op Monitoring at the Vet Clinic
After surgery, the dog is moved to recovery and closely monitored for pain, bleeding, or complications. Pain medications and antibiotics are administered, and vets ensure the dog is stable before planning the transition home. Owners receive detailed post-op care instructions for managing pain, mobility, and incision care.
Risks and Potential Complications of Double TPLO Surgery
While bilateral TPLO surgery is highly effective, it comes with risks and potential complications that pet owners should be aware of.
- One significant concern is the risk of infection, which can occur at the surgical site or internally around the implants. Infection risk is minimized by using sterile surgical techniques, prescribing antibiotics, and ensuring proper at-home wound care. Keeping the incision site clean and preventing the dog from licking or biting the sutures is essential for avoiding post-operative infections.
- Another risk is delayed healing, as both legs are recovering at the same time. Unlike a staged TPLO, where the healthy leg supports weight during recovery, dogs undergoing bilateral TPLO may struggle with mobility. Strict activity restrictions, proper pain management, and joint-supporting supplements can help promote faster healing.
- Implant failure or loosening is another complication that may arise, especially in highly active dogs or those with improper post-op care. Excessive movement or jumping can put stress on the surgical plates and screws, potentially leading to implant shifting or breakage. This can require additional surgery to correct.
- Lastly, anesthesia-related risks and post-operative pain are concerns with any major surgery. Though modern anesthetics are generally safe, dogs with underlying health conditions may face complications. Post-op pain is managed with medications, but owners must monitor for signs of discomfort, swelling, or limping.
Following the vet’s post-op care instructions, including strict rest and controlled rehabilitation, significantly reduces these risks and ensures a smoother recovery.
What to Expect After Double TPLO Surgery
First 24–48 Hours: Managing Pain, Limited Movement
Immediately after surgery, your dog will experience grogginess from anesthesia and discomfort from the procedure. Pain management is crucial, with vets prescribing anti-inflammatory medications and opioids for relief.
Movement should be extremely limited, and your dog may need assistance standing or going outside for bathroom breaks. Using a harness or sling can help support their weight. Swelling around the incisions is normal, but excessive redness, oozing, or heat could indicate infection.
First 2 Weeks: Strict Rest, Keeping the Dog Confined
During this period, strict crate rest or confinement in a small, quiet space is essential. Jumping, running, or sudden movements should be avoided to prevent stress on the healing bones.
Short, controlled leash walks for bathroom breaks are allowed, but no excessive movement. The surgical site should be monitored daily for any signs of infection or swelling.
Weeks 3–6: Gradual Improvement, Light Movement
By the third week, mild weight-bearing on both legs should improve, but full activity is still restricted. Short, controlled leash walks (5-10 minutes) may be introduced if the vet approves. Most dogs begin regaining stability, but muscle weakness is common.
Weeks 6–12: Rehab Starts, Monitoring for Complications
With vet approval, rehabilitation exercises such as slow leash walks, underwater treadmill therapy, or passive range-of-motion exercises can begin. Any signs of excessive limping, pain, or swelling should be reported to the vet immediately.
Full Recovery Timeline: When the Dog Can Walk, Run, and Return to Normal
By 12–16 weeks, most dogs can walk comfortably, and by 4–6 months, they regain full mobility, including running and playing. However, high-impact activities should be reintroduced cautiously under veterinary guidance to prevent re-injury.
Read more about - Post-Surgery Recovery After TPLO in Dogs
Pain Management and Medications After Surgery
Managing pain effectively after bilateral TPLO surgery is crucial for a smooth recovery. Veterinarians typically prescribe a combination of NSAIDs (non-steroidal anti-inflammatory drugs), opioids, and supplements to control pain and inflammation.
- NSAIDs (e.g., Carprofen, Meloxicam) help reduce inflammation and swelling. These should always be given with food to prevent stomach irritation.
- Opioids (e.g., Tramadol, Buprenorphine) provide stronger pain relief in the first few days post-surgery, especially when discomfort is severe.
- Joint supplements (e.g., glucosamine, chondroitin, omega-3 fatty acids) support long-term joint health and aid in recovery.
To manage swelling and discomfort, cold therapy (icing the surgical area for 10–15 minutes, 2–3 times a day) can help reduce inflammation. Anti-inflammatory treatments, including prescribed medications and natural supplements, may further support healing.
It’s important to monitor for signs of excessive pain, such as persistent whining, heavy panting, restlessness, refusal to move, or loss of appetite. If your dog shows these symptoms despite medication, or if swelling and redness worsen, contact your vet immediately. Proper pain management not only ensures comfort but also promotes faster recovery and prevents complications.
Importance of Physical Therapy and Rehabilitation
Physical therapy plays a critical role in speeding up healing and restoring mobility after bilateral TPLO surgery. Without proper rehabilitation, dogs may experience muscle atrophy, stiffness, or prolonged discomfort.
Controlled movement helps strengthen the muscles around the knee joints, improves flexibility, and ensures a smoother recovery.
Recommended Rehab Exercises:
- Passive stretching – Gentle range-of-motion exercises help prevent stiffness and improve flexibility. These should be done 2–3 times daily with slow, controlled movements.
- Water therapy (underwater treadmill or swimming) – This is an excellent low-impact exercise that builds strength while reducing stress on the joints. Typically introduced 4–6 weeks post-surgery, if approved by the vet.
- Controlled leash walks – Short, slow walks (starting at 5 minutes per session) encourage weight-bearing and muscle engagement. Walk duration is gradually increased over time.
When to Start Rehab and Frequency:
Most rehab exercises begin around 2–3 weeks post-surgery, depending on the dog’s progress. Sessions should be daily but short to avoid fatigue. A structured rehabilitation plan, guided by a veterinarian or certified canine rehab therapist, ensures the safest and most effective recovery. Proper rehab improves strength, reduces re-injury risks, and helps dogs regain full mobility faster.
Home Care and Activity Restrictions for Recovery
Creating a safe and controlled recovery space is essential after bilateral TPLO surgery. A quiet, confined area with non-slip flooring, soft bedding, and limited space to move helps prevent accidental injuries. Using a crate or a small enclosed area with baby gates ensures your dog stays in a controlled environment while healing.
Restricting movement is crucial in the first 8–12 weeks. Jumping, running, or climbing stairs must be avoided, as sudden movements can put stress on healing bones and implants. Furniture should be blocked off, and leash walks should be strictly supervised.
For mobility assistance, supportive slings or harnesses (such as a rear-lift harness) help dogs stand up, walk for bathroom breaks, and shift weight safely. This is particularly important in the first few weeks when both legs are weak.
Since physical activity is limited, mental stimulation is key to preventing boredom and restlessness. Provide interactive toys, puzzle feeders, and scent-based games to keep your dog engaged without physical strain.
Spending extra time with your dog through gentle petting and calm interaction helps keep them relaxed and comfortable throughout recovery. Careful management ensures a smoother healing process and reduces complications.
Cost of Double or Bilateral TPLO Surgery and Financial Considerations
The cost of bilateral TPLO surgery varies depending on location, veterinary expertise, and hospital fees. In the U.S., the average cost for a single TPLO ranges from $3,500 to $6,000 per knee, meaning bilateral TPLO can cost $7,000 to $12,000. In other regions, such as Canada, the U.K., or Australia, prices may be slightly lower or higher based on veterinary costs and currency differences.
Factors affecting cost include:
- Geographic location – Urban areas with higher living costs tend to have more expensive veterinary services.
- Veterinarian experience – Board-certified surgeons may charge higher fees due to their expertise.
- Hospital fees – Costs for anesthesia, post-op care, medications, and follow-up visits add to the total.
Does pet insurance cover TPLO surgery? Coverage depends on the policy. Many comprehensive pet insurance plans cover TPLO if it’s not a pre-existing condition. Some require a waiting period before covering ligament injuries.
Financing options include payment plans through veterinary clinics, CareCredit, Scratchpay, or pet-specific credit programs to help spread out the cost. Some non-profits and crowdfunding platforms also assist pet owners facing high medical expenses.
Read more about - How Much Does TPLO Surgery Cost?
Final Thoughts on Double or Bilateral TPLO Surgery
Bilateral TPLO surgery is a highly effective solution for dogs with cranial cruciate ligament injuries in both knees. While the procedure requires a significant commitment in terms of cost, recovery time, and post-op care, the long-term benefits—restored mobility, reduced pain, and improved quality of life—make it worth considering for most dogs.
If your dog is struggling with severe knee instability but surgery isn’t an immediate option, consult your vet about alternative treatments like physical therapy, joint supplements, weight management, or custom braces. However, these may only provide temporary relief rather than a permanent solution.
For pet owners navigating this process, patience and commitment are key. Recovery may feel overwhelming, but with proper care and rehabilitation, most dogs return to an active, happy life. Stay in close contact with your vet, follow post-op guidelines, and trust the healing process.
Read more about -
- TPLO failure symptoms
- Common causes of limping in dogs post-TPLO surgery
- Before and after TPLO surgery: Dog health & recovery timeline
- TPLO surgery for older dogs: Is it a worthwhile option?
FAQs
Can a dog have TPLO surgery on both legs?
Yes, a dog can undergo bilateral TPLO surgery if both cranial cruciate ligaments (CCLs) are torn or unstable. This can be done simultaneously or in a staged approach. Simultaneous TPLO addresses both knees in one procedure, while staged TPLO repairs one knee first, followed by the second after recovery. The choice depends on the dog’s health and the surgeon’s recommendation.
How much does bilateral TPLO surgery cost?
The cost of bilateral TPLO surgery varies by location and veterinary clinic. In the U.S., it typically ranges from $7,000 to $12,000 for both knees. Factors such as surgeon expertise, hospital fees, medications, and follow-up care affect the final price. Some pet insurance policies may cover TPLO if it is not a pre-existing condition, and financing options are available at many clinics.
What is the recovery time for bilateral TPLO surgery in dogs?
Full recovery from bilateral TPLO surgery typically takes 12 to 16 weeks. In the first 2 weeks, strict rest and pain management are essential. By weeks 3 to 6, controlled movement starts. Around weeks 6 to 12, rehab exercises begin, gradually improving strength. Most dogs return to normal activity by 4 to 6 months, but high-impact activities should be reintroduced cautiously.
What is bilateral TPLO?
Bilateral TPLO refers to Tibial Plateau Leveling Osteotomy surgery performed on both knees to treat cranial cruciate ligament (CCL) tears. It stabilizes the knee joint by altering the tibial plateau angle, preventing excessive movement. This procedure is common in large, active dogs or those genetically prone to CCL injuries. It can be done simultaneously or in two separate surgeries.
What happens if a dog tears both CCLs?
If a dog tears both cranial cruciate ligaments (CCLs), it may experience severe pain, difficulty standing, and an unstable gait. Without surgery, arthritis and joint degeneration can develop quickly. Treatment options include bilateral TPLO surgery, custom knee braces, weight management, and physical therapy. Surgery is typically the best option for restoring long-term mobility and preventing further joint damage.
X min read

What is TPLO Surgery in Dogs?
Tibial Plateau Leveling Osteotomy (TPLO) is a surgery used to treat cranial cruciate ligament (CCL) tears in dogs. Unlike traditional methods that try to replace or mimic the damaged ligament, TPLO changes how the knee joint works to restore stability.
The procedure involves cutting the top part of the tibia (shin bone) and rotating it to a flatter position. This change reduces the natural forward sliding motion of the femur over the tibia, removing the need for the CCL. A special bone plate and screws hold the new position, allowing the bone to heal over time.
TPLO is considered better than traditional extracapsular repairs, which use artificial sutures to mimic the ligament’s function. Those methods can fail in active or large dogs. TPLO offers better long-term stability, faster recovery, and a lower risk of complications, making it the preferred choice for many veterinarians treating CCL injuries.

Function of the Cranial Cruciate Ligament (CCL)
The Cranial Cruciate Ligament (CCL) is a key stabilizing part of a dog's knee (stifle) joint. It connects the femur (thigh bone) to the tibia (shin bone) and prevents excessive forward movement (tibial thrust) and rotation of the tibia when the dog walks, runs, or jumps. The CCL also helps distribute weight evenly across the joint, reducing stress on cartilage and minimizing wear over time.
When the CCL ruptures, the knee joint becomes unstable. Without this ligament, the femur slides abnormally over the tibia, causing pain, inflammation, and lameness. Dogs with a CCL tear may limp, have trouble bearing weight on the affected leg, and avoid activities like running or jumping. Over time, instability leads to arthritis, worsening discomfort and mobility.
CCL injuries greatly affect a dog's ability to move comfortably. Many dogs compensate by shifting weight to the opposite leg, increasing the risk of injuring the other knee. If left untreated, a torn CCL can cause chronic pain, muscle loss, and permanent joint damage. Surgical intervention, such as TPLO, is often the best option to restore knee function, relieve pain, and help dogs regain an active lifestyle.
Indications for TPLO Surgery: Which Dogs Need It?
TPLO surgery is most commonly recommended for large and active dog breeds, as they are more prone to cranial cruciate ligament (CCL) injuries due to their weight and activity levels.
Breeds like Labrador Retrievers, Golden Retrievers, Rottweilers, German Shepherds, and Boxers are at higher risk. However, TPLO can also be beneficial for medium-sized and small dogs, especially those with persistent knee instability.
Common Symptoms of a Torn CCL
- Limping or favoring one leg, especially after exercise
- Stiffness after resting, particularly in the morning
- Swelling and pain around the knee joint
- Difficulty rising, jumping, or using stairs
- Progressive worsening of lameness over time
When Is TPLO Surgery Necessary?
A veterinary evaluation is essential to determine the best treatment approach. TPLO is typically recommended if:
- The dog is large or highly active, where other repairs may fail
- There is significant knee instability affecting mobility
- Conservative management (rest, pain medication, and physiotherapy) has not improved symptoms
When Conservative Management May Work
For small dogs (under 30 lbs) or older, less active dogs, non-surgical options such as joint supplements, anti-inflammatory medications, weight management, and physical therapy may be considered. However, these methods do not fix the underlying instability, and arthritis will progress over time.
For high-energy or large dogs, TPLO remains the gold standard because it restores stability, allowing them to regain normal movement and minimize arthritis risk.
Mechanism of TPLO Surgery
Tibial Plateau Leveling Osteotomy (TPLO) is a surgery that aims to stabilize the knee joint by changing how the tibia (shin bone) works. Normally, when a dog walks, the femur (thigh bone) slides down the tibia because of the natural slope of the tibial plateau. The cranial cruciate ligament (CCL) stops this forward movement, keeping the knee stable.
How TPLO Alters the Tibial Plateau Angle
In TPLO, a curved cut (osteotomy) is made in the top portion of the tibia, allowing the surgeon to rotate the bone and reduce the tibial plateau angle (TPA) to nearly level (5-7 degrees from 20-30 degrees in most dogs). This new position eliminates the forward sliding motion (cranial tibial thrust) that occurs when the CCL is torn.
Why the CCL Is No Longer Needed
After TPLO, the knee no longer relies on the CCL for stability because the new bone alignment prevents abnormal movement. The femur rests in a neutral position, and weight-bearing forces are transferred evenly across the joint. The cut bone is then stabilized with a metal plate and screws, allowing it to heal in its new position.
Biomechanics in Simple Terms
Before TPLO, a torn CCL allows the tibia to slide forward with each step, causing pain and instability. After TPLO, the adjusted bone alignment prevents this sliding motion, making the knee function normally even without the ligament. This technique is particularly effective in large, active dogs, offering long-term stability and reducing the risk of arthritis progression.
TPLO Surgical Procedure Steps
Pre-Surgical Preparations
Before TPLO surgery, a veterinarian performs a thorough examination, including:
- X-rays of the knee to assess the tibial plateau angle and confirm CCL rupture.
- Blood tests to ensure the dog is healthy for anesthesia.
- Fasting for 8-12 hours before surgery to prevent complications.
- General anesthesia is administered, and the leg is shaved and disinfected.
Step-by-Step Breakdown
- Making the Curved Cut in the Tibia
- A semi-circular osteotomy (bone cut) is made in the upper tibia using a specialized saw. This allows the surgeon to reposition the tibial plateau.
- Rotating the Tibial Plateau
- The cut bone is rotated to reduce the tibial plateau angle from its natural slope (20-30 degrees) to a nearly level position (5-7 degrees).
- This prevents the femur from sliding forward, eliminating the need for the CCL.
- Fixing the New Position
- A metal plate and screws secure the rotated tibial plateau in place. These implants provide stability while the bone heals.
TPLO Surgical Duration and Hospital Stay
- TPLO surgery usually takes 60-90 minutes, depending on the dog's size and the complexity of the procedure.
- Most dogs stay in the hospital for 12-24 hours after surgery for pain management and monitoring.
- Full recovery takes 8-12 weeks, with limited activity and follow-up X-rays to ensure proper healing.
Why TPLO Surgery is Preferred Over Other Methods
TPLO surgery is considered the gold standard for treating cranial cruciate ligament (CCL) injuries, especially in large and active dogs. It provides superior joint stability and long-term success compared to other methods like Tibial Tuberosity Advancement (TTA), lateral suture stabilization, and conservative management.
Comparison with Other Techniques
- Tibial Tuberosity Advancement (TTA)
- Like TPLO, TTA alters knee mechanics but focuses on shifting the patellar tendon’s force rather than leveling the tibial plateau.
- Less effective for severe arthritis or extreme tibial slopes.
- Similar recovery time, but TPLO is often preferred for better long-term stability.
- Lateral Suture Stabilization (Extracapsular Repair)
- Uses an artificial suture outside the joint to mimic the CCL.
- Less reliable in large, active dogs, as the suture can stretch or break over time.
- Suitable for small dogs (<30 lbs) but not ideal for high-energy breeds.
- Conservative Management (Rest, Medication, Therapy)
- Does not restore knee stability, leading to progressive arthritis.
- May be an option for very small or senior dogs, but often results in chronic pain and reduced mobility.
Why TPLO is Preferred
- Higher success rate (~90-95%) with long-term joint stability.
- Faster recovery (dogs can bear weight within days, full recovery in ~12 weeks).
- Best suited for large and active dogs, as it withstands high physical demands better than other methods.
Benefits of TPLO Surgery
Restores Joint Stability for Normal Movement: TPLO surgery eliminates the instability caused by a torn cranial cruciate ligament (CCL) by changing the biomechanics of the knee. By leveling the tibial plateau, the femur no longer slides forward, allowing smooth, pain-free movement. This lets dogs return to normal activities like running, jumping, and playing after recovery.
Reduces Long-Term Arthritis Risk: A torn CCL leads to chronic joint instability, which accelerates cartilage damage and arthritis. TPLO provides permanent knee stability, significantly slowing down the degenerative changes that cause pain and stiffness. While arthritis can still develop, it progresses much slower compared to untreated or poorly repaired injuries.
Faster Recovery Compared to Traditional Repairs: Unlike lateral suture techniques, which rely on an artificial ligament that can weaken or break, TPLO stabilizes the knee through bone healing. Dogs start bearing weight within days after surgery, and most regain normal mobility within 8-12 weeks. This is faster and more reliable than other surgical methods, especially for large, active dogs.
Higher Success Rates and Better Long-Term Outcomes: Studies show TPLO has a 90-95% success rate, with fewer complications and a longer-lasting solution than alternative techniques. Dogs undergoing TPLO generally have a higher chance of returning to full activity, making it the preferred option for high-energy or working dogs.
Potential Risks and Complications of TPLO Surgery
While TPLO surgery has a high success rate, complications can still occur, including:
- Implant Failure (Plate or Screw Loosening) – If a dog is too active too soon, the metal implants can shift or break.
- Bone Fractures – The tibia is weakened during surgery, and excessive strain may cause small fractures, especially in high-energy dogs.
- Delayed Bone Healing – Some dogs, particularly older ones or those with underlying conditions, may take longer to recover.
Post-surgical infections are one of the biggest concerns in orthopedic surgeries, but many veterinary surgeons now use Simini Protect Lavage, a non-antibiotic surgical lavage solution. Simini reduces bacterial contamination and biofilms, lowering infection risks significantly. This makes TPLO surgery safer and helps prevent complications that could delay recovery.
How to Minimize Risks with Proper Post-Op Care
- Strict activity restriction for 8-12 weeks to prevent implant damage.
- Regular vet check-ups and follow-up X-rays to monitor healing.
- Wound care and infection prevention – Keeping the incision clean and using solutions like Simini helps reduce infection risk.
- Controlled physical therapy – Gentle exercises, under veterinary guidance, help regain mobility without stressing the joint.
With the right precautions and the use of advanced infection control methods like Simini Protect Lavage, most dogs recover successfully with minimal complications.
Success Rates and Long-Term Outcomes of TPLO Surgery
High Success Rate and Improved Mobility: TPLO surgery has a 90-95% success rate, making it one of the most reliable treatments for cranial cruciate ligament (CCL) injuries in dogs. Most dogs experience significant pain relief and restored joint stability within weeks. Studies show that 85-90% of dogs regain near-normal function, allowing them to walk, run, and play without limping or discomfort.
Long-Term Prognosis: Can Dogs Return to Normal Activity? For most dogs, TPLO provides a permanent solution, allowing them to return to normal activity levels once fully healed. Large, active, and working dogs particularly benefit from TPLO, as it withstands high-impact movement better than other surgical options. With proper post-op care, arthritis progression is slowed, and joint function remains strong for years.
Cases Where Additional Treatment May Be Needed
While TPLO is highly effective, some dogs may require further treatment, such as:
- Severe pre-existing arthritis – Some dogs may need joint supplements, weight management, or physical therapy for long-term comfort.
- Implant-related complications – Rare cases of plate or screw loosening may require revision surgery.
- Bilateral CCL injuries – If both knees are affected, a second TPLO may be needed once the first knee has healed.
With proper rehabilitation and veterinary follow-ups, TPLO surgery allows dogs to live pain-free, active lives with minimal long-term issues.
Also read more about:
Before and After TPLO Surgery: Dog Health Recovery Timeline
Common Myths About TPLO Surgery Explained
Post-Operative Infection in Dogs: Symptoms and Solutions
Conclusion
In conclusion, Tibial Plateau Leveling Osteotomy (TPLO) surgery is a highly effective treatment for cranial cruciate ligament (CCL) injuries in dogs, especially for large and active breeds. By changing the knee joint's biomechanics, TPLO offers better stability, lowers the risk of arthritis, and allows for quicker recovery compared to traditional repair methods.
Although there are possible risks and complications, proper post-operative care and advanced infection control can reduce these issues. With a high success rate and the ability to restore normal activity levels, TPLO remains the top choice for veterinarians looking to improve the quality of life for dogs with CCL injuries.
FAQs
How long does it take for a dog to recover from TPLO surgery?
Full recovery from TPLO surgery takes about 8-12 weeks. Most dogs start bearing weight within a few days, but strict activity restriction is necessary for proper healing. By 6-8 weeks, follow-up X-rays check bone healing. Gradual return to normal activity happens after 12 weeks, with complete muscle recovery taking up to 6 months in some cases.
Can a dog walk immediately after TPLO surgery?
Yes, most dogs can bear weight on the leg within 24-72 hours after TPLO surgery. However, their movement should be strictly limited to prevent complications. Short, controlled leash walks for bathroom breaks are allowed, but running, jumping, and stairs must be avoided for at least 8-12 weeks to ensure proper healing.
Does TPLO surgery prevent arthritis in dogs?
TPLO surgery does not completely prevent arthritis but significantly slows its progression. By stabilizing the knee joint, TPLO reduces abnormal wear on cartilage, which helps minimize long-term joint damage. However, some arthritis may still develop, especially if the injury was untreated for a long time before surgery.
Will my dog need physical therapy after TPLO surgery?
Yes, physical therapy helps speed recovery and improves mobility. Controlled range-of-motion exercises, underwater treadmill therapy, and strength training can reduce stiffness and rebuild muscle. While not always required, veterinary-supervised rehab improves outcomes, especially in large or highly active dogs.
Can a dog tear the CCL in the other leg after TPLO?
Yes, dogs that rupture one CCL have a 40-60% chance of tearing the other within two years. TPLO surgery helps restore stability in the operated leg, but increased weight-bearing on the opposite limb can strain the remaining CCL. Weight management, joint supplements, and controlled activity can help reduce this risk.
Is Bruising Normal After TPLO Surgery?
Yes, bruising after TPLO surgery is common and occurs due to tissue manipulation, blood vessel disruption, and surgical trauma. Mild to moderate bruising around the incision site typically fades within 1–2 weeks. However, excessive bruising, swelling, or warmth may indicate infection or complications. If bruising worsens or persists beyond two weeks, consult your veterinarian for further evaluation.
X min read

Common Myths About TPLO Surgery Explained
TPLO (Tibial Plateau Leveling Osteotomy) surgery is known as one of the best treatments for cranial cruciate ligament (CCL) tears in dogs, similar to ACL injuries in humans. This surgery has greatly improved outcomes for dogs, allowing them to move freely and live without pain.
Despite its success, there are several myths about TPLO surgery. These misconceptions can cause hesitation in recommending or choosing this procedure, which might delay the best care for dogs in need.
Knowing the facts about TPLO surgery is important for making informed decisions about your dog's health. In this article, we will clear up common myths, providing clear and evidence-based information to help pet owners confidently choose the best care for their furry friends.
Myth 1 - TPLO Surgery Isn't Always Necessary for ACL Tears
While TPLO surgery is the best treatment for CCL tears, it isn't necessary for every case. For mild or partial tears in less active dogs, alternatives like the lateral suture technique or conservative management, including physical therapy and weight management, can be effective. These options are often best for smaller breeds or older dogs with minimal joint instability.
In our experience, TPLO surgery is the best option for active dogs or those with complete ligament tears. This procedure stabilizes the knee by changing the joint's biomechanics, preventing further damage and greatly reducing the risk of degenerative joint disease. For highly active dogs, this stability is essential for maintaining long-term function and quality of life.
Myth 2 - TPLO Surgery is Only for Large Breed Dogs
A common myth we often hear is that TPLO surgery is mainly for large or giant breeds. While it's true that TPLO was initially developed for these dogs due to the biomechanical challenges their size presents, we have found it to be just as effective for small and toy breeds.
For smaller dogs, we adjust the procedure to meet their specific anatomical needs, ensuring precise results. The core principles of TPLO remain the same: restoring joint stability, reducing pain, and preventing further damage. Whether the patient is a 5-pound Chihuahua or a 100-pound Labrador Retriever, the goal is the same—helping them regain full function and enjoy a pain-free life.
Myth 3 - TPLO Surgery is Only Necessary for Show or Performance Dogs
Some pet owners mistakenly believe that TPLO surgery is only for show dogs or high-performance athletes. While these dogs do benefit from the procedure to maintain their competitive edge, the truth is that TPLO is valuable for any dog needing long-term knee stability and pain relief.
In our practice, we perform TPLO surgery on a wide range of canine patients, from household companions to working dogs. This procedure isn't about a dog's role or lifestyle; it's about ensuring they can walk, run, and play without pain. For active family pets, TPLO surgery greatly improves mobility, helping them enjoy a better quality of life well into their senior years.
Myth 4 - Recovery From TPLO is Extremely Difficult
It's natural for pet owners to worry about recovery, but we assure you that with proper care, the process is manageable and the outcomes are very positive. Most dogs start putting weight on the operated leg within a few days after surgery, and most return to nearly normal activity levels by the 12-week mark.
The recovery process follows a structured plan, including controlled activity, regular check-ups, and physical therapy if needed. During the first two weeks, we recommend strict rest to ensure the surgical site heals properly.
Gradual reintroduction of activity follows, guided by specific milestones at 4, 8, and 12 weeks after surgery. Following these protocols reduces the risk of complications and increases the success of the procedure.
In our experience, pet owners who closely follow post-operative instructions often see their dogs recover faster and with fewer challenges.
Myth 5 - TPLO Surgery Carries Significant Risks
One of the most common worries about TPLO surgery is the belief that it carries significant risks. While no surgery is completely without risk, advancements in veterinary medicine have greatly reduced complications, making TPLO surgery a safe and effective option. Improved surgical techniques, advanced tools, and strict cleanliness protocols have significantly improved outcomes for dogs.
To further reduce risks like bacterial contamination and biofilm formation, many surgeons use solutions such as Simini Protect Lavage. This innovative surgical lavage keeps the operating area clean by actively removing contaminants, reducing bacteria, and preventing complications that could slow recovery. By using these advancements, we can confidently provide safer procedures with excellent results.
Myth 6 - Postoperative Pain is Severe
It is a misconception that dogs experience severe pain after TPLO surgery. Postoperative pain is carefully managed using a multimodal approach to ensure patients remain comfortable throughout their recovery. We use a combination of pain-relief methods, including non-steroidal anti-inflammatory drugs (NSAIDs), local anesthetics, and sometimes opioids for short-term relief.
In our practice, postoperative care goes beyond just managing pain. Regular follow-ups, client education, and personalized recovery plans ensure that both the dog and their family feel supported at every stage. With these measures in place, most patients recover comfortably and return to normal activities within the expected timeframe.
Myth 7 - TPLO Surgery is Unreasonably Expensive
A common concern among pet owners is that TPLO surgery is too expensive. While the initial cost of TPLO surgery can range from $3,000 to $6,000, it's important to consider the benefits it offers for a dog's long-term mobility and quality of life. Compared to other procedures like the lateral suture technique, which may cost less initially (around $1,000 to $2,500), TPLO provides much better results, especially for active dogs or those with complete cranial cruciate ligament (CCL) tears.
The cost reflects the procedure's complexity, the surgeon's expertise, and the use of advanced tools. Unlike less durable options that may cause complications or require additional surgeries, TPLO ensures long-term joint stability, slows arthritis, and helps dogs return to an active, pain-free life. Therefore, TPLO is a cost-effective investment in your dog's health and happiness.
Proactive Steps to Ensure a Successful TPLO Surgery
Ensuring a successful outcome from TPLO surgery requires proactive steps and careful attention. Here are the key measures we recommend to pet owners:
Follow Post-Operative Care Instructions
It's crucial to follow the post-surgery care plan provided by your veterinary team. This usually includes managing your pet's activity levels, checking the surgical site for signs of infection, and attending scheduled follow-up appointments. Being consistent and attentive during recovery is essential for optimal healing.
Prevent Infections with Proper Wound Care
Preventing infections is vital for a smooth recovery. If your vet surgeon has used advanced solutions like Simini Protect Lavage during surgery, it can greatly reduce the risk of bacterial contamination and biofilm formation. At home, regularly inspect and clean the incision site as instructed by your veterinarian.
Manage the Dog’s Activity Level During Recovery
Limiting your dog’s physical activity during the first few weeks after surgery is crucial. Keep movement to short, supervised leash walks and avoid running, jumping, or climbing stairs. Gradually reintroduce activity under your veterinarian’s guidance to ensure your dog rebuilds strength safely without risking the surgical repair.
Conclusion
Misconceptions about TPLO surgery can cause unnecessary fear and hesitation, stopping dogs from getting the care they need. By addressing these myths with evidence-based facts, we aim to empower pet owners and professionals to make informed decisions.
Advancements in surgical practices have greatly improved outcomes, reducing risks and enhancing recovery. TPLO surgery continues to be a reliable and effective option for dogs of all sizes and activity levels, offering a path to a pain-free, active life. Always consult your veterinarian for personalized guidance tailored to your dog’s specific needs.
X min read

13 Long-Term Effects of TPLO Surgery on Dogs
Tibial Plateau Leveling Osteotomy (TPLO) surgery is a common procedure used to treat a torn cranial cruciate ligament (CCL) in dogs. This ligament is crucial for stabilizing the knee joint, and when it's damaged, it can cause pain, lameness, and arthritis.
TPLO surgery is very effective in restoring mobility, but many pet owners are curious about its long-term effects. Knowing what to expect years after the surgery can help you provide better care for your dog and make informed health decisions.
In this article, we’ll discuss the potential long-term effects of TPLO surgery, including the benefits, risks, and challenges. By the end, you’ll have a clear understanding of how this surgery affects your dog’s quality of life and what you can do to help them thrive.
1. Improved Mobility and Quality of Life
One of the biggest long-term benefits of TPLO surgery is improved mobility. After recovery, most dogs regain full use of the affected leg and return to activities they enjoyed before the injury. This improvement usually lasts a long time, and many dogs stay active for years after the surgery.
If your dog has trouble walking or playing because of a torn CCL, TPLO surgery can often make a big difference. With less pain and more stability, they can move comfortably. However, it's important to keep an eye on their activity levels, as too much exertion can lead to other joint issues. You might also notice your dog slightly favoring the surgical leg less than the other one as they age, which is completely normal.
2. Risk of Arthritis in the Affected Joint
Arthritis is a common concern after TPLO surgery. While the procedure stabilizes the knee and slows down the progression of arthritis, it doesn't completely eliminate the risk. Dogs with a history of CCL tears often develop arthritis in the affected joint over time, which can lead to stiffness, discomfort, and reduced flexibility.
To reduce the impact of arthritis, it's important to manage your dog's weight, provide joint supplements like glucosamine, and ensure they get regular, low-impact exercise. Activities like swimming or gentle walks can help keep their joints healthy without putting too much stress on the repaired knee.
You can also discuss long-term pain management options with your veterinarian, such as anti-inflammatory medications or physical therapy.
3. Potential for Opposite Leg Injuries
A less-discussed long-term effect of TPLO surgery is the increased risk of a CCL tear in the opposite leg. Studies suggest that up to 50% of dogs who have had TPLO surgery on one leg may experience a similar injury on the other leg within a few years. This often happens because the opposite leg compensates for the injured one during recovery, leading to extra strain.
To reduce this risk, focus on balanced physical therapy and muscle-strengthening exercises after surgery. Keeping your dog at a healthy weight is also important, as extra weight puts more stress on the joints. If your dog does tear the other CCL, the good news is that TPLO surgery can also be performed on the second leg with similar success rates.
4. Long-Term Scar Tissue and Stiffness
Scar tissue formation is a natural part of healing after TPLO surgery. Usually, this tissue helps stabilize the joint and doesn't cause major problems. However, some dogs might feel stiff occasionally, especially in colder weather or after being inactive for a long time.
You can help reduce stiffness by keeping your dog warm in the winter and encouraging gentle movement throughout the day. Joint massages and passive range-of-motion exercises can also improve flexibility. If the stiffness continues or gets worse, consult your veterinarian to check for any complications.
5. Implant-Related Complications
During TPLO surgery, a metal plate and screws are used to stabilize the knee. These implants are meant to stay in place permanently, but in rare cases, they can cause problems. For example, some dogs may develop infections around the implant or experience loosening of the hardware over time.
Signs of implant-related issues include swelling, redness, or limping long after the surgery has healed. If you notice any of these symptoms, it’s important to have your dog checked by a veterinarian. In some cases, the implant may need to be removed, but this is uncommon when the surgery is done correctly.
6. Weight Management Challenges
As we discussed in the sections above, maintaining your dog’s ideal weight is one of the most important long-term considerations after TPLO surgery. Excess weight can strain the repaired knee and increase the risk of arthritis and other joint problems. Unfortunately, some dogs become less active during their recovery, which can lead to weight gain.
To manage this, ensure your dog has a balanced diet with controlled portions. Your veterinarian can recommend a weight management plan tailored to your dog’s needs. Regular exercise, such as swimming or short walks, can also help keep them fit without putting too much pressure on their joints.
7. Joint Mechanics and Biomechanics Over Time
After TPLO surgery, the way your dog's knee joint works changes a lot. The surgery changes the angle of the tibial plateau to stop instability, which can affect how your dog moves. Over time, these changes might lead to different posture or walking patterns.
While these adjustments are usually well-tolerated, it's important to keep an eye on your dog's movement. Any noticeable changes in walking or weight distribution should be checked by a veterinarian to catch potential issues early.
8. Age-Related Factors
Your dog's age at the time of TPLO surgery significantly affects their recovery and long-term outcomes. Younger dogs usually heal faster and regain full mobility more easily. Their bodies are more resilient, making them less likely to develop complications like arthritis or stiffness.
Older dogs, however, may heal more slowly and have a higher chance of developing age-related conditions such as arthritis or joint issues. If your dog is older, your veterinarian might suggest additional pre-surgical tests to check their overall health and customize the recovery plan.
Supplements, weight management, and ongoing physical therapy can further enhance their long-term quality of life, even if they encounter age-related challenges.
9. Infection Risks and Chronic Inflammation
Infections after TPLO surgery are rare but can happen, especially around the surgical implants. Chronic or delayed infections may cause inflammation, discomfort, and even joint instability if not treated.
However, many surgeons now use surgical lavage solutions like Simini Protect Lavage to significantly reduce the risk of infections. These advanced solutions help keep the surgical area sterile, resulting in safer outcomes.
Signs of infection include redness, swelling, warmth, or ongoing limping near the surgical site. If you see any of these symptoms, contact your veterinarian right away. Early treatment can stop infections from getting worse and help ensure a smoother recovery.
10. Ongoing Rehabilitation Needs
TPLO surgery is just the first step in your dog’s recovery. Long-term success often relies on regular rehabilitation and strengthening exercises. Physiotherapy and hydrotherapy are especially effective for improving mobility, rebuilding muscle mass, and reducing joint stiffness.
Your veterinarian might suggest a customized rehabilitation plan that includes specific exercises like sit-to-stand repetitions, controlled leash walks, or underwater treadmill sessions. These activities can help restore muscle strength and balance, ensuring your dog fully uses the affected leg.
Regular follow-ups with a canine physical therapist or vet will ensure the plan adjusts to your dog’s changing needs.
11. Nutritional Considerations for Joint Health
Nutrition is crucial for supporting your dog's joints after TPLO surgery. Veterinarians often suggest adding supplements like glucosamine, chondroitin, and omega-3 fatty acids to your dog's diet. These supplements help maintain cartilage health, improve joint lubrication, and reduce inflammation.
A balanced diet with high-quality protein is also important for rebuilding muscle and supporting overall recovery. If your dog is overweight, a weight management plan guided by a veterinarian is essential to reduce stress on the repaired knee. Always consult your vet before adding any new supplements to make sure they are suitable for your dog's specific needs.
12. Behavioral Adjustments and Anxiety
It's common for dogs to experience behavioral changes, like anxiety or reduced activity levels, after TPLO surgery. Limited mobility during recovery can cause frustration, boredom, or even depression. Dogs that were very active before may find it hard to adjust to temporary restrictions.
To keep your dog mentally engaged, try using puzzle toys, treat-dispensing games, or gentle training exercises that don't strain their knee. Spending quality time with your dog during recovery can also help reduce anxiety. If your dog shows signs of ongoing stress or behavioral changes, consult your veterinarian for advice or consider working with an animal behaviorist.
13. Genetic Predispositions
Certain breeds are genetically more prone to joint problems, which can affect their long-term outcomes after TPLO surgery. For example, large breeds like Labrador Retrievers, Golden Retrievers, and Rottweilers often have a higher risk of developing arthritis or degenerative joint issues as they age. These genetic factors can impact their recovery and increase the chance of future joint instability.
If your dog is a high-risk breed, taking preventive steps is crucial. These include keeping a healthy weight, providing joint supplements, and following a regular, low-impact exercise routine. Regular check-ups with your vet will help detect potential issues early, ensuring your dog remains active and comfortable for as long as possible.
Conclusion
That's all you need to know about the long-term effects of TPLO surgery, which include both benefits and challenges, such as improved mobility and the risk of arthritis or joint degeneration. By actively managing your dog's care—through weight control, balanced exercise, and regular vet visits—you can help them enjoy a high quality of life.
Although challenges like implant wear, muscle loss, or age-related changes may occur, ongoing care and rehabilitation can significantly help in keeping your dog happy and active for years to come.
Sources:
- Six Risk Factors for Arthritis in Dogs - Dog Arthritis Aware
- Arthritis in Dogs: Information and Advice - Guide Dogs UK
X min read

Signs of TPLO Failure in Dogs & When to See a Vet
Tibial Plateau Leveling Osteotomy (TPLO) is a surgery used to treat cranial cruciate ligament (CCL) injuries in dogs. Instead of replacing the damaged ligament, TPLO changes the knee's mechanics by cutting and rotating the tibia to stabilize the joint. This procedure greatly improves mobility and reduces pain, making it one of the most effective treatments for CCL injuries.
While TPLO is often successful, complications can occur. Problems may arise from surgical errors, implant issues, infections, or improper post-operative care. These issues can cause severe pain, lameness, and reduced mobility, requiring immediate attention.
Recognizing symptoms of TPLO failure early is crucial. Pet owners and veterinarians must closely monitor recovery to spot signs of complications. Identifying problems early can prevent further damage, improve treatment outcomes, and sometimes avoid the need for corrective surgery. Being aware ensures a better quality of life for the dog.
Early Warning Signs of TPLO Failure
Recognizing early symptoms of TPLO failure is crucial for timely intervention. While mild discomfort and swelling are normal during the initial recovery period, persistent or worsening symptoms may indicate complications.
Persistent Lameness or Limping
Mild lameness is expected for the first few weeks after TPLO surgery. Most dogs show significant improvement within 8–12 weeks. However, if limping persists beyond this period or worsens, it may signal poor bone healing, implant failure, or an underlying infection.
Signs of concern include the dog favoring the other leg, difficulty bearing weight, or sudden regression in mobility. If the leg does not seem to be healing as expected or if there is no gradual improvement, further veterinary evaluation is necessary. X-rays can help determine if the bone is healing correctly or if complications exist.
Read more about: Common Causes of Limping in Dogs Post-TPLO Surgery
Pain During Movement or Reluctance to Use the Affected Leg
Some discomfort is normal post-surgery, but persistent pain when walking, climbing stairs, or standing up may indicate a problem. If a dog avoids using the leg weeks after surgery or shows hesitation in movement, it could be due to implant irritation, improper bone healing, or inflammation. Pain when touching the leg, vocalization, or a stiff gait are red flags.
A dog that initially improves but later develops increased pain needs urgent assessment. A vet may perform imaging and physical exams to check for implant loosening, joint infections, or soft tissue complications affecting recovery.
Swelling Around the Surgical Site
Mild swelling is expected for a few days post-op but should gradually decrease. If swelling persists, worsens, or becomes firm and painful, it may indicate a complication. Excessive swelling could result from implant irritation, fluid buildup, or infection. If the area feels warm or if swelling is accompanied by lameness, immediate veterinary attention is necessary.
A seroma (fluid accumulation) may require drainage, while severe swelling linked to infection or implant rejection may necessitate medical intervention or revision surgery. Monitoring the surgical site daily helps detect abnormal swelling before it leads to more serious issues.
Signs of Infection (Redness, Discharge, Heat)
Post-surgical infections can occur around the incision or deep within the joint, though they are less common when Simini Protect Lavage is used, as it helps reduce bacterial contamination during surgery. However, infections can still develop due to improper wound care, immune response issues, or implant-related complications.
Early symptoms include redness, swelling, heat, and discharge from the incision site. A foul odor, increased pain, or excessive licking are also concerning. If untreated, infections can spread, leading to implant instability, fever, lethargy, and appetite loss. In severe cases, infection may require implant removal and surgical intervention.
Prompt antibiotic therapy is essential to control bacterial growth. Regular wound monitoring, proper hygiene, and early veterinary attention help prevent minor infections from escalating.
Structural and Mechanical Failures
These complications indicate that the surgical repair is not functioning correctly, leading to ongoing instability and pain. Unlike early post-op discomfort, structural failures can cause long-term mobility issues and may require corrective surgery.
Recurrent Knee Joint Instability
After TPLO, the knee joint should be stable due to the new tibial alignment. However, if a dog shows difficulty walking, wobbling, or an unstable gait, it may signal failed bone healing or implant issues. Instability can result from improper fusion of the cut tibia, loose screws, or excessive strain on the joint.
A dog may shift weight frequently or show reluctance to move, indicating mechanical failure. X-rays and physical exams help confirm whether the joint is unstable. Left untreated, instability can lead to severe arthritis, chronic pain, and reduced mobility, making early intervention critical.
Meniscal Injury or Tear
Meniscal damage is a common complication following TPLO surgery, as this cartilage helps cushion the knee joint. A torn meniscus can occur due to improper knee mechanics or residual instability. Symptoms include a sudden return of lameness, difficulty bearing weight, or a clicking or popping sound when the knee moves.
Dogs may yelp when standing or walking and may become more inactive due to pain. A torn meniscus may require surgical removal or repair to restore function. Without treatment, the condition can worsen, leading to chronic discomfort and long-term joint deterioration.
Post-Operative Meniscal Tear
A meniscal tear can occur at the time of surgery (primary tear) or develop later due to knee instability (secondary tear). A secondary meniscus tear is particularly concerning, as it often happens weeks or months after the initial procedure. This results in immediate pain, limping, and reluctance to move.
Dogs with a new meniscus tear may suddenly regress in their recovery, refusing to put weight on the leg despite previous improvements. Surgical intervention is often required to remove the damaged cartilage and restore comfort. Regular post-op checkups help detect meniscal issues before they become severe.
Implant Loosening, Bending, or Breakage
TPLO implants, including plates and screws, must remain secure for proper healing. If an implant loosens, bends, or breaks, the bone may fail to stabilize, causing pain and mobility loss. Signs include swelling, limping, reluctance to use the leg, or a clicking sensation in the joint. Implant failure can result from improper post-op care, excessive activity, or underlying bone weakness.
Overweight dogs and those resuming activity too soon are at higher risk. X-rays are necessary to confirm implant damage. Severe cases may require revision surgery to replace or secure the implants and restore knee stability.
Advanced TPLO Failure Symptoms
These symptoms indicate severe complications requiring medical intervention. If TPLO failure progresses, a dog may experience chronic pain, loss of function, or permanent joint damage. Early detection is key to preventing irreversible issues.
Delayed Bone Healing or Nonunion
Bone healing after TPLO typically takes 8–12 weeks. However, some dogs experience delayed healing or nonunion, where the bone fails to fuse properly. Causes include poor nutrition, excessive movement, infections, or improper plate positioning.
Dogs with nonunion may show persistent limping, pain, or swelling at the surgical site. X-rays can confirm if the bone is healing correctly. Nonunion requires intervention, such as adjusting activity levels, improving diet, or, in severe cases, revision surgery. If left untreated, it can lead to chronic instability and increased risk of implant failure.
Muscle Atrophy Around the Thigh
Muscle atrophy occurs when a dog avoids using the affected leg, leading to gradual muscle loss in the thigh. Mild atrophy is normal post-surgery but should improve with rehabilitation. However, progressive muscle loss suggests long-term mobility issues, improper healing, or ongoing pain. Dogs with severe atrophy may struggle with balance, fatigue quickly, or rely heavily on the other leg.
Physical therapy, controlled exercise, and pain management help restore muscle strength. If left unaddressed, muscle atrophy can make recovery difficult and reduce overall limb function, leading to permanent weakness.
Recurrent or Persistent Mobility Issues
Most dogs regain near-normal function within a few months after TPLO. However, if mobility issues persist beyond this period, it could indicate implant failure, arthritis, or joint instability. Some dogs may continue limping, struggle with stairs, or hesitate to run and jump. Persistent dysfunction suggests that TPLO did not fully correct the knee mechanics, leading to long-term discomfort.
Chronic instability may also cause secondary joint problems. Veterinary evaluation, including X-rays and orthopedic exams, is needed to determine if additional treatment or revision surgery is required. Without intervention, mobility may decline further, affecting quality of life.
Signs of Implant Failure (Mild Discomfort to Acute Pain)
Implant failure can range from mild discomfort to severe pain. Early signs include persistent limping, swelling, and difficulty bearing weight. If an implant loosens or breaks, symptoms can suddenly worsen, causing acute distress, refusal to move, or vocalization when walking. Clicking or grinding noises may also indicate implant instability.
Severe cases require urgent veterinary care, as implant failure can lead to bone fractures or infection. X-rays confirm implant integrity, and treatment may involve pain management, restricted movement, or surgical revision. Delayed care increases the risk of complications, making early detection crucial.
Potential Need for Revision Surgery
Revision TPLO surgery is necessary when the original procedure fails due to nonunion, implant failure, or chronic instability. This involves replacing damaged implants, repositioning the tibial cut, or addressing infections. Revision surgery is often more complex than the initial procedure and requires strict post-op management.
Recovery may take longer, but successful revision can restore knee stability and improve function. If left untreated, TPLO failure can result in chronic pain, severe arthritis, or loss of mobility. A thorough veterinary evaluation determines if revision surgery is the best option for improving the dog’s quality of life.
When to See a Veterinarian
Pet owners should contact a veterinarian if their dog shows signs of worsening pain, persistent lameness beyond 12 weeks, or sudden regression in mobility after initial improvement.
Other concerning symptoms include swelling that does not subside, redness or discharge from the surgical site, difficulty bearing weight, or signs of infection like fever and lethargy. Any clicking or grinding sounds from the knee may indicate meniscal damage or implant instability, requiring immediate attention.
To confirm TPLO failure, veterinarians use diagnostic tests such as X-rays to assess bone healing and implant positioning, CT scans for detailed imaging of the knee structure, and joint fluid analysis to detect infections or inflammation. In severe cases, additional tests may be needed to evaluate soft tissue damage.
Early veterinary intervention can prevent further complications, reducing the need for complex revision surgery and ensuring a better long-term outcome for the dog.
Preventing TPLO Failure
Proper post-operative care is essential for preventing TPLO failure and ensuring a smooth recovery. Strict activity restriction is crucial in the first 8–12 weeks—dogs should avoid running, jumping, or using stairs. A knee brace may provide additional joint support, especially for highly active dogs. Physical therapy helps restore strength and mobility while minimizing the risk of complications.
To promote proper healing, a nutrient-rich diet with adequate protein, calcium, and joint supplements (such as glucosamine) supports bone repair. Regular follow-up vet visits allow for X-ray monitoring to confirm bone fusion and implant stability.
Recognizing early red flags—such as persistent limping, swelling, or signs of infection—can prevent serious complications. Pet owners should check the incision site daily and report any unusual symptoms.
By following post-op guidelines and addressing concerns promptly, the risk of TPLO failure can be significantly reduced, leading to a successful recovery and long-term joint stability.
Read more about:
- Long-term outcomes of TPLO surgery
- Common myths about TPLO surgery explained
- Long-term effects of TPLO surgery on dogs
- Post-surgery recovery after TPLO in dogs
- TPLO surgery for older dogs: Is it a worthwhile option?
Conclusion
TPLO surgery is usually successful, but failures can happen due to improper healing, implant problems, or post-operative complications. Key symptoms of TPLO failure include:
- persistent lameness
- swelling
- pain during movement
- joint instability
- signs of infection
Structural issues like implant loosening, meniscal tears, or delayed bone healing can further hinder recovery.
Early detection is crucial—addressing warning signs quickly can prevent serious complications and reduce the need for additional surgery. Regular vet checkups, diagnostic imaging, and close monitoring of mobility help catch problems before they worsen.
Strict adherence to post-op care is essential in preventing TPLO failure. Pet owners should limit activity, ensure proper nutrition, and follow rehabilitation plans as advised by their veterinarian. By recognizing symptoms early and sticking to recovery guidelines, pet owners can improve their dog’s chances of a successful TPLO outcome and long-term mobility.
FAQs
What happens if TPLO fails in dogs?
If TPLO fails, the affected leg may remain unstable, leading to chronic pain, persistent lameness, and arthritis. The knee joint may not heal properly, causing difficulty in movement. In severe cases, implant failure or bone nonunion may require revision surgery to correct the issue. If left untreated, TPLO failure can significantly impact a dog’s mobility and overall quality of life.
What percent of TPLO surgeries fail?
TPLO has a high success rate, with over 90-95% of dogs recovering well. However, failure can occur in 5-10% of cases due to infections, implant loosening, meniscal injuries, or delayed bone healing. Factors like improper post-op care, excessive activity, or underlying health conditions increase the risk. Early detection and proper recovery management can reduce complications and improve surgical outcomes.
How to tell if a dog's ACL surgery failed?
Signs of TPLO failure include persistent limping, swelling, pain, and reluctance to use the affected leg beyond the expected recovery period. Clicking sounds in the joint, excessive stiffness, or visible implant issues may also indicate failure. If a dog’s condition worsens instead of improving, a vet should perform X-rays or CT scans to assess healing and detect complications.
Why is my dog limping 2 years after TPLO surgery?
Limping two years post-TPLO may result from arthritis, implant irritation, meniscal damage, or muscle atrophy. Some dogs develop scar tissue or secondary joint issues that cause discomfort. If limping is sudden, it could indicate a late meniscus tear or implant problem. A veterinary exam, including imaging, can determine the cause and guide appropriate treatment, such as pain management or revision surgery.
What does a failed TPLO look like?
A failed TPLO often presents as persistent pain, joint instability, swelling, or difficulty bearing weight on the affected leg. Dogs may show progressive lameness, reluctance to move, or audible joint clicking. Severe cases may involve implant loosening, infection, or nonunion of the bone, which can be confirmed through X-rays or CT scans. Early intervention is crucial to prevent worsening complications.
Can TPLO surgery be redone?
Yes, revision TPLO surgery can be performed if the initial procedure fails. This may involve removing or replacing implants, repositioning the tibial cut, or addressing infections. Revision surgery is often more complex and requires strict post-op care. In some cases, alternative treatments like custom knee braces or joint fusion procedures may be considered if TPLO cannot be successfully redone.
What is the alternative to TPLO on dogs?
Alternatives to TPLO include Lateral Suture Stabilization (Extracapsular Repair), Tibial Tuberosity Advancement (TTA), and CBLO (Cora-Based Leveling Osteotomy). These procedures also stabilize the knee but may be better suited for smaller dogs or specific cases. Non-surgical options like custom braces, weight management, and physical therapy may help in mild or inoperable cases, though they do not provide the same level of stability as TPLO.
How long can a dog go without TPLO surgery?
Dogs with a torn CCL can survive without TPLO, but untreated ligament injuries lead to chronic pain, arthritis, and joint deterioration. Some small or inactive dogs may adapt with braces, weight control, and pain management, but larger, active dogs usually require surgery for long-term stability. Without intervention, progressive joint damage can severely impact mobility, making walking difficult or painful over time.
X min read

Does Pet Insurance Cover TPLO Surgery in Dogs?
Understanding TPLO Surgery and Why It’s Needed
Tibial Plateau Leveling Osteotomy (TPLO) is a surgical procedure used to repair a torn cranial cruciate ligament (CCL) in dogs — a common injury that causes pain and hind limb instability. The surgery reshapes the tibia bone to restore stable joint movement without depending on the damaged ligament.
- Purpose of TPLO Surgery: Recommended for active or large-breed dogs where conservative treatments cannot restore function.
- Recovery Period: Most dogs need 8–12 weeks for bone healing, followed by controlled physical therapy for full recovery.
- Cost Overview: TPLO surgery is one of the more expensive orthopedic procedures, often ranging from $3,000 to $6,000 depending on clinic and location.
Understanding these basics sets the stage for evaluating insurance coverage options.
Average Cost of TPLO Surgery for Dogs
TPLO surgery is a complex orthopedic procedure, and its cost varies widely based on case difficulty, hospital standards, and regional pricing. Understanding the range helps owners plan financially before exploring insurance options.
- National Cost Range: In the U.S., TPLO surgery typically costs between $3,000 and $6,000 for a single leg. In some specialty hospitals or metropolitan areas, costs can exceed $7,000, especially for large breeds.
- Simple vs. Complex Cases: Minor ligament tears with minimal complications are less costly, while complex fractures, bilateral surgeries, or infections increase total expenses significantly.
- Influence of Dog Size: Larger dogs require stronger plates, longer anesthesia, and extended recovery monitoring, leading to higher bills.
- Hospital and Surgeon Type: Referral centers and board-certified surgeons charge more due to specialized equipment and experience.
- Follow-Up and Rehabilitation: Post-surgical care, including X-rays and physiotherapy, can add $500–$1,500.
Because of these high expenses, many pet owners consider insurance coverage essential to make TPLO surgery affordable without compromising care quality.
Does Pet Insurance Cover TPLO Surgery?
Most modern pet insurance plans do cover TPLO surgery, but eligibility depends on policy terms and your dog’s medical history. The key factor is whether the cruciate ligament injury is considered pre-existing.
- General Coverage Rule: If your dog’s CCL injury occurs after the waiting period and is not pre-existing, TPLO surgery is usually included under accident or illness coverage.
- Waiting Periods: Many insurers enforce a 6–12 month waiting period for cruciate ligament coverage to prevent claims on undiagnosed injuries.
- Plan Type Differences: Comprehensive plans with illness and injury coverage are most likely to include TPLO, while accident-only policies may exclude it.
- Common Exclusions: Some policies do not cover congenital joint disorders or prior CCL injuries in the opposite leg.
- Importance of Documentation: Detailed veterinary records proving the injury is new are often required for claim approval.
In most cases, TPLO is covered when the policy is active before the injury, making early insurance enrollment a smart preventive decision.
How Pre-Existing Conditions Affect TPLO Coverage
Pre-existing conditions are the most common reason pet insurance denies TPLO-related claims. Understanding what qualifies as “pre-existing” helps you protect your dog’s future eligibility.
- Definition of Pre-Existing Conditions: Any medical issue diagnosed or showing symptoms before policy activation or during the waiting period is considered pre-existing.
- Prior Cruciate Ligament Injuries: If your dog previously tore a CCL or ACL in either leg, many insurers exclude future coverage for both knees under a bilateral condition clause.
- Breed Predisposition: Large or active breeds prone to ligament tears may face stricter review before approval.
- Importance of Early Enrollment: Getting insurance while your dog is young and injury-free ensures eligibility for full cruciate coverage later in life.
- Proof of Clean Health Record: Regular vet visits and medical documentation help verify no pre-existing issues existed at policy start.
Early planning and transparent medical history are crucial for securing TPLO coverage when unexpected injuries occur.
What Pet Insurance Typically Covers for TPLO Surgery
When TPLO surgery is approved under your insurance, most plans cover a wide range of medical services related to diagnosis, treatment, and recovery. This support can significantly reduce financial stress.
- Diagnostic Imaging: X-rays, CT scans, or MRIs used to confirm ligament rupture are usually included in coverage.
- Surgery and Hospitalization: The main surgical procedure, anesthesia, and hospitalization costs are covered up to policy limits.
- Post-Surgery Medications: Pain relievers, antibiotics, and anti-inflammatories prescribed during recovery are typically reimbursable.
- Physical Therapy: Many plans include hydrotherapy or physiotherapy sessions for rehabilitation under extended recovery benefits.
- Follow-Up Visits and Complications: Recheck exams, wound care, or treatment of infections that occur after surgery are generally included within your policy’s time and cost caps.
Comprehensive coverage ensures your dog’s TPLO treatment is managed safely from diagnosis through recovery, minimizing both physical and financial strain.
What’s Not Covered by Pet Insurance for TPLO Surgery
Even though many pet insurance plans include TPLO coverage, certain conditions and costs fall outside standard policies. Knowing these exclusions helps prevent surprises during reimbursement.
- Pre-Existing Injuries: If your dog showed signs of a cruciate tear before enrollment or during the waiting period, TPLO surgery won’t be covered.
- Bilateral Exclusion Clauses: Some insurers exclude the second knee once one cruciate injury occurs, even if it happens years later.
- Preventive or Elective Procedures: Pre-surgical screenings, optional rehab sessions, or supplements are often excluded from reimbursement.
- Rehabilitation Limits: Physiotherapy or hydrotherapy may only be covered for a set number of weeks or up to a cost cap.
- Deductibles and Co-Pays: Owners are responsible for annual deductibles, coinsurance percentages, and any charges beyond policy limits.
- Waiting Period Restrictions: Claims made before the orthopedic waiting period ends are automatically denied.
Understanding these exclusions helps you plan better and choose insurance that aligns with your dog’s long-term orthopedic needs.
Best Pet Insurance Providers That Cover TPLO Surgery
Several leading pet insurance companies offer coverage for TPLO surgery, but each has unique rules for cruciate ligament injuries. Comparing policies ensures you find the best fit for your dog’s medical and financial needs.
- Healthy Paws: Covers TPLO if the injury occurs after enrollment and the waiting period. Offers unlimited annual payouts but no coverage for pre-existing conditions.
- Trupanion: Known for 90% reimbursement on eligible costs and direct vet payments, but has a 30-day waiting period for orthopedic claims.
- Embrace: Includes TPLO surgery under illness coverage, with the option to reduce or waive the orthopedic waiting period through a vet exam.
- Spot and Fetch: Both cover cruciate ligament injuries after the waiting period, with flexible reimbursement and deductible options.
- ASPCA Pet Health Insurance: Offers comprehensive coverage but applies a 14-day illness waiting period for orthopedic procedures.
Selecting a provider with transparent cruciate coverage and high reimbursement rates ensures better financial protection for major surgeries like TPLO.
How to File a TPLO Surgery Claim
Filing a TPLO surgery claim correctly helps speed up reimbursement and avoids processing delays. Most insurers require detailed veterinary documentation and itemized invoices.
- Collect Required Documents: Obtain a full medical report, diagnostic imaging results, itemized invoices, and proof of payment from your veterinarian.
- Submit Through the Portal: Most insurance providers allow online submissions through their official portals or mobile apps for faster review.
- Attach Medical History: Include your dog’s previous health records to confirm the cruciate injury isn’t pre-existing.
- Timeline for Reimbursement: Claims are typically processed within 10–15 business days, though some complex cases may take longer.
- Follow Up Promptly: Contact your insurer if documentation requests arise or delays occur. Keeping communication open prevents claim rejection.
- Save Copies: Always keep digital or printed copies of every document for future claims.
Timely, organized submission of records ensures smoother claim approval and quicker financial relief after TPLO surgery.
Tips for Choosing the Right Pet Insurance for Orthopedic Coverage
Choosing the right insurance plan can make a major difference in managing expensive orthopedic procedures like TPLO surgery. Understanding policy details beforehand prevents financial stress later.
- Avoid Bilateral Exclusions: Choose insurers that cover both knees even if one is previously injured. This is critical for breeds prone to cruciate tears.
- Check Waiting Periods: Some plans have 6–12 month orthopedic waiting periods. Early enrollment ensures coverage is active when needed.
- Customizable Reimbursement Options: Plans allowing flexible deductibles and payout percentages help control monthly premiums.
- Understand Policy Limits: Review annual and lifetime caps to ensure coverage remains adequate for long-term orthopedic care.
- Read Fine Print Carefully: Always confirm whether physical therapy, imaging, and post-surgical complications are included.
- Ask About Direct Payments: Some insurers pay veterinarians directly, saving you from covering full costs upfront.
Selecting a policy that combines comprehensive coverage with transparency ensures peace of mind when facing orthopedic surgeries like TPLO.
Conclusion
TPLO surgery is one of the costliest orthopedic procedures for dogs, making strong insurance coverage essential. While most insurers cover the operation for non-pre-existing injuries, exclusions and waiting periods can greatly affect eligibility.
- Coverage Essentials: Understand plan inclusions, orthopedic waiting times, and bilateral condition policies.
- Early Enrollment: Starting coverage before injuries occur ensures full eligibility for TPLO claims.
- Policy Comparison: Review reimbursement rates, deductibles, and annual caps to choose the best protection for your dog’s long-term health.
- Consultation: Discuss all coverage details with your insurer before scheduling surgery to avoid claim denial or hidden costs.
With the right pet insurance plan and proper timing, you can manage TPLO expenses confidently while securing the best surgical outcome for your dog.
FAQs
Will insurance cover both legs if both cruciate ligaments tear?
Most pet insurance plans cover both legs only if the policy doesn’t include a bilateral exclusion clause. Some insurers consider cruciate injuries as linked conditions, meaning if one leg tears before enrollment, the other may not be covered. Always confirm your insurer’s bilateral coverage terms in writing before surgery.
Can I get coverage if my dog already tore one ligament?
If your dog had a previous cruciate ligament injury before the policy began, most insurers will treat future TPLO claims as pre-existing and deny coverage. However, enrolling early or choosing a plan without bilateral exclusions ensures future injuries can still qualify for reimbursement.
How long is the waiting period for TPLO coverage?
Orthopedic waiting periods vary by provider, typically ranging from 6 to 12 months after policy activation. Some companies allow a vet exam waiver to shorten this period. Starting insurance early ensures your dog’s coverage is active before any ligament injury occurs.
What if my dog needs a second TPLO later?
If both legs require TPLO surgery and your policy includes bilateral coverage, the second operation is usually covered as long as it occurs after the waiting period. Keep consistent records and ensure premiums remain active to avoid claim rejection for the second procedure.
Which pet insurance companies cover TPLO the best?
Top-rated providers for TPLO coverage include Trupanion, Embrace, Healthy Paws, and Fetch. These plans typically offer 80–90% reimbursement on approved orthopedic claims with clear terms for cruciate ligament injuries. Always compare waiting periods, bilateral rules, and annual payout limits before finalizing your plan.
X min read
Get a Free Poster for Your Clinic
Enhance your workspace with a high-quality radiographs reference poster, designed for veterinary professionals. This free physical poster will be shipped directly to you—just fill out the form to request your copy.

Taking Great TPLO Radiographs
Click Below to Watch Live Video Demos
We'll send you a Free Wall Poster with all the steps
Now that you are a pro at TPLO rads
Let's take your infection control to the next level
Watch these videos!
Step #1
Getting Ready
Ensuring a clean surgical field starts with proper skin preparation. This video demonstrates the best practices for:
- Shaving the patient – Achieving a close, even shave while minimizing skin irritation
- The Dirty Scrub – The initial skin prep step to remove surface debris and reduce bacterial load before the sterile scrub.
Following these techniques helps reduce infection risk and improve surgical outcomes. Watch the video to see how it’s done effectively!
Step #2
Reduce Your Risks
Many surgeons are shocked to find out that their patients are not protected from biofilms and resistant bacteria when they use saline and post-op antibiotics.
That’s Where Simini Comes In.
Why leave these risks and unmanaged? Just apply Simini Protect Lavage for one minute. Biofilms and resistant bacteria can be removed, and you can reduce two significant sources of infection.
Step #3
Take the Course
Preventing surgical infections is critical for patient safety and successful outcomes. This course covers:
- Aseptic techniques – Best practices to maintain a sterile field.
- Skin prep & draping – Proper methods to minimize contamination.
- Antibiotic stewardship – When and how to use perioperative antibiotics effectively.
Stay up to date with the latest evidence-based protocols. Click the link to start learning and earn CE credits!

Related articles

TPLO
5 min read
Signs of TPLO Failure in Dogs & When to See a Vet
Learn the key symptoms of TPLO failure in dogs, from limping to implant issues. Spot warning signs early and know when to seek veterinary care
Tibial Plateau Leveling Osteotomy (TPLO) is a surgery used to treat cranial cruciate ligament (CCL) injuries in dogs. Instead of replacing the damaged ligament, TPLO changes the knee's mechanics by cutting and rotating the tibia to stabilize the joint. This procedure greatly improves mobility and reduces pain, making it one of the most effective treatments for CCL injuries.
While TPLO is often successful, complications can occur. Problems may arise from surgical errors, implant issues, infections, or improper post-operative care. These issues can cause severe pain, lameness, and reduced mobility, requiring immediate attention.
Recognizing symptoms of TPLO failure early is crucial. Pet owners and veterinarians must closely monitor recovery to spot signs of complications. Identifying problems early can prevent further damage, improve treatment outcomes, and sometimes avoid the need for corrective surgery. Being aware ensures a better quality of life for the dog.
Early Warning Signs of TPLO Failure
Recognizing early symptoms of TPLO failure is crucial for timely intervention. While mild discomfort and swelling are normal during the initial recovery period, persistent or worsening symptoms may indicate complications.
Persistent Lameness or Limping
Mild lameness is expected for the first few weeks after TPLO surgery. Most dogs show significant improvement within 8–12 weeks. However, if limping persists beyond this period or worsens, it may signal poor bone healing, implant failure, or an underlying infection.
Signs of concern include the dog favoring the other leg, difficulty bearing weight, or sudden regression in mobility. If the leg does not seem to be healing as expected or if there is no gradual improvement, further veterinary evaluation is necessary. X-rays can help determine if the bone is healing correctly or if complications exist.
Read more about: Common Causes of Limping in Dogs Post-TPLO Surgery
Pain During Movement or Reluctance to Use the Affected Leg
Some discomfort is normal post-surgery, but persistent pain when walking, climbing stairs, or standing up may indicate a problem. If a dog avoids using the leg weeks after surgery or shows hesitation in movement, it could be due to implant irritation, improper bone healing, or inflammation. Pain when touching the leg, vocalization, or a stiff gait are red flags.
A dog that initially improves but later develops increased pain needs urgent assessment. A vet may perform imaging and physical exams to check for implant loosening, joint infections, or soft tissue complications affecting recovery.
Swelling Around the Surgical Site
Mild swelling is expected for a few days post-op but should gradually decrease. If swelling persists, worsens, or becomes firm and painful, it may indicate a complication. Excessive swelling could result from implant irritation, fluid buildup, or infection. If the area feels warm or if swelling is accompanied by lameness, immediate veterinary attention is necessary.
A seroma (fluid accumulation) may require drainage, while severe swelling linked to infection or implant rejection may necessitate medical intervention or revision surgery. Monitoring the surgical site daily helps detect abnormal swelling before it leads to more serious issues.
Signs of Infection (Redness, Discharge, Heat)
Post-surgical infections can occur around the incision or deep within the joint, though they are less common when Simini Protect Lavage is used, as it helps reduce bacterial contamination during surgery. However, infections can still develop due to improper wound care, immune response issues, or implant-related complications.
Early symptoms include redness, swelling, heat, and discharge from the incision site. A foul odor, increased pain, or excessive licking are also concerning. If untreated, infections can spread, leading to implant instability, fever, lethargy, and appetite loss. In severe cases, infection may require implant removal and surgical intervention.
Prompt antibiotic therapy is essential to control bacterial growth. Regular wound monitoring, proper hygiene, and early veterinary attention help prevent minor infections from escalating.
Structural and Mechanical Failures
These complications indicate that the surgical repair is not functioning correctly, leading to ongoing instability and pain. Unlike early post-op discomfort, structural failures can cause long-term mobility issues and may require corrective surgery.
Recurrent Knee Joint Instability
After TPLO, the knee joint should be stable due to the new tibial alignment. However, if a dog shows difficulty walking, wobbling, or an unstable gait, it may signal failed bone healing or implant issues. Instability can result from improper fusion of the cut tibia, loose screws, or excessive strain on the joint.
A dog may shift weight frequently or show reluctance to move, indicating mechanical failure. X-rays and physical exams help confirm whether the joint is unstable. Left untreated, instability can lead to severe arthritis, chronic pain, and reduced mobility, making early intervention critical.
Meniscal Injury or Tear
Meniscal damage is a common complication following TPLO surgery, as this cartilage helps cushion the knee joint. A torn meniscus can occur due to improper knee mechanics or residual instability. Symptoms include a sudden return of lameness, difficulty bearing weight, or a clicking or popping sound when the knee moves.
Dogs may yelp when standing or walking and may become more inactive due to pain. A torn meniscus may require surgical removal or repair to restore function. Without treatment, the condition can worsen, leading to chronic discomfort and long-term joint deterioration.
Post-Operative Meniscal Tear
A meniscal tear can occur at the time of surgery (primary tear) or develop later due to knee instability (secondary tear). A secondary meniscus tear is particularly concerning, as it often happens weeks or months after the initial procedure. This results in immediate pain, limping, and reluctance to move.
Dogs with a new meniscus tear may suddenly regress in their recovery, refusing to put weight on the leg despite previous improvements. Surgical intervention is often required to remove the damaged cartilage and restore comfort. Regular post-op checkups help detect meniscal issues before they become severe.
Implant Loosening, Bending, or Breakage
TPLO implants, including plates and screws, must remain secure for proper healing. If an implant loosens, bends, or breaks, the bone may fail to stabilize, causing pain and mobility loss. Signs include swelling, limping, reluctance to use the leg, or a clicking sensation in the joint. Implant failure can result from improper post-op care, excessive activity, or underlying bone weakness.
Overweight dogs and those resuming activity too soon are at higher risk. X-rays are necessary to confirm implant damage. Severe cases may require revision surgery to replace or secure the implants and restore knee stability.
Advanced TPLO Failure Symptoms
These symptoms indicate severe complications requiring medical intervention. If TPLO failure progresses, a dog may experience chronic pain, loss of function, or permanent joint damage. Early detection is key to preventing irreversible issues.
Delayed Bone Healing or Nonunion
Bone healing after TPLO typically takes 8–12 weeks. However, some dogs experience delayed healing or nonunion, where the bone fails to fuse properly. Causes include poor nutrition, excessive movement, infections, or improper plate positioning.
Dogs with nonunion may show persistent limping, pain, or swelling at the surgical site. X-rays can confirm if the bone is healing correctly. Nonunion requires intervention, such as adjusting activity levels, improving diet, or, in severe cases, revision surgery. If left untreated, it can lead to chronic instability and increased risk of implant failure.
Muscle Atrophy Around the Thigh
Muscle atrophy occurs when a dog avoids using the affected leg, leading to gradual muscle loss in the thigh. Mild atrophy is normal post-surgery but should improve with rehabilitation. However, progressive muscle loss suggests long-term mobility issues, improper healing, or ongoing pain. Dogs with severe atrophy may struggle with balance, fatigue quickly, or rely heavily on the other leg.
Physical therapy, controlled exercise, and pain management help restore muscle strength. If left unaddressed, muscle atrophy can make recovery difficult and reduce overall limb function, leading to permanent weakness.
Recurrent or Persistent Mobility Issues
Most dogs regain near-normal function within a few months after TPLO. However, if mobility issues persist beyond this period, it could indicate implant failure, arthritis, or joint instability. Some dogs may continue limping, struggle with stairs, or hesitate to run and jump. Persistent dysfunction suggests that TPLO did not fully correct the knee mechanics, leading to long-term discomfort.
Chronic instability may also cause secondary joint problems. Veterinary evaluation, including X-rays and orthopedic exams, is needed to determine if additional treatment or revision surgery is required. Without intervention, mobility may decline further, affecting quality of life.
Signs of Implant Failure (Mild Discomfort to Acute Pain)
Implant failure can range from mild discomfort to severe pain. Early signs include persistent limping, swelling, and difficulty bearing weight. If an implant loosens or breaks, symptoms can suddenly worsen, causing acute distress, refusal to move, or vocalization when walking. Clicking or grinding noises may also indicate implant instability.
Severe cases require urgent veterinary care, as implant failure can lead to bone fractures or infection. X-rays confirm implant integrity, and treatment may involve pain management, restricted movement, or surgical revision. Delayed care increases the risk of complications, making early detection crucial.
Potential Need for Revision Surgery
Revision TPLO surgery is necessary when the original procedure fails due to nonunion, implant failure, or chronic instability. This involves replacing damaged implants, repositioning the tibial cut, or addressing infections. Revision surgery is often more complex than the initial procedure and requires strict post-op management.
Recovery may take longer, but successful revision can restore knee stability and improve function. If left untreated, TPLO failure can result in chronic pain, severe arthritis, or loss of mobility. A thorough veterinary evaluation determines if revision surgery is the best option for improving the dog’s quality of life.
When to See a Veterinarian
Pet owners should contact a veterinarian if their dog shows signs of worsening pain, persistent lameness beyond 12 weeks, or sudden regression in mobility after initial improvement.
Other concerning symptoms include swelling that does not subside, redness or discharge from the surgical site, difficulty bearing weight, or signs of infection like fever and lethargy. Any clicking or grinding sounds from the knee may indicate meniscal damage or implant instability, requiring immediate attention.
To confirm TPLO failure, veterinarians use diagnostic tests such as X-rays to assess bone healing and implant positioning, CT scans for detailed imaging of the knee structure, and joint fluid analysis to detect infections or inflammation. In severe cases, additional tests may be needed to evaluate soft tissue damage.
Early veterinary intervention can prevent further complications, reducing the need for complex revision surgery and ensuring a better long-term outcome for the dog.
Preventing TPLO Failure
Proper post-operative care is essential for preventing TPLO failure and ensuring a smooth recovery. Strict activity restriction is crucial in the first 8–12 weeks—dogs should avoid running, jumping, or using stairs. A knee brace may provide additional joint support, especially for highly active dogs. Physical therapy helps restore strength and mobility while minimizing the risk of complications.
To promote proper healing, a nutrient-rich diet with adequate protein, calcium, and joint supplements (such as glucosamine) supports bone repair. Regular follow-up vet visits allow for X-ray monitoring to confirm bone fusion and implant stability.
Recognizing early red flags—such as persistent limping, swelling, or signs of infection—can prevent serious complications. Pet owners should check the incision site daily and report any unusual symptoms.
By following post-op guidelines and addressing concerns promptly, the risk of TPLO failure can be significantly reduced, leading to a successful recovery and long-term joint stability.
Read more about:
- Long-term outcomes of TPLO surgery
- Common myths about TPLO surgery explained
- Long-term effects of TPLO surgery on dogs
- Post-surgery recovery after TPLO in dogs
- TPLO surgery for older dogs: Is it a worthwhile option?
Conclusion
TPLO surgery is usually successful, but failures can happen due to improper healing, implant problems, or post-operative complications. Key symptoms of TPLO failure include:
- persistent lameness
- swelling
- pain during movement
- joint instability
- signs of infection
Structural issues like implant loosening, meniscal tears, or delayed bone healing can further hinder recovery.
Early detection is crucial—addressing warning signs quickly can prevent serious complications and reduce the need for additional surgery. Regular vet checkups, diagnostic imaging, and close monitoring of mobility help catch problems before they worsen.
Strict adherence to post-op care is essential in preventing TPLO failure. Pet owners should limit activity, ensure proper nutrition, and follow rehabilitation plans as advised by their veterinarian. By recognizing symptoms early and sticking to recovery guidelines, pet owners can improve their dog’s chances of a successful TPLO outcome and long-term mobility.
FAQs
What happens if TPLO fails in dogs?
If TPLO fails, the affected leg may remain unstable, leading to chronic pain, persistent lameness, and arthritis. The knee joint may not heal properly, causing difficulty in movement. In severe cases, implant failure or bone nonunion may require revision surgery to correct the issue. If left untreated, TPLO failure can significantly impact a dog’s mobility and overall quality of life.
What percent of TPLO surgeries fail?
TPLO has a high success rate, with over 90-95% of dogs recovering well. However, failure can occur in 5-10% of cases due to infections, implant loosening, meniscal injuries, or delayed bone healing. Factors like improper post-op care, excessive activity, or underlying health conditions increase the risk. Early detection and proper recovery management can reduce complications and improve surgical outcomes.
How to tell if a dog's ACL surgery failed?
Signs of TPLO failure include persistent limping, swelling, pain, and reluctance to use the affected leg beyond the expected recovery period. Clicking sounds in the joint, excessive stiffness, or visible implant issues may also indicate failure. If a dog’s condition worsens instead of improving, a vet should perform X-rays or CT scans to assess healing and detect complications.
Why is my dog limping 2 years after TPLO surgery?
Limping two years post-TPLO may result from arthritis, implant irritation, meniscal damage, or muscle atrophy. Some dogs develop scar tissue or secondary joint issues that cause discomfort. If limping is sudden, it could indicate a late meniscus tear or implant problem. A veterinary exam, including imaging, can determine the cause and guide appropriate treatment, such as pain management or revision surgery.
What does a failed TPLO look like?
A failed TPLO often presents as persistent pain, joint instability, swelling, or difficulty bearing weight on the affected leg. Dogs may show progressive lameness, reluctance to move, or audible joint clicking. Severe cases may involve implant loosening, infection, or nonunion of the bone, which can be confirmed through X-rays or CT scans. Early intervention is crucial to prevent worsening complications.
Can TPLO surgery be redone?
Yes, revision TPLO surgery can be performed if the initial procedure fails. This may involve removing or replacing implants, repositioning the tibial cut, or addressing infections. Revision surgery is often more complex and requires strict post-op care. In some cases, alternative treatments like custom knee braces or joint fusion procedures may be considered if TPLO cannot be successfully redone.
What is the alternative to TPLO on dogs?
Alternatives to TPLO include Lateral Suture Stabilization (Extracapsular Repair), Tibial Tuberosity Advancement (TTA), and CBLO (Cora-Based Leveling Osteotomy). These procedures also stabilize the knee but may be better suited for smaller dogs or specific cases. Non-surgical options like custom braces, weight management, and physical therapy may help in mild or inoperable cases, though they do not provide the same level of stability as TPLO.
How long can a dog go without TPLO surgery?
Dogs with a torn CCL can survive without TPLO, but untreated ligament injuries lead to chronic pain, arthritis, and joint deterioration. Some small or inactive dogs may adapt with braces, weight control, and pain management, but larger, active dogs usually require surgery for long-term stability. Without intervention, progressive joint damage can severely impact mobility, making walking difficult or painful over time.

TPLO
5 min read
Why Is My Dog's Leg Clicking After TPLO Surgery?
Wondering why your dog’s leg is clicking after TPLO surgery? Learn common causes, when to worry, and what to expect during recovery
Is Clicking Normal After TPLO Surgery?
Yes, clicking is a common sign after TPLO (Tibial Plateau Leveling Osteotomy) surgery. Many dogs experience this during the healing process. The clicking sound often happens when your dog walks, especially in the early weeks after surgery. It usually comes from the knee joint or nearby soft tissues adjusting to the new implant and bone alignment.
In most cases, the clicking is not painful or harmful. It may be due to muscle weakness, swelling, or the movement of healing tissues around the surgical site. As your dog builds strength and the joint stabilizes, the clicking often goes away on its own.
However, while it is usually harmless, clicking that gets worse or lasts longer than expected should be checked by your vet. It’s important to track any changes in your dog’s walking, behavior, or comfort level during recovery to rule out complications.
Common Reasons Behind the Clicking Sound
Several factors can cause a clicking sound in your dog’s leg after TPLO surgery. One of the most common reasons is scar tissue formation around the joint. As the tissues heal, they can tighten or shift slightly, creating a clicking noise when your dog moves.
Another reason is muscle or tendon movement over the joint. After surgery, the muscles and tendons may not glide smoothly due to inflammation or changes in joint structure. This can lead to a clicking or popping sound during certain motions.
The bone healing and remodeling process also plays a role. As the bone heals and reshapes around the implant, small adjustments happen within the joint that can produce sounds. This is usually temporary and improves as healing continues.
Sometimes, the implants—such as the plate or screws—may shift slightly or settle into position, especially in the early stages of healing. This minor movement can also cause clicking but is often not serious.
Lastly, natural joint movement itself can create a clicking noise. As your dog regains strength and mobility, the knee may make sounds during stretching, walking, or sudden turns. Most of these causes are harmless, but it's always good to consult your vet if the clicking is persistent or paired with pain.
When Should You Be Concerned?
Clicking sounds are usually harmless after TPLO surgery, but in some cases, they can point to a problem. Contact your vet if you notice any of the following:
- Clicking is new or getting louder - If the clicking sound wasn't there before or is increasing over time, it could mean something has shifted in the joint or implant.
- Swelling around the surgical site - Mild swelling early on is normal, but swelling that appears later or keeps growing may be a sign of infection or poor healing.
- Signs of pain, limping, or stiffness - If your dog starts limping again, avoids putting weight on the leg, or shows stiffness when moving, it may indicate discomfort or complications.
- Decreased activity or appetite - Dogs often hide pain, so a sudden drop in energy, playfulness, or appetite should raise concern.
- Clicking with joint instability - If the knee feels wobbly or your dog’s leg gives out when walking, this could mean the implant has loosened or the bone isn’t healing well.
In any of these cases, it’s best to have your vet check your dog’s leg to make sure the recovery is going as planned.
Could It Be a Complication?
In some cases, clicking after TPLO surgery may point to a complication. One possible cause is meniscus damage that wasn’t found or treated during surgery. The meniscus is a small piece of cartilage that cushions the knee. If it tears or becomes damaged later, it can cause pain, limping, and clicking sounds.
Another rare but serious issue is implant failure. Plates or screws can loosen, shift, or break, especially if the dog is too active too soon after surgery. This can lead to discomfort and joint noises.
Joint instability is also a concern if the bone hasn’t fully healed or if the implant isn’t holding the bone tightly. In this case, the knee may move abnormally, causing clicking or popping sounds.
Larger dogs are more likely to make joint sounds during recovery. Their extra weight puts more pressure on the healing leg, which can make clicking more noticeable. While this doesn’t always mean there’s a problem, it’s important to monitor them closely.
If the clicking is paired with pain, swelling, or limping, it’s best to have your vet check for complications and take X-rays to confirm that everything is healing as it should.
What Can Help Reduce the Clicking?
To help reduce clicking sounds after TPLO surgery, focus on proper recovery care. Here are some helpful steps:
- Limit activity and allow proper rest - Too much movement early on can cause stress on the joint. Keep your dog’s activity low during the first 8–10 weeks after surgery.
- Use physical therapy or controlled exercises - Gentle rehab movements can strengthen muscles around the joint, reduce instability, and help the leg move more smoothly. Ask your vet for a safe exercise plan.
- Give anti-inflammatory medications if prescribed - These help reduce swelling and irritation in the joint, making movement more comfortable and quiet. Only use medications approved by your vet.
- Manage your dog’s weight - Extra weight puts more stress on the healing leg, especially in large breeds. Keeping your dog at a healthy weight supports smoother recovery and fewer joint sounds.
By following these steps and staying in touch with your vet, the clicking sound usually fades over time. Most dogs heal well with rest, patience, and proper care.
What to Expect During Recovery
During recovery from TPLO surgery, it’s common to hear clicking sounds in your dog’s leg, especially in the first few weeks. In most cases, this clicking fades over time as the bone heals, muscles strengthen, and the joint stabilizes. For many dogs, the sound goes away completely within a few months.
However, some dogs may still have a soft clicking sound even after full healing. This is often not painful and doesn’t affect how they walk or play. Many dogs adapt well, and the clicking becomes less noticeable over time.
Healing timelines can vary depending on your dog’s size, age, and overall health. Larger dogs or those with other joint issues may take longer to recover. Regular follow-ups, controlled activity, and proper rest are key during this time.
Always keep an eye on any changes and check with your vet if anything feels off during recovery.
When to Visit the Vet
While clicking after TPLO surgery is often harmless, there are times when a vet visit is necessary. You should contact your vet if the clicking sound is persistent or getting worse over time. A mild clicking early in recovery is normal, but it should improve as healing progresses.
If the clicking is accompanied by other symptoms—like pain, swelling, limping, stiffness, or your dog avoiding the leg—this could signal a problem. These signs may point to joint instability, implant issues, or even a torn meniscus that needs attention.
It’s also important to follow up with your vet for scheduled post-op checks. These visits often include physical exams and sometimes X-rays to confirm that the bone is healing properly and the implant is stable. Don’t skip these checkups, even if your dog seems fine.
If you notice anything unusual, it’s always safer to have your vet take a look. Early care can prevent bigger problems later in recovery.
Conclusion
Clicking after TPLO surgery is common and usually not a cause for concern. It often happens during the healing phase and may come from scar tissue, joint movement, or muscle adjustment. In most cases, the sound fades over time as your dog regains strength and the joint stabilizes.
However, it’s important to watch for any changes. If the clicking gets louder, doesn’t go away, or comes with pain, swelling, or limping, don’t wait—contact your vet. Regular rest, controlled exercise, and follow-up visits play a big role in a smooth recovery.
Every dog heals at a different pace, and some may adapt even if mild clicking remains. With proper care and attention, most dogs return to normal activity and enjoy a pain-free life after TPLO surgery. Stay patient, stay observant, and always follow your vet’s guidance.

TPLO
5 min read
Does Pet Insurance Cover TPLO Surgery in Dogs?
Find out if pet insurance covers TPLO surgery, what affects eligibility, and how to get reimbursed for your dog’s treatment.
Understanding TPLO Surgery and Why It’s Needed
Tibial Plateau Leveling Osteotomy (TPLO) is a surgical procedure used to repair a torn cranial cruciate ligament (CCL) in dogs — a common injury that causes pain and hind limb instability. The surgery reshapes the tibia bone to restore stable joint movement without depending on the damaged ligament.
- Purpose of TPLO Surgery: Recommended for active or large-breed dogs where conservative treatments cannot restore function.
- Recovery Period: Most dogs need 8–12 weeks for bone healing, followed by controlled physical therapy for full recovery.
- Cost Overview: TPLO surgery is one of the more expensive orthopedic procedures, often ranging from $3,000 to $6,000 depending on clinic and location.
Understanding these basics sets the stage for evaluating insurance coverage options.
Average Cost of TPLO Surgery for Dogs
TPLO surgery is a complex orthopedic procedure, and its cost varies widely based on case difficulty, hospital standards, and regional pricing. Understanding the range helps owners plan financially before exploring insurance options.
- National Cost Range: In the U.S., TPLO surgery typically costs between $3,000 and $6,000 for a single leg. In some specialty hospitals or metropolitan areas, costs can exceed $7,000, especially for large breeds.
- Simple vs. Complex Cases: Minor ligament tears with minimal complications are less costly, while complex fractures, bilateral surgeries, or infections increase total expenses significantly.
- Influence of Dog Size: Larger dogs require stronger plates, longer anesthesia, and extended recovery monitoring, leading to higher bills.
- Hospital and Surgeon Type: Referral centers and board-certified surgeons charge more due to specialized equipment and experience.
- Follow-Up and Rehabilitation: Post-surgical care, including X-rays and physiotherapy, can add $500–$1,500.
Because of these high expenses, many pet owners consider insurance coverage essential to make TPLO surgery affordable without compromising care quality.
Does Pet Insurance Cover TPLO Surgery?
Most modern pet insurance plans do cover TPLO surgery, but eligibility depends on policy terms and your dog’s medical history. The key factor is whether the cruciate ligament injury is considered pre-existing.
- General Coverage Rule: If your dog’s CCL injury occurs after the waiting period and is not pre-existing, TPLO surgery is usually included under accident or illness coverage.
- Waiting Periods: Many insurers enforce a 6–12 month waiting period for cruciate ligament coverage to prevent claims on undiagnosed injuries.
- Plan Type Differences: Comprehensive plans with illness and injury coverage are most likely to include TPLO, while accident-only policies may exclude it.
- Common Exclusions: Some policies do not cover congenital joint disorders or prior CCL injuries in the opposite leg.
- Importance of Documentation: Detailed veterinary records proving the injury is new are often required for claim approval.
In most cases, TPLO is covered when the policy is active before the injury, making early insurance enrollment a smart preventive decision.
How Pre-Existing Conditions Affect TPLO Coverage
Pre-existing conditions are the most common reason pet insurance denies TPLO-related claims. Understanding what qualifies as “pre-existing” helps you protect your dog’s future eligibility.
- Definition of Pre-Existing Conditions: Any medical issue diagnosed or showing symptoms before policy activation or during the waiting period is considered pre-existing.
- Prior Cruciate Ligament Injuries: If your dog previously tore a CCL or ACL in either leg, many insurers exclude future coverage for both knees under a bilateral condition clause.
- Breed Predisposition: Large or active breeds prone to ligament tears may face stricter review before approval.
- Importance of Early Enrollment: Getting insurance while your dog is young and injury-free ensures eligibility for full cruciate coverage later in life.
- Proof of Clean Health Record: Regular vet visits and medical documentation help verify no pre-existing issues existed at policy start.
Early planning and transparent medical history are crucial for securing TPLO coverage when unexpected injuries occur.
What Pet Insurance Typically Covers for TPLO Surgery
When TPLO surgery is approved under your insurance, most plans cover a wide range of medical services related to diagnosis, treatment, and recovery. This support can significantly reduce financial stress.
- Diagnostic Imaging: X-rays, CT scans, or MRIs used to confirm ligament rupture are usually included in coverage.
- Surgery and Hospitalization: The main surgical procedure, anesthesia, and hospitalization costs are covered up to policy limits.
- Post-Surgery Medications: Pain relievers, antibiotics, and anti-inflammatories prescribed during recovery are typically reimbursable.
- Physical Therapy: Many plans include hydrotherapy or physiotherapy sessions for rehabilitation under extended recovery benefits.
- Follow-Up Visits and Complications: Recheck exams, wound care, or treatment of infections that occur after surgery are generally included within your policy’s time and cost caps.
Comprehensive coverage ensures your dog’s TPLO treatment is managed safely from diagnosis through recovery, minimizing both physical and financial strain.
What’s Not Covered by Pet Insurance for TPLO Surgery
Even though many pet insurance plans include TPLO coverage, certain conditions and costs fall outside standard policies. Knowing these exclusions helps prevent surprises during reimbursement.
- Pre-Existing Injuries: If your dog showed signs of a cruciate tear before enrollment or during the waiting period, TPLO surgery won’t be covered.
- Bilateral Exclusion Clauses: Some insurers exclude the second knee once one cruciate injury occurs, even if it happens years later.
- Preventive or Elective Procedures: Pre-surgical screenings, optional rehab sessions, or supplements are often excluded from reimbursement.
- Rehabilitation Limits: Physiotherapy or hydrotherapy may only be covered for a set number of weeks or up to a cost cap.
- Deductibles and Co-Pays: Owners are responsible for annual deductibles, coinsurance percentages, and any charges beyond policy limits.
- Waiting Period Restrictions: Claims made before the orthopedic waiting period ends are automatically denied.
Understanding these exclusions helps you plan better and choose insurance that aligns with your dog’s long-term orthopedic needs.
Best Pet Insurance Providers That Cover TPLO Surgery
Several leading pet insurance companies offer coverage for TPLO surgery, but each has unique rules for cruciate ligament injuries. Comparing policies ensures you find the best fit for your dog’s medical and financial needs.
- Healthy Paws: Covers TPLO if the injury occurs after enrollment and the waiting period. Offers unlimited annual payouts but no coverage for pre-existing conditions.
- Trupanion: Known for 90% reimbursement on eligible costs and direct vet payments, but has a 30-day waiting period for orthopedic claims.
- Embrace: Includes TPLO surgery under illness coverage, with the option to reduce or waive the orthopedic waiting period through a vet exam.
- Spot and Fetch: Both cover cruciate ligament injuries after the waiting period, with flexible reimbursement and deductible options.
- ASPCA Pet Health Insurance: Offers comprehensive coverage but applies a 14-day illness waiting period for orthopedic procedures.
Selecting a provider with transparent cruciate coverage and high reimbursement rates ensures better financial protection for major surgeries like TPLO.
How to File a TPLO Surgery Claim
Filing a TPLO surgery claim correctly helps speed up reimbursement and avoids processing delays. Most insurers require detailed veterinary documentation and itemized invoices.
- Collect Required Documents: Obtain a full medical report, diagnostic imaging results, itemized invoices, and proof of payment from your veterinarian.
- Submit Through the Portal: Most insurance providers allow online submissions through their official portals or mobile apps for faster review.
- Attach Medical History: Include your dog’s previous health records to confirm the cruciate injury isn’t pre-existing.
- Timeline for Reimbursement: Claims are typically processed within 10–15 business days, though some complex cases may take longer.
- Follow Up Promptly: Contact your insurer if documentation requests arise or delays occur. Keeping communication open prevents claim rejection.
- Save Copies: Always keep digital or printed copies of every document for future claims.
Timely, organized submission of records ensures smoother claim approval and quicker financial relief after TPLO surgery.
Tips for Choosing the Right Pet Insurance for Orthopedic Coverage
Choosing the right insurance plan can make a major difference in managing expensive orthopedic procedures like TPLO surgery. Understanding policy details beforehand prevents financial stress later.
- Avoid Bilateral Exclusions: Choose insurers that cover both knees even if one is previously injured. This is critical for breeds prone to cruciate tears.
- Check Waiting Periods: Some plans have 6–12 month orthopedic waiting periods. Early enrollment ensures coverage is active when needed.
- Customizable Reimbursement Options: Plans allowing flexible deductibles and payout percentages help control monthly premiums.
- Understand Policy Limits: Review annual and lifetime caps to ensure coverage remains adequate for long-term orthopedic care.
- Read Fine Print Carefully: Always confirm whether physical therapy, imaging, and post-surgical complications are included.
- Ask About Direct Payments: Some insurers pay veterinarians directly, saving you from covering full costs upfront.
Selecting a policy that combines comprehensive coverage with transparency ensures peace of mind when facing orthopedic surgeries like TPLO.
Conclusion
TPLO surgery is one of the costliest orthopedic procedures for dogs, making strong insurance coverage essential. While most insurers cover the operation for non-pre-existing injuries, exclusions and waiting periods can greatly affect eligibility.
- Coverage Essentials: Understand plan inclusions, orthopedic waiting times, and bilateral condition policies.
- Early Enrollment: Starting coverage before injuries occur ensures full eligibility for TPLO claims.
- Policy Comparison: Review reimbursement rates, deductibles, and annual caps to choose the best protection for your dog’s long-term health.
- Consultation: Discuss all coverage details with your insurer before scheduling surgery to avoid claim denial or hidden costs.
With the right pet insurance plan and proper timing, you can manage TPLO expenses confidently while securing the best surgical outcome for your dog.
FAQs
Will insurance cover both legs if both cruciate ligaments tear?
Most pet insurance plans cover both legs only if the policy doesn’t include a bilateral exclusion clause. Some insurers consider cruciate injuries as linked conditions, meaning if one leg tears before enrollment, the other may not be covered. Always confirm your insurer’s bilateral coverage terms in writing before surgery.
Can I get coverage if my dog already tore one ligament?
If your dog had a previous cruciate ligament injury before the policy began, most insurers will treat future TPLO claims as pre-existing and deny coverage. However, enrolling early or choosing a plan without bilateral exclusions ensures future injuries can still qualify for reimbursement.
How long is the waiting period for TPLO coverage?
Orthopedic waiting periods vary by provider, typically ranging from 6 to 12 months after policy activation. Some companies allow a vet exam waiver to shorten this period. Starting insurance early ensures your dog’s coverage is active before any ligament injury occurs.
What if my dog needs a second TPLO later?
If both legs require TPLO surgery and your policy includes bilateral coverage, the second operation is usually covered as long as it occurs after the waiting period. Keep consistent records and ensure premiums remain active to avoid claim rejection for the second procedure.
Which pet insurance companies cover TPLO the best?
Top-rated providers for TPLO coverage include Trupanion, Embrace, Healthy Paws, and Fetch. These plans typically offer 80–90% reimbursement on approved orthopedic claims with clear terms for cruciate ligament injuries. Always compare waiting periods, bilateral rules, and annual payout limits before finalizing your plan.

TPLO
5 min read
10 Essential TPLO Recovery Tips for Pet Owners
Help your dog heal faster after TPLO surgery with these 10 simple, vet-approved recovery tips every pet owner should know
What to Expect After TPLO Surgery
TPLO (Tibial Plateau Leveling Osteotomy) is a surgery used to treat a torn cranial cruciate ligament (CCL) in a dog’s knee. It involves cutting and rotating the top of the tibia to stabilize the joint without needing the ligament.
In the first few days, your dog may have swelling, mild pain, and limited movement. Strict rest is needed during this time. Your vet may also provide pain medication and antibiotics.
In the first few weeks, your dog will start putting more weight on the leg. Short, slow walks and controlled exercises may begin under vet guidance.
By 8 to 12 weeks, most dogs show good improvement, though full bone healing may take up to 4 months.
Every dog heals differently, so regular vet check-ups and follow-up X-rays are important to make sure everything is on track.
Week 1: The Critical Rest Period
1. Keep Your Dog Rested and Safe
The first week after TPLO surgery is all about strict rest. Your dog’s body needs time to start healing the bone and soft tissues. Keep your dog in a crate or a small room with soft bedding to prevent movement.
Avoid stairs, running, or jumping on and off furniture, as these can damage the surgical site. Calm, quiet surroundings help lower stress and reduce the chance of injury. Limiting movement now supports a stronger, smoother recovery later.
2. Manage Pain and Swelling
Your vet will prescribe pain and anti-inflammatory medications—give them exactly as directed to keep your dog comfortable. Never skip doses, even if your dog seems fine. To reduce swelling, use a cold pack wrapped in a towel and gently apply it to the surgical area for 10–15 minutes, 2–3 times a day during the first 48–72 hours.
This helps ease inflammation and supports healing. Always monitor your dog’s response and stop if discomfort increases.
3. Help Your Dog Walk Safely
Only allow your dog to walk when absolutely needed, such as going outside for bathroom breaks. Always use a short leash and walk slowly. You can support your dog’s rear end using a towel or sling under the belly, especially for larger dogs.
This reduces strain on the healing leg. Avoid any sudden movements, pulling, or distractions during walks. Controlled support prevents accidents and keeps pressure off the surgical site while your dog gains confidence in using the leg again.
4. Protect the Surgical Site
To protect the incision, your dog should wear an E-collar (cone) at all times. Licking or chewing at the stitches can lead to infection or wound opening. Check the surgical site daily. Signs of infection include redness, swelling, warmth, discharge, or a bad smell.
If you notice any of these symptoms, contact your vet right away. Keep the area clean and dry—don’t bathe your dog or allow the wound to get wet during this week. Healing starts with protection.
Weeks 2–4: Keeping Recovery on Track
5. Stick to a Calm Routine
During weeks 2 to 4, your dog may start feeling better—but they still need to stay calm. Keep them confined to a crate or small room and always use a leash when taking them outside. Even small bursts of excitement or sudden movements can stress the healing joint.
Try to keep daily routines predictable. Calm, steady days help your dog stay relaxed and reduce the risk of re-injury while the bone and tissues continue to heal.
6. Keep Their Mind Busy
Your dog’s body needs rest, but their brain still needs activity. Use safe, vet-approved chew toys or treat puzzles to keep them mentally engaged. Gentle training with simple commands can also help. Mental stimulation reduces boredom, lowers stress, and can prevent behaviors like barking, whining, or trying to escape confinement.
A mentally calm dog is less likely to make sudden movements, helping their body heal more smoothly during the recovery process.
7. Feed a Healthy Diet
Since your dog’s activity is limited, weight gain can happen quickly. Extra weight puts stress on the healing leg and can slow recovery. Feed a balanced, healthy diet and avoid giving too many treats. Use portion control based on your vet’s advice, and consider switching to a lower-calorie or recovery-specific food if recommended.
Fresh water should always be available. Keeping your dog at a healthy weight supports joint health and makes walking easier as they recover.
8. Create a Healing Environment
Set up a quiet, cozy space for your dog that supports healing. Use soft bedding to cushion their joints and prevent pressure sores. Keep this space away from slippery floors, loud noises, or other pets that may cause stress or excitement.
Avoid busy areas of the home where your dog might feel the need to move around or follow you. A peaceful environment keeps your dog calm, safe, and focused on healing.
After Week 4: Slowly Getting Back to Normal
9. Gradually Increase Movement
After week 4, your dog may start gentle movement, but only with your vet’s approval. Short leash walks and light exercises can begin once healing is confirmed. Signs your dog may be ready include steady walking, good weight-bearing on the leg, and no signs of pain.
Always go slow—avoid running, stairs, or off-leash activity. Controlled movement helps build strength and balance without risking damage to the healing bone or implant. Your vet will guide the right pace.
10. Follow-Up Appointments Matter
Follow-up vet visits are key to a safe recovery. These appointments usually include a physical exam and sometimes X-rays to check how well the bone is healing and if the implant is stable. Your vet will look for signs of infection, swelling, or joint issues like meniscus damage.
They’ll also assess how your dog moves and how much weight they put on the leg. These checkups help decide when to safely increase activity or start physical therapy.
Also read about:
- Common Myths About TPLO Surgery Explained
- TPLO Surgery for Older Dogs: Is It a Worthwhile Option
- Post-Operative Infection in Dogs: Symptoms and Solutions
Conclusion
Recovery after TPLO surgery takes time, patience, and care—but you’re not alone in this journey. The clicking sound you hear may seem worrying, but in most cases, it’s a normal part of healing. With proper rest, safe movement, and regular vet checkups, your dog has a strong chance of making a full recovery.
By following the tips in each stage—from strict rest in week 1 to gentle activity after week 4—you’re giving your dog the best support possible. Watching their behavior, protecting the surgical site, and keeping their mind and body healthy all play a role in a smooth recovery.
Stay consistent, stay observant, and don’t hesitate to reach out to your vet with any questions. With time and the right care, your dog can return to a happy, active life—stronger and healthier than before.
FAQs
How long does TPLO recovery take for most dogs?
Most dogs take about 8 to 12 weeks to recover from TPLO surgery. Full bone healing can take up to 4 months. During this time, rest, follow-up vet visits, and slow return to activity are important to ensure the leg heals properly and gains strength.
Can I leave my dog alone during recovery?
Yes, but only if your dog is safely confined in a crate or small room. Avoid leaving them unsupervised in open spaces where they might jump or move too much. Keep their environment calm and secure to prevent injury during the critical healing period.
What if my dog refuses to rest or stay confined?
If your dog is restless, use calming toys, puzzle feeders, or light training to keep them busy without moving much. Speak to your vet about safe calming aids if needed. Rest is key, so finding ways to reduce energy and stress will help healing.
Is physical therapy needed after TPLO surgery?
Physical therapy isn’t always required but can help many dogs regain strength and movement faster. Gentle exercises, guided walks, or professional rehab sessions improve recovery. Ask your vet if therapy is right for your dog’s age, size, and healing progress.
What signs of infection should I watch for at home?
Watch for redness, swelling, warmth, discharge, or a bad smell at the incision site. Other signs include licking the area, limping, or changes in behavior. If you notice any of these symptoms, contact your vet right away for treatment. Early care prevents bigger issues.

TPLO
5 min read
TPLO Surgery for Older Dogs: Is It a Worthwhile Option?
Considering TPLO surgery for your old dog? Learn the benefits, risks, and alternatives to ensure the best decision for their joint health
As dogs get older, joint health often becomes a major concern, especially when issues like a torn cranial cruciate ligament (CCL) affect their movement and quality of life. Tibial Plateau Leveling Osteotomy (TPLO) surgery is commonly recommended to treat CCL injuries by stabilizing the knee and restoring function.
For senior dogs, choosing invasive surgery is tough. Consider recovery time, risks, and benefits. Alternatives like therapy, braces, or pain management may not offer the same long-term results. Can older dogs benefit from TPLO surgery, or is a less invasive approach better? Understanding their challenges helps owners decide.
In this article, we will explain why your older dog might need TPLO surgery and why it might not.
What Is TPLO Surgery and How Does It Work?
Tibial Plateau Leveling Osteotomy (TPLO) is a surgery used to treat cranial cruciate ligament (CCL) injuries in dogs. The CCL is crucial for keeping the knee joint stable and preventing the tibia (shinbone) from moving forward relative to the femur (thighbone). When this ligament tears, it leads to instability, pain, and difficulty moving.
In TPLO surgery, the angle of the tibial plateau is adjusted to remove the knee's dependence on the damaged ligament. This involves making a precise cut in the tibia, rotating it to a more stable position, and securing it with metal plates and screws. By realigning the bone, the forces within the joint are spread out, allowing the knee to work properly without causing further damage or pain.
Now let's take a look at some benefits of TPLO.
Benefits of TPLO Surgery for Older Dogs
For older dogs, TPLO surgery provides several life-enhancing benefits, even in their senior years. While age can bring unique challenges, the advantages of this procedure often outweigh the concerns when carefully considered.
1. Improved Mobility and Reduced Pain
TPLO surgery stabilizes the knee joint, significantly reducing the pain caused by a torn cranial cruciate ligament (CCL). For senior dogs, regaining stable and pain-free movement can be transformative. Many older dogs return to activities like walking, climbing stairs, and playing within weeks of recovery, giving them a new lease on life.
2. Prevention of Arthritis Progression
Untreated CCL injuries often lead to arthritis in the knee due to ongoing instability and inflammation. By restoring joint stability, TPLO surgery helps slow or even stop the progression of arthritis. This is especially important for senior dogs, as arthritis can greatly affect their comfort and ability to move.
3. Enhanced Quality of Life
Even for older dogs, maintaining an active lifestyle is crucial to their overall health. TPLO surgery allows them to stay mobile and engaged with their families, improving their mental well-being along with their physical health. Owners often report that their senior dogs show renewed energy and enthusiasm after recovery.
Potential Risks and Complications for Older Dogs
While TPLO surgery provides significant benefits, it's important to consider the potential risks, especially for senior dogs. Understanding these challenges helps us make informed decisions that are tailored to the unique needs of older pets.
Surgical Risks
As with any major surgery, TPLO carries certain risks:
- Infection: The surgical site can get infected. To reduce this risk, many surgeons use advanced techniques like Simini Protect Lavage, a non-antibiotic solution that helps control infection without causing antibiotic resistance.
- Anesthesia Complications: Older dogs are more prone to anesthesia-related issues because of underlying health conditions like heart, liver, or kidney disease. Pre-surgical screenings help reduce these risks.
- Implant Issues: In rare cases, the metal plates and screws used to stabilize the bone might loosen or cause irritation, which may require further treatment.
Post-Surgical Risks
- Stiffness and Reduced Range of Motion: Older dogs might feel stiff after surgery, which can slow down their return to full movement.
- Prolonged Recovery: Healing can take longer in senior dogs due to slower tissue regeneration and age-related issues like arthritis or obesity.
- Age-Related Complications: Conditions like diabetes or chronic inflammation can affect recovery and may need more intensive care.
Slower Recovery Compared to Younger Dogs
Senior dogs often need a longer recovery time, with extra monitoring and rehabilitation. Physical therapy and a controlled exercise plan can help improve results, but patience is essential. Adjusting expectations for the recovery timeline is important to ensure a positive post-surgical experience.
By carefully evaluating these risks and collaborating closely with a veterinary team, we can help older dogs go through surgery and recovery safely, enhancing their quality of life in the long run.
Recovery Expectations and Timeline for Older Dogs
Recovery from TPLO surgery can take longer for older dogs than for younger ones. Understanding the process and setting realistic expectations are important for a successful outcome.
Typical Recovery Stages
- Initial Rest (Weeks 1–2): In the first two weeks, strict rest is crucial to help the bone and surgical site start healing. Dogs may need to be kept in a confined space, like a crate, to prevent too much movement. Swelling and mild discomfort are normal but can be managed with prescribed pain relief and anti-inflammatory medications.
- Controlled Mobility (Weeks 3–6): Gradually reintroduce activity with short, leash-controlled walks. Older dogs might need more encouragement and patience during this stage, as stiffness can make moving difficult at first.
- Strengthening and Full Recovery (Weeks 7–12): By this time, dogs usually regain better mobility. Physical therapy, including range-of-motion exercises, is very helpful for older dogs to rebuild strength and flexibility.
Tips for a Smooth Recovery
- Maintain a Safe Environment: Use non-slip mats and remove obstacles to prevent slips and falls.
- Support Mobility: Ramps and orthopedic beds can help reduce joint strain during recovery.
- Limit Movement: Leash walks and avoiding stairs are crucial to prevent stress on the healing joint.
With proper care and by following the recovery plan, many older dogs can greatly improve their mobility and comfort after TPLO surgery.
Cost of TPLO Surgery: Is It Justified for Older Dogs?
TPLO surgery is a significant financial investment, but it is especially beneficial for active older dogs or those with manageable pre-existing conditions.
Average Costs
The cost of TPLO surgery usually ranges from $3,000 to $6,000, depending on factors like the surgeon’s experience, location, and included services. This cost often includes pre-surgical diagnostics, anesthesia, surgical materials, hospitalization, and follow-up appointments.
Comparing Costs: Surgery vs. Long-Term Alternatives
While non-surgical treatments like braces, medications, or physical therapy might seem cheaper at first, their long-term costs can add up. Managing chronic pain with medications alone can cost $500–$1,000 annually, and braces may require frequent replacements or adjustments.
For dogs with severe CCL injuries, surgery often offers a better cost-benefit ratio. TPLO addresses the root cause of knee instability, potentially removing the need for ongoing medical management and improving the dog’s quality of life.
Success Rates and Real-Life Outcomes
TPLO surgery has high success rates, even for senior dogs. Studies estimate that 85–90% of dogs who undergo TPLO surgery regain near-normal or improved limb function, including senior pets. Although older dogs might take longer to recover, their overall surgical outcomes are similar to those of younger dogs when given proper post-operative care.
We have observed that while younger dogs tend to heal faster, older dogs can achieve similar success rates if conditions like arthritis are managed well. The key is to customize recovery plans to fit each dog's specific needs and abilities.
Signs TPLO Surgery Might Not Be Suitable for an Older Dog
While TPLO surgery can greatly improve mobility for many dogs, it might not be the best choice in certain situations. Recognizing these signs helps us select the safest and most suitable option for older pets.
Indicators Surgery May Not Be Suitable
- Advanced Arthritis: Severe arthritis in the affected joint can limit the benefits of TPLO surgery, as the underlying degenerative changes may still cause discomfort even after stabilization.
- Significant Health Issues: Chronic conditions like heart disease, kidney failure, or uncontrolled diabetes can increase surgical risks and prolong recovery.
- Limited Mobility: If a dog is already frail and has difficulty moving due to age or other conditions, surgery might place unnecessary strain on their overall health.
- Shortened Life Expectancy: In cases where a dog’s life expectancy is significantly reduced due to age or illness, less invasive options may be more humane and practical.
Alternatives to TPLO Surgery for Older Dogs
When surgery isn’t suitable for an older dog, there are several non-invasive alternatives to consider. These options focus on managing pain, improving stability, and enhancing quality of life.
Rest and Physical Therapy
Conservative management often begins with rest, combined with specific physical therapy exercises. These therapies can strengthen the surrounding muscles, improve joint stability, and reduce pain. Hydrotherapy is particularly helpful, as it allows dogs to build strength with minimal strain on their joints.
Braces and Supportive Devices
Knee braces can help stabilize the joint, reducing the sliding motion that causes pain. While braces don’t fix the underlying injury, they can provide immediate relief and are a cost-effective option for less active dogs.
Injections and Medications
- Pain Management: Nonsteroidal anti-inflammatory drugs (NSAIDs) and other pain relievers can reduce inflammation and improve mobility, as prescribed by a surgeon.
- Joint Injections: Treatments like hyaluronic acid or platelet-rich plasma (PRP) injections may help alleviate joint pain and slow degenerative changes. This should be decided by your vet after assessing your dog's health.
Choosing the right approach depends on the dog’s overall health, activity level, and long-term needs.
Conclusion
TPLO surgery can offer significant benefits for many older dogs, including better mobility, less pain, and an improved quality of life. However, it does carry risks, especially for dogs with severe arthritis, major health problems, or limited mobility.
For dogs that aren't good candidates for surgery, alternatives like physical therapy, braces, and pain management can still provide comfort and stability, though with some limitations. Each option has its own considerations regarding effectiveness, cost, and long-term effects.
Ultimately, every dog is unique, and the most important thing is to choose the approach that best supports your pet's health and happiness. Consult your veterinarian to create a plan tailored to your dog's needs and situation, ensuring their later years are as comfortable and fulfilling as possible.
Sources:

TPLO
5 min read
How Long Does Swelling Last After TPLO Surgery
Find out how long swelling lasts after TPLO surgery, what’s normal, and when to call your vet for possible infection or complications.
Understanding Swelling After TPLO Surgery
Swelling is one of the most common post-surgical effects after TPLO surgery and a normal response to bone and soft-tissue manipulation. It’s part of the body’s natural repair process, helping deliver immune cells and nutrients to the surgical site. Understanding how much swelling is normal helps you track healing progress and detect problems early.
- Why Swelling Happens: During TPLO surgery, tissues are cut and repositioned around the tibia. The body reacts by sending inflammatory fluids and white blood cells to protect the area, causing temporary puffiness or firmness.
- Healing Function: Controlled inflammation aids recovery by clearing damaged cells and promoting tissue repair. It’s a key part of early bone healing in orthopedic surgeries.
- Types of Swelling: Mild swelling looks soft and reduces within a week with rest and cold compresses. Moderate swelling may cause mild warmth or stiffness but remains non-painful. Severe swelling, redness, or oozing signals infection or internal bleeding and needs urgent veterinary evaluation.
Recognizing normal versus abnormal swelling ensures timely intervention and supports a smoother, safer recovery after TPLO surgery.
Normal Timeline: How Long Swelling Lasts After TPLO Surgery
Mild to moderate swelling is expected after TPLO surgery, as the body responds to tissue trauma and healing begins. Understanding the normal timeline helps you distinguish healthy inflammation from potential complications.
- Typical Duration: Most dogs experience visible swelling for 3–7 days after surgery, peaking around day two or three. It gradually decreases as tissues start healing.
- Improvement Signs: Swelling should reduce noticeably by the end of the first week, with the incision area looking less puffy and the leg regaining flexibility.
- Extended Swelling Causes: Persistent swelling beyond a week may occur if the dog is overactive, licks the incision, or experiences friction from bandages.
- Influencing Factors: Large breeds, older dogs, or those with delayed healing may show prolonged swelling, especially without adequate rest.
- Monitoring Daily: Measuring or photographing the incision area helps track recovery progress and detect abnormal changes early.
As a general rule, swelling should lessen steadily each day. Any worsening or lack of improvement after one week warrants a call to your veterinarian.
What Normal Post-Operative Swelling Looks Like
Recognizing what healthy swelling looks like helps prevent unnecessary concern during your dog’s recovery. Normal post-operative inflammation is mild, symmetrical, and typically improves with basic care.
- Mild Puffiness: A soft, localized swelling around the knee joint or incision area is expected. The tissue may feel slightly firm but not painful when gently touched.
- Slight Warmth and Color Change: A light pink tone and mild warmth indicate good blood flow supporting healing. It should not feel hot or tender.
- Visible Improvement: Swelling starts to subside within several days as fluid drains naturally through the lymphatic system.
- Effect on Movement: Dogs may walk stiffly or limp slightly due to mild discomfort but should still bear some weight on the leg.
- Response to Care: Cold compresses, prescribed anti-inflammatory medication, and controlled rest help visible improvement appear within a week.
These mild signs of swelling represent the body’s healthy inflammatory phase and are an important part of tissue repair after TPLO surgery.
When Swelling Becomes a Concern After TPLO Surgery
While some inflammation is normal, excessive or worsening swelling can signal infection, seroma formation, or implant-related problems. Recognizing warning signs early is critical to prevent complications.
- Heat and Redness: If the surgical area feels hot, reddened, or painful to touch, infection or deeper inflammation may be developing.
- Discharge or Odor: Fluid leakage, pus, or foul smell from the incision suggests bacterial contamination that requires immediate veterinary care.
- Swelling Spreading Up the Leg: Puffy tissue moving toward the thigh or ankle indicates fluid buildup (seroma) or poor lymph drainage.
- Pain and Reluctance to Move: If your dog avoids using the leg, vocalizes when touched, or becomes lethargic, inflammation may be extending beyond normal levels.
- Fever or Appetite Loss: Systemic infection signs, such as fever or lack of appetite, mean urgent medical attention is needed.
Contact your veterinarian immediately if swelling increases after the first week or if any of these red flags appear. Prompt treatment prevents serious post-surgical complications.
Factors That Affect How Long Swelling Lasts After TPLO Surgery
Every dog heals differently, and several factors determine how long swelling persists after TPLO surgery. Paying attention to these variables helps guide proper recovery management.
- Dog’s Size and Age: Larger and older dogs often experience longer healing periods because their tissues repair more slowly.
- Surgical Technique: Advanced surgical precision and proper implant placement reduce post-operative trauma and minimize inflammation duration.
- Implant Type: Stainless steel or titanium plates can influence swelling based on how the body responds to foreign materials.
- Post-Surgery Care: Following activity restrictions, preventing licking, and maintaining crate rest are crucial for controlling inflammation.
- Use of Medication: Anti-inflammatory drugs and prescribed cold therapy shorten swelling duration by controlling tissue fluid buildup.
- Underlying Health: Dogs with obesity, arthritis, or poor circulation tend to show delayed recovery and prolonged swelling.
By understanding these factors, owners can set realistic expectations and work with their vet to customize an effective recovery plan.
How to Reduce Swelling After TPLO Surgery
Proper aftercare plays a key role in controlling swelling and supporting bone healing. Consistent management helps reduce discomfort and speeds recovery.
- Cold Compress Therapy: Apply a cold pack wrapped in a towel for 10–15 minutes every few hours during the first 48 hours to limit inflammation.
- Rest and Confinement: Restrict activity with crate rest or limited movement to prevent fluid accumulation or incision strain.
- Medication Adherence: Use prescribed pain relievers and anti-inflammatory drugs exactly as directed to control swelling from within.
- Incision Protection: Prevent licking or scratching by using an e-collar or surgical suit to keep the wound clean.
- Monitor Bandages: Ensure wraps aren’t too tight, as restricted blood flow can worsen swelling instead of helping it.
With consistent rest, medication, and monitoring, most swelling resolves smoothly, supporting a faster and more comfortable TPLO recovery.
Role of Physical Therapy in Managing Swelling After TPLO Surgery
Physical therapy is an important part of recovery after TPLO surgery, helping to restore mobility and prevent fluid buildup once the incision has healed.
- Timing of Rehabilitation: Gentle range-of-motion exercises usually begin 2–3 weeks post-surgery after your vet confirms bone stability.
- Improving Circulation: Controlled movement promotes lymphatic drainage, reducing swelling while maintaining joint flexibility.
- Muscle Strength Preservation: Gradual exercises prevent muscle loss and stiffness caused by extended rest periods.
- Hydrotherapy Benefits: Water-based therapy supports weightless exercise, improving motion without putting strain on the operated leg.
- Professional Guidance: Rehabilitation should always be supervised by your vet or a certified rehab specialist to prevent overexertion.
Properly timed and guided therapy significantly improves comfort and reduces lingering swelling, ensuring a stronger, more balanced recovery.
When Swelling Reappears Weeks After TPLO Surgery
If swelling returns weeks after TPLO surgery, it often points to secondary issues rather than normal healing. Identifying the cause early ensures timely intervention.
- Implant Irritation: Metal plates or screws can sometimes irritate nearby tissues, especially if the dog resumes activity too soon.
- Overuse or Early Exercise: Premature running, jumping, or playing can trigger soft tissue inflammation and localized swelling.
- Seroma Formation: Fluid pockets under the incision may develop if tissue healing is incomplete or disrupted.
- Infection Recurrence: Bacterial contamination can cause delayed redness, discharge, and swelling weeks after surgery.
- Follow-Up X-Rays: Imaging helps confirm implant stability and bone healing progress if swelling persists unexpectedly.
Recurrent swelling is not typical and requires prompt veterinary assessment to rule out infection, hardware complications, or incomplete bone union.
Conclusion
Swelling after TPLO surgery is normal, but its duration and appearance offer important clues about healing progress. Mild swelling should begin to fade within a week, while redness, heat, or discharge require prompt veterinary attention.
- Normal vs. Abnormal: Healthy swelling is mild, localized, and improves daily; worsening inflammation signals complications.
- Daily Monitoring: Check the incision site every day for color, warmth, or texture changes to catch issues early.
- Vet Check-Ups: Scheduled follow-ups and post-operative imaging confirm bone healing and implant stability.
By staying observant and following your vet’s care instructions, you can ensure swelling resolves safely and your dog recovers comfortably after TPLO surgery.
FAQs
How long should I expect swelling to last after TPLO?
Most swelling lasts between 3 and 7 days after TPLO surgery. It usually peaks within the first 48 hours, then gradually subsides as healing progresses. If swelling persists beyond a week or worsens instead of improving, contact your veterinarian for an examination to rule out infection or fluid buildup.
Is it normal for swelling to get worse at night?
Yes, mild nighttime swelling can occur because your dog moves less while resting, allowing fluids to settle around the surgical site. This should improve by morning or after gentle repositioning. Persistent or painful swelling overnight, however, may indicate inflammation that needs veterinary evaluation.
Can cold compresses help reduce swelling faster?
Cold therapy is highly effective in the first 48 hours after TPLO surgery. Applying a cold compress wrapped in a soft cloth for 10–15 minutes several times daily helps minimize fluid buildup and reduce pain. Always avoid direct ice contact with the incision area to prevent skin irritation.
When should I worry about swelling or redness?
You should be concerned if swelling increases after the first week or is accompanied by heat, redness, oozing, or a bad odor. These may signal infection, seroma, or implant irritation. Immediate veterinary assessment ensures early treatment and prevents more serious complications.
What if my dog starts limping again weeks later?
Limping weeks after surgery may suggest muscle overuse, implant irritation, or delayed healing. Recurring swelling along with limping can indicate inflammation or hardware issues. Schedule a follow-up appointment and, if needed, X-rays to confirm proper bone healing and plate stability.

TPLO
5 min read
Signs of TPLO Failure in Dogs & When to See a Vet
Learn the key symptoms of TPLO failure in dogs, from limping to implant issues. Spot warning signs early and know when to seek veterinary care
Tibial Plateau Leveling Osteotomy (TPLO) is a surgery used to treat cranial cruciate ligament (CCL) injuries in dogs. Instead of replacing the damaged ligament, TPLO changes the knee's mechanics by cutting and rotating the tibia to stabilize the joint. This procedure greatly improves mobility and reduces pain, making it one of the most effective treatments for CCL injuries.
While TPLO is often successful, complications can occur. Problems may arise from surgical errors, implant issues, infections, or improper post-operative care. These issues can cause severe pain, lameness, and reduced mobility, requiring immediate attention.
Recognizing symptoms of TPLO failure early is crucial. Pet owners and veterinarians must closely monitor recovery to spot signs of complications. Identifying problems early can prevent further damage, improve treatment outcomes, and sometimes avoid the need for corrective surgery. Being aware ensures a better quality of life for the dog.
Early Warning Signs of TPLO Failure
Recognizing early symptoms of TPLO failure is crucial for timely intervention. While mild discomfort and swelling are normal during the initial recovery period, persistent or worsening symptoms may indicate complications.
Persistent Lameness or Limping
Mild lameness is expected for the first few weeks after TPLO surgery. Most dogs show significant improvement within 8–12 weeks. However, if limping persists beyond this period or worsens, it may signal poor bone healing, implant failure, or an underlying infection.
Signs of concern include the dog favoring the other leg, difficulty bearing weight, or sudden regression in mobility. If the leg does not seem to be healing as expected or if there is no gradual improvement, further veterinary evaluation is necessary. X-rays can help determine if the bone is healing correctly or if complications exist.
Read more about: Common Causes of Limping in Dogs Post-TPLO Surgery
Pain During Movement or Reluctance to Use the Affected Leg
Some discomfort is normal post-surgery, but persistent pain when walking, climbing stairs, or standing up may indicate a problem. If a dog avoids using the leg weeks after surgery or shows hesitation in movement, it could be due to implant irritation, improper bone healing, or inflammation. Pain when touching the leg, vocalization, or a stiff gait are red flags.
A dog that initially improves but later develops increased pain needs urgent assessment. A vet may perform imaging and physical exams to check for implant loosening, joint infections, or soft tissue complications affecting recovery.
Swelling Around the Surgical Site
Mild swelling is expected for a few days post-op but should gradually decrease. If swelling persists, worsens, or becomes firm and painful, it may indicate a complication. Excessive swelling could result from implant irritation, fluid buildup, or infection. If the area feels warm or if swelling is accompanied by lameness, immediate veterinary attention is necessary.
A seroma (fluid accumulation) may require drainage, while severe swelling linked to infection or implant rejection may necessitate medical intervention or revision surgery. Monitoring the surgical site daily helps detect abnormal swelling before it leads to more serious issues.
Signs of Infection (Redness, Discharge, Heat)
Post-surgical infections can occur around the incision or deep within the joint, though they are less common when Simini Protect Lavage is used, as it helps reduce bacterial contamination during surgery. However, infections can still develop due to improper wound care, immune response issues, or implant-related complications.
Early symptoms include redness, swelling, heat, and discharge from the incision site. A foul odor, increased pain, or excessive licking are also concerning. If untreated, infections can spread, leading to implant instability, fever, lethargy, and appetite loss. In severe cases, infection may require implant removal and surgical intervention.
Prompt antibiotic therapy is essential to control bacterial growth. Regular wound monitoring, proper hygiene, and early veterinary attention help prevent minor infections from escalating.
Structural and Mechanical Failures
These complications indicate that the surgical repair is not functioning correctly, leading to ongoing instability and pain. Unlike early post-op discomfort, structural failures can cause long-term mobility issues and may require corrective surgery.
Recurrent Knee Joint Instability
After TPLO, the knee joint should be stable due to the new tibial alignment. However, if a dog shows difficulty walking, wobbling, or an unstable gait, it may signal failed bone healing or implant issues. Instability can result from improper fusion of the cut tibia, loose screws, or excessive strain on the joint.
A dog may shift weight frequently or show reluctance to move, indicating mechanical failure. X-rays and physical exams help confirm whether the joint is unstable. Left untreated, instability can lead to severe arthritis, chronic pain, and reduced mobility, making early intervention critical.
Meniscal Injury or Tear
Meniscal damage is a common complication following TPLO surgery, as this cartilage helps cushion the knee joint. A torn meniscus can occur due to improper knee mechanics or residual instability. Symptoms include a sudden return of lameness, difficulty bearing weight, or a clicking or popping sound when the knee moves.
Dogs may yelp when standing or walking and may become more inactive due to pain. A torn meniscus may require surgical removal or repair to restore function. Without treatment, the condition can worsen, leading to chronic discomfort and long-term joint deterioration.
Post-Operative Meniscal Tear
A meniscal tear can occur at the time of surgery (primary tear) or develop later due to knee instability (secondary tear). A secondary meniscus tear is particularly concerning, as it often happens weeks or months after the initial procedure. This results in immediate pain, limping, and reluctance to move.
Dogs with a new meniscus tear may suddenly regress in their recovery, refusing to put weight on the leg despite previous improvements. Surgical intervention is often required to remove the damaged cartilage and restore comfort. Regular post-op checkups help detect meniscal issues before they become severe.
Implant Loosening, Bending, or Breakage
TPLO implants, including plates and screws, must remain secure for proper healing. If an implant loosens, bends, or breaks, the bone may fail to stabilize, causing pain and mobility loss. Signs include swelling, limping, reluctance to use the leg, or a clicking sensation in the joint. Implant failure can result from improper post-op care, excessive activity, or underlying bone weakness.
Overweight dogs and those resuming activity too soon are at higher risk. X-rays are necessary to confirm implant damage. Severe cases may require revision surgery to replace or secure the implants and restore knee stability.
Advanced TPLO Failure Symptoms
These symptoms indicate severe complications requiring medical intervention. If TPLO failure progresses, a dog may experience chronic pain, loss of function, or permanent joint damage. Early detection is key to preventing irreversible issues.
Delayed Bone Healing or Nonunion
Bone healing after TPLO typically takes 8–12 weeks. However, some dogs experience delayed healing or nonunion, where the bone fails to fuse properly. Causes include poor nutrition, excessive movement, infections, or improper plate positioning.
Dogs with nonunion may show persistent limping, pain, or swelling at the surgical site. X-rays can confirm if the bone is healing correctly. Nonunion requires intervention, such as adjusting activity levels, improving diet, or, in severe cases, revision surgery. If left untreated, it can lead to chronic instability and increased risk of implant failure.
Muscle Atrophy Around the Thigh
Muscle atrophy occurs when a dog avoids using the affected leg, leading to gradual muscle loss in the thigh. Mild atrophy is normal post-surgery but should improve with rehabilitation. However, progressive muscle loss suggests long-term mobility issues, improper healing, or ongoing pain. Dogs with severe atrophy may struggle with balance, fatigue quickly, or rely heavily on the other leg.
Physical therapy, controlled exercise, and pain management help restore muscle strength. If left unaddressed, muscle atrophy can make recovery difficult and reduce overall limb function, leading to permanent weakness.
Recurrent or Persistent Mobility Issues
Most dogs regain near-normal function within a few months after TPLO. However, if mobility issues persist beyond this period, it could indicate implant failure, arthritis, or joint instability. Some dogs may continue limping, struggle with stairs, or hesitate to run and jump. Persistent dysfunction suggests that TPLO did not fully correct the knee mechanics, leading to long-term discomfort.
Chronic instability may also cause secondary joint problems. Veterinary evaluation, including X-rays and orthopedic exams, is needed to determine if additional treatment or revision surgery is required. Without intervention, mobility may decline further, affecting quality of life.
Signs of Implant Failure (Mild Discomfort to Acute Pain)
Implant failure can range from mild discomfort to severe pain. Early signs include persistent limping, swelling, and difficulty bearing weight. If an implant loosens or breaks, symptoms can suddenly worsen, causing acute distress, refusal to move, or vocalization when walking. Clicking or grinding noises may also indicate implant instability.
Severe cases require urgent veterinary care, as implant failure can lead to bone fractures or infection. X-rays confirm implant integrity, and treatment may involve pain management, restricted movement, or surgical revision. Delayed care increases the risk of complications, making early detection crucial.
Potential Need for Revision Surgery
Revision TPLO surgery is necessary when the original procedure fails due to nonunion, implant failure, or chronic instability. This involves replacing damaged implants, repositioning the tibial cut, or addressing infections. Revision surgery is often more complex than the initial procedure and requires strict post-op management.
Recovery may take longer, but successful revision can restore knee stability and improve function. If left untreated, TPLO failure can result in chronic pain, severe arthritis, or loss of mobility. A thorough veterinary evaluation determines if revision surgery is the best option for improving the dog’s quality of life.
When to See a Veterinarian
Pet owners should contact a veterinarian if their dog shows signs of worsening pain, persistent lameness beyond 12 weeks, or sudden regression in mobility after initial improvement.
Other concerning symptoms include swelling that does not subside, redness or discharge from the surgical site, difficulty bearing weight, or signs of infection like fever and lethargy. Any clicking or grinding sounds from the knee may indicate meniscal damage or implant instability, requiring immediate attention.
To confirm TPLO failure, veterinarians use diagnostic tests such as X-rays to assess bone healing and implant positioning, CT scans for detailed imaging of the knee structure, and joint fluid analysis to detect infections or inflammation. In severe cases, additional tests may be needed to evaluate soft tissue damage.
Early veterinary intervention can prevent further complications, reducing the need for complex revision surgery and ensuring a better long-term outcome for the dog.
Preventing TPLO Failure
Proper post-operative care is essential for preventing TPLO failure and ensuring a smooth recovery. Strict activity restriction is crucial in the first 8–12 weeks—dogs should avoid running, jumping, or using stairs. A knee brace may provide additional joint support, especially for highly active dogs. Physical therapy helps restore strength and mobility while minimizing the risk of complications.
To promote proper healing, a nutrient-rich diet with adequate protein, calcium, and joint supplements (such as glucosamine) supports bone repair. Regular follow-up vet visits allow for X-ray monitoring to confirm bone fusion and implant stability.
Recognizing early red flags—such as persistent limping, swelling, or signs of infection—can prevent serious complications. Pet owners should check the incision site daily and report any unusual symptoms.
By following post-op guidelines and addressing concerns promptly, the risk of TPLO failure can be significantly reduced, leading to a successful recovery and long-term joint stability.
Read more about:
- Long-term outcomes of TPLO surgery
- Common myths about TPLO surgery explained
- Long-term effects of TPLO surgery on dogs
- Post-surgery recovery after TPLO in dogs
- TPLO surgery for older dogs: Is it a worthwhile option?
Conclusion
TPLO surgery is usually successful, but failures can happen due to improper healing, implant problems, or post-operative complications. Key symptoms of TPLO failure include:
- persistent lameness
- swelling
- pain during movement
- joint instability
- signs of infection
Structural issues like implant loosening, meniscal tears, or delayed bone healing can further hinder recovery.
Early detection is crucial—addressing warning signs quickly can prevent serious complications and reduce the need for additional surgery. Regular vet checkups, diagnostic imaging, and close monitoring of mobility help catch problems before they worsen.
Strict adherence to post-op care is essential in preventing TPLO failure. Pet owners should limit activity, ensure proper nutrition, and follow rehabilitation plans as advised by their veterinarian. By recognizing symptoms early and sticking to recovery guidelines, pet owners can improve their dog’s chances of a successful TPLO outcome and long-term mobility.
FAQs
What happens if TPLO fails in dogs?
If TPLO fails, the affected leg may remain unstable, leading to chronic pain, persistent lameness, and arthritis. The knee joint may not heal properly, causing difficulty in movement. In severe cases, implant failure or bone nonunion may require revision surgery to correct the issue. If left untreated, TPLO failure can significantly impact a dog’s mobility and overall quality of life.
What percent of TPLO surgeries fail?
TPLO has a high success rate, with over 90-95% of dogs recovering well. However, failure can occur in 5-10% of cases due to infections, implant loosening, meniscal injuries, or delayed bone healing. Factors like improper post-op care, excessive activity, or underlying health conditions increase the risk. Early detection and proper recovery management can reduce complications and improve surgical outcomes.
How to tell if a dog's ACL surgery failed?
Signs of TPLO failure include persistent limping, swelling, pain, and reluctance to use the affected leg beyond the expected recovery period. Clicking sounds in the joint, excessive stiffness, or visible implant issues may also indicate failure. If a dog’s condition worsens instead of improving, a vet should perform X-rays or CT scans to assess healing and detect complications.
Why is my dog limping 2 years after TPLO surgery?
Limping two years post-TPLO may result from arthritis, implant irritation, meniscal damage, or muscle atrophy. Some dogs develop scar tissue or secondary joint issues that cause discomfort. If limping is sudden, it could indicate a late meniscus tear or implant problem. A veterinary exam, including imaging, can determine the cause and guide appropriate treatment, such as pain management or revision surgery.
What does a failed TPLO look like?
A failed TPLO often presents as persistent pain, joint instability, swelling, or difficulty bearing weight on the affected leg. Dogs may show progressive lameness, reluctance to move, or audible joint clicking. Severe cases may involve implant loosening, infection, or nonunion of the bone, which can be confirmed through X-rays or CT scans. Early intervention is crucial to prevent worsening complications.
Can TPLO surgery be redone?
Yes, revision TPLO surgery can be performed if the initial procedure fails. This may involve removing or replacing implants, repositioning the tibial cut, or addressing infections. Revision surgery is often more complex and requires strict post-op care. In some cases, alternative treatments like custom knee braces or joint fusion procedures may be considered if TPLO cannot be successfully redone.
What is the alternative to TPLO on dogs?
Alternatives to TPLO include Lateral Suture Stabilization (Extracapsular Repair), Tibial Tuberosity Advancement (TTA), and CBLO (Cora-Based Leveling Osteotomy). These procedures also stabilize the knee but may be better suited for smaller dogs or specific cases. Non-surgical options like custom braces, weight management, and physical therapy may help in mild or inoperable cases, though they do not provide the same level of stability as TPLO.
How long can a dog go without TPLO surgery?
Dogs with a torn CCL can survive without TPLO, but untreated ligament injuries lead to chronic pain, arthritis, and joint deterioration. Some small or inactive dogs may adapt with braces, weight control, and pain management, but larger, active dogs usually require surgery for long-term stability. Without intervention, progressive joint damage can severely impact mobility, making walking difficult or painful over time.

TPLO
5 min read
Staph Infection After TPLO Surgery: Signs & Risks
Staph infections after TPLO surgery can cause serious issues. Learn how to spot early symptoms, treat infections, and prevent complications
A Staph infection after TPLO surgery is a bacterial infection caused by Staphylococcus species at the surgical site. These infections happen when bacteria enter the incision, leading to inflammation, pain, swelling, and, in severe cases, delayed healing or implant issues.
The most common bacteria involved are
- Staphylococcus pseudintermedius (S. pseudintermedius is naturally found on a dog's skin and can become problematic after surgery.)
- Staphylococcus aureus (S. aureus is less common in dogs but can still cause serious infections, sometimes resistant to antibiotics like MRSA.)
TPLO surgeries are particularly prone to infection because of the metal implants, which provide a surface for bacteria to stick to and form biofilms. Additionally, open incisions, surgical trauma, and a dog's licking or scratching increase the risk of infection.
Using proper sterile techniques, taking care of the wound after surgery, and detecting infections early are crucial for preventing complications and ensuring a smooth recovery.
TL;DR
- Staph infections after TPLO surgery are rare but can happen, with Staphylococcus pseudintermedius being the most common culprit.
- Early treatment with antibiotics is crucial as infections typically won't heal on their own and can lead to serious complications.
- Untreated infections may cause osteomyelitis, implant failure, or systemic illness, requiring more invasive treatments.
- Proper post-op care and monitoring the incision site are key to preventing infections.
- If an infection is severe, the TPLO plate may need to be removed to prevent further complications.
Causes of Staph Infection After TPLO Surgery
Staph infections after TPLO surgery occur when Staphylococcus bacteria enter the surgical site, multiply, and trigger an inflammatory response. These infections can develop due to various factors, often related to contamination, improper wound care, or the dog's overall health.
Surgical Site Contamination - Even with strict sterile protocols, bacteria from the skin, surgical instruments, or operating room can enter the incision. Staphylococcus pseudintermedius is naturally found on a dog's skin and may infect the site if proper antiseptic measures are not followed.
Improper Wound Care - After surgery, poor wound management increases infection risk. If bandages are not changed regularly, the incision is exposed to dirt, or the dog licks the wound, bacteria can enter. Delayed healing also creates an opportunity for bacterial overgrowth.
Weakened Immunity - Dogs with weakened immune systems due to age, chronic illnesses (like diabetes or Cushing’s disease), or prolonged use of immunosuppressive medications are more vulnerable to infections. Their bodies struggle to fight bacteria, increasing the risk of severe complications.
Hospital-Acquired vs. Environmental Bacteria - Hospital-acquired infections, often resistant to antibiotics (e.g., MRSA), pose a serious threat. Environmental bacteria, from bedding, floors, or other animals, can also infect wounds if hygiene is inadequate. Proper post-op care and monitoring are essential for prevention.
Risk Factors for Developing Infections Post-TPLO
Several factors increase the risk of Staph infection after TPLO surgery, including dog-related, surgical, and post-op care factors. Understanding these risks helps in preventing complications and ensuring a smooth recovery.
Dog-Related Factors
Certain dogs are more prone to infections. Older dogs, immunocompromised pets (diabetes, Cushing’s disease), and breeds with skin folds (like Bulldogs) are at higher risk due to weaker immune defenses or bacterial colonization. Overweight dogs also have reduced blood flow to the incision, slowing healing.
Surgical Factors
Implant contamination is a major concern, as metal plates provide a surface for bacteria to form biofilms, making infections harder to treat. Prolonged surgery times, non-sterile conditions, and inadequate antibiotic prophylaxis increase infection risk.
To minimize this, many surgeons use Simini Protect Lavage, a non-antibiotic surgical lavage that helps reduce bacterial contamination and biofilm formation on implants, lowering the chances of post-op infections.
Post-Op Care Factors
Excessive licking, poor hygiene, and delayed wound healing significantly raise infection risks. Dogs licking their incision introduce bacteria, while unclean bedding and surroundings expose wounds to environmental contaminants. Owners must follow strict post-op wound care guidelines and monitor for early signs of infection.
Symptoms of a Staph Infection After TPLO Surgery
Recognizing the early signs of Staph infection after TPLO surgery is crucial for timely treatment. Infections can range from mild to severe, potentially leading to implant complications or systemic illness if left untreated.
Early Signs - In the initial stages, the infection may cause redness, swelling, and warmth around the incision site. Mild discomfort is normal post-surgery, but persistent inflammation or increasing pain could indicate bacterial activity. Some dogs may start licking or chewing the incision, further worsening the condition.
Moderate Symptoms - As the infection progresses, pus or thick discharge may develop, often accompanied by a foul odor. The incision may start to separate or appear moist and inflamed. Dogs might also show signs of discomfort, such as limping, stiffness, or reluctance to bear weight on the affected leg. These symptoms suggest that the infection is spreading deeper into the tissue.
Severe Symptoms - In advanced cases, the infection can lead to systemic illness, causing fever, lethargy, loss of appetite, and general weakness. If bacteria spread to the bone or implant, it can result in implant loosening or failure, requiring urgent medical intervention. Immediate veterinary attention is needed to prevent complications and ensure proper healing.
How Staph Infections Are Diagnosed After TPLO Surgery
Diagnosing a Staph infection after TPLO surgery requires a thorough veterinary examination, laboratory tests, and sometimes imaging to assess the severity of the infection and its impact on the surgical site.
Veterinary Examination and Wound Assessment
A veterinarian will start by visually inspecting the incision site for signs of infection, such as redness, swelling, pus, or a foul odor. They will also check for pain, heat, and any abnormal discharge. If the dog is limping, lethargic, or showing signs of discomfort, it may indicate a deeper infection affecting the bone or implant.
Lab Tests: Bacterial Culture and Antibiotic Sensitivity
To confirm a Staph infection, a bacterial culture is performed by collecting a sample from the infected area. This test identifies the specific bacteria causing the infection, typically Staphylococcus pseudintermedius or Staphylococcus aureus.
Antibiotic sensitivity testing is then conducted to determine which antibiotics will be most effective, especially important for resistant strains like MRSP (Methicillin-Resistant Staphylococcus pseudintermedius).
Imaging Methods for Implant-Associated Infections
If an infection is suspected to have spread to the bone or implant, X-rays or advanced imaging like CT scans may be used. These help detect signs of bone lysis, implant loosening, or deep tissue infection, which could require additional surgical intervention. Early diagnosis is crucial to prevent complications and improve treatment outcomes.
The Role of Multidrug-Resistant Bacteria in TPLO Infections
One of the biggest challenges in treating Staph infections after TPLO surgery is the presence of multidrug-resistant bacteria, particularly Methicillin-Resistant Staphylococcus pseudintermedius (MRSP). This bacterial strain has developed resistance to many commonly used antibiotics, making infections harder to treat and increasing the risk of complications.
What is MRSP?
MRSP is a resistant form of Staphylococcus pseudintermedius, a bacterium normally found on a dog’s skin. In healthy dogs, it rarely causes issues, but after TPLO surgery, it can infect the surgical incision and implants, leading to persistent infections. MRSP is similar to MRSA (Methicillin-Resistant Staphylococcus aureus) in humans, making it difficult to eliminate with standard antibiotics.
Why Traditional Antibiotics May Not Work
Since MRSP is resistant to beta-lactam antibiotics (penicillins and cephalosporins), commonly prescribed antibiotics may be ineffective. Inappropriate antibiotic use can worsen resistance, making treatment options more limited. Infected implants and biofilm formation further protect the bacteria, requiring alternative treatments.
Impact on Treatment Complexity and Recovery Time
Resistant infections prolong recovery, as stronger antibiotics, prolonged treatment, or even implant removal may be necessary. In severe cases, advanced antimicrobial therapies, surgical debridement, or alternative infection-control measures like Simini Protect Lavage may be required to manage the infection and prevent recurrence. Early culture and sensitivity testing is essential for selecting the most effective treatment.
How Biofilms on Implants Worsen Staph Infections
Biofilms are colonies of bacteria that form a protective layer on surfaces, such as TPLO plates and screws. In post-surgical infections, Staphylococcus pseudintermedius and other bacteria can attach to the metal implant, creating a slimy, protective matrix that shields them from antibiotics and the immune system.
How Biofilms Form on TPLO Implants
After TPLO surgery, bacteria from the skin, surgical instruments, or environment can adhere to the implant. Once attached, they produce a sticky extracellular substance, allowing them to grow and form a dense bacterial community. These biofilms anchor bacteria to the implant surface, making infections harder to eradicate.
Why Biofilms Resist Antibiotics and Immune Responses
Biofilms create a physical and chemical barrier that prevents antibiotics from fully reaching the bacteria. Additionally, bacteria within biofilms enter a dormant state, reducing their susceptibility to drugs that typically target active bacterial growth. The immune system also struggles to clear biofilms, as white blood cells cannot penetrate the bacterial layer effectively.
Treatment Challenges and Surgical Interventions
Because biofilm-associated infections are difficult to treat, prolonged antibiotic therapy alone is often ineffective. In severe cases, surgical debridement or implant removal may be required.
Many surgeons use Simini Protect Lavage during TPLO procedures to reduce bacterial adhesion and biofilm formation, helping to lower the risk of persistent infections.
Complications of Staph Infection After TPLO Surgery
A Staph infection after TPLO surgery can lead to severe complications if not treated promptly. The presence of metal implants, biofilm formation, and antibiotic-resistant bacteria make these infections particularly challenging.
- Implant Rejection or Failure - When bacteria colonize the TPLO plate, they can cause loosening of the implant, preventing proper bone healing. The immune system may recognize the infection as a foreign threat, triggering chronic inflammation and implant rejection. In severe cases, implant removal and revision surgery are required.
- Chronic Infections Leading to Osteomyelitis - Untreated or persistent infections can spread to the bone, causing osteomyelitis (bone infection). This condition leads to bone destruction, pain, and ongoing inflammation. Osteomyelitis often requires long-term antibiotics, surgical debridement, and sometimes implant removal to eliminate infected tissue.
- Increased Surgical Costs and Prolonged Recovery - Managing an infection often involves extended hospitalization, additional lab tests, imaging, and stronger antibiotics, significantly increasing treatment costs. The healing process is also delayed, prolonging the dog's discomfort and recovery timeline.
- When Amputation Might Become Necessary - In rare and extreme cases, if the infection is severe, untreatable, or has caused significant bone damage, limb amputation may be the only option to prevent systemic infection and further suffering. Early intervention is critical to avoid this drastic measure.
Treatment Options for Staph Infection Post-TPLO Surgery
Antibiotic Therapy
Common antibiotics for Staph infections include Clindamycin and Cephalexin, but resistant strains like MRSP require targeted antibiotics based on culture and sensitivity testing. If standard treatments fail, fluoroquinolones or chloramphenicol may be necessary. Completing the full antibiotic course is essential to prevent recurrence and resistance. Improper use of antibiotics can worsen resistance, making future infections harder to treat.
Surgical Interventions
If the infection is severe or antibiotics fail, surgical debridement is required to remove infected tissue and biofilm. In persistent infections, implant removal or revision surgery may be necessary. Surgeons may use antibiotic-impregnated beads to deliver localized medication directly to the infected site. This approach helps manage deep infections while preserving limb function, reducing the need for implant removal.
Supportive Care & Wound Management
Topical treatments like chlorhexidine and silver-based dressings help control bacterial growth at the incision. Proper wound cleaning, bandaging, and preventing licking are essential for recovery. Pain management with NSAIDs or opioids reduces discomfort, while anti-inflammatory medications control swelling. Supportive care ensures healing and prevents the infection from worsening or spreading further.
Why Early Detection and Intervention Are Crucial
Early detection and intervention are essential in preventing serious complications from Staph infections after TPLO surgery. The longer an infection goes untreated, the more likely it is to spread and cause severe complications such as osteomyelitis (bone infection), implant failure, or systemic illness. Timely treatment helps limit the damage, reduce recovery time, and avoid costly surgical interventions.
How Early Treatment Prevents Serious Complications - When infections are caught early, antibiotics can effectively control the bacteria before it forms a biofilm on the implant, making it resistant to treatment. Early intervention reduces the chances of bone destruction, chronic infections, and the need for implant removal or amputation.
When to Consult a Vet Immediately - If your dog shows any signs of infection, such as increased swelling, redness, warmth, or pus at the incision site, limping, lethargy, or fever, contact your vet immediately. Foul-smelling discharge or worsening symptoms require urgent attention, as they indicate that the infection is spreading.
The Importance of Regular Follow-Ups After TPLO Surgery - Post-surgery follow-ups are crucial for monitoring the surgical site and identifying early signs of infection. Regular check-ups help ensure that any issues are detected before they develop into more severe problems, ensuring the best possible recovery and reducing the risk of complications.
How to Prevent Staph Infections After TPLO Surgery
Pre-Surgical Prevention
Preventing Staph infections starts before surgery with proper planning. The sterile surgical environment is crucial in minimizing contamination during the procedure. Surgeons should follow strict sterilization protocols to prevent bacteria from entering the wound.
For high-risk dogs, pre-operative antibiotic protocols are recommended, especially if the dog has underlying health conditions like diabetes or is older, as these factors can weaken the immune system and increase infection susceptibility.
Post-Surgical Care Guidelines
Post-surgery, wound monitoring and cleaning are essential for preventing infection. Keep the surgical site dry and clean, changing bandages as instructed. Using an e-collar (cone of shame) can help prevent your dog from licking or biting the wound, which can introduce bacteria.
Avoid exposing your dog to contaminated environments, such as dog parks, dirty floors, or areas with other animals, until the wound is fully healed. This minimizes the risk of external contamination.
Long-Term Prevention Strategies
To maintain your dog’s health after surgery, ensure they have a well-balanced diet and consider supplements that support immune function, such as omega-3 fatty acids. Regular vet checkups help monitor recovery and prevent potential infections.
Even months after surgery, look for signs like swelling, redness, or changes in behavior that could indicate infection risks. Early intervention can prevent complications and ensure your dog’s full recovery.
Read more about:
- Post-Surgery Recovery After TPLO in Dogs
- TPLO Surgery for Older Dogs: Is It a Worthwhile Option?
- Common Myths About TPLO Surgery Explained
- 13 Long-Term Effects of TPLO Surgery on Dogs
Final Thoughts
Staph infections after TPLO surgery can be very serious, leading to implant failure, bone infections, and longer recovery times. Early signs like redness, swelling, or discharge around the incision should never be ignored. Quick treatment with antibiotics and, if needed, surgery is vital to avoid serious problems.
Catching these infections early is crucial to stopping them from getting worse. Noticing the signs early and getting veterinary care right away can lead to better results and lower the risk of long-term harm. Proper post-surgery care, like cleaning the wound, using e-collars, and avoiding dirty areas, is key to preventing infections.
Pet owners should actively monitor their dog’s recovery and keep up with regular vet visits. If any issues arise, consult a vet without delay. Prevention and quick action are the best ways to ensure a smooth recovery and reduce the risk of Staph infections after TPLO surgery.
FAQs
How common is a staph infection after TPLO surgery?
Staph infections after TPLO surgery are relatively uncommon but still a risk, especially in high-risk dogs. Approximately 5-10% of dogs undergoing TPLO may develop infections, with Staphylococcus pseudintermedius being the most common bacterial culprit. Proper sterile technique during surgery, post-op care, and infection prevention strategies can reduce the chances of infection.
Can a staph infection after TPLO surgery heal on its own?
A staph infection after TPLO surgery typically does not heal on its own. Bacterial infections require medical treatment, such as antibiotics, to clear up. Without proper treatment, the infection can spread, causing serious complications like bone infection or implant failure. Seeking veterinary care immediately for proper diagnosis and treatment is essential.
What happens if a TPLO infection is left untreated?
If a TPLO infection is left untreated, it can lead to severe complications such as osteomyelitis (bone infection), implant failure, or systemic illness. The infection may spread deeper, causing chronic pain and delayed healing. In some cases, untreated infections may require surgical intervention, including implant removal or even amputation in extreme situations.
How long does it take for an infection to clear up after TPLO?
The time it takes for an infection to clear up after TPLO surgery depends on the severity of the infection and treatment method. Mild infections may clear up in 2-4 weeks with antibiotics, while severe infections can take several months and may require additional surgeries. Follow-up care is crucial to monitor progress and ensure full recovery.
Are certain dog breeds more prone to infections after TPLO?
Certain dog breeds are more prone to infections after TPLO surgery due to factors like skin folds, immune system strength, or breed-specific health issues. Breeds like Bulldogs, Pugs, and Boxers with compromised immune systems or skin conditions may have a higher risk of infection. Additionally, older dogs or those with chronic conditions like diabetes are more vulnerable.
What should I do if my dog’s TPLO incision looks infected?
If your dog’s TPLO incision looks infected, such as showing redness, swelling, pus, or a foul odor, you should consult your vet immediately. Early intervention with antibiotics or surgical debridement is essential to prevent the infection from spreading. Avoid letting your dog lick the wound and keep the incision clean while awaiting professional care.
Can a TPLO plate be removed if it causes infection?
Yes, a TPLO plate can be removed if it causes infection. In cases where the infection is persistent or deep, or if the implant becomes loose or infected, removal of the plate may be necessary to eliminate the source of the infection. The veterinarian will assess the situation and determine whether removal or revision surgery is the best option for recovery.

TPLO
5 min read
How to Confine Your Dog Post-TPLO Surgery
Keep your dog safe after TPLO surgery with smart confinement tips. Learn crate setup, barriers, and daily care for smooth healing
Why Confinement Matters After TPLO Surgery
Confinement is one of the most important parts of TPLO recovery. After surgery, your dog’s knee is healing and not yet stable. Limiting movement protects the surgical site and gives the bone, soft tissues, and implant time to settle and heal properly.
Without proper confinement, your dog may jump, run, or twist the leg—movements that can cause serious problems. These actions can lead to re-injury, implant failure, or delayed healing. Even a short burst of energy during the early weeks can undo the surgical repair.
Use a crate, pen, or small room with non-slip flooring to keep your dog calm and safe. Always use a leash when outside, even for bathroom breaks. Proper confinement supports faster healing, reduces pain, and lowers the risk of complications, helping your dog return to normal life sooner.
Choosing the Right Confinement Setup
Crate or Small Room
A crate is one of the safest ways to confine your dog after TPLO surgery. It limits movement while allowing rest in a cozy, secure space. Crates help prevent jumping, running, or sudden twisting that can damage the healing leg.
Choose a crate that’s large enough for your dog to stand, turn around, and lie down comfortably, but not so big that they can run inside it. Use soft bedding and avoid wire flooring. A small, quiet room can also work if the crate feels too restrictive for your dog.
Exercise Pen (X-pen) as an Alternative
An exercise pen (X-pen) is a good option for dogs who don’t do well in crates. It allows more room to stretch while still limiting unsafe movement. Use it only if your dog is calm and not likely to jump or push against the sides.
To make it secure, place it on non-slip flooring and anchor the panels so they don’t move. Avoid putting toys that may cause too much excitement inside. An X-pen works best when placed in a quiet corner of the home, away from distractions.
Baby Gates and Physical Barriers
Baby gates or other barriers can help block off areas like stairs, hallways, or rooms where your dog may try to run or jump. They’re useful when using a small room as a recovery space or to limit access within your home.
Make sure gates are tall enough and securely installed to prevent your dog from pushing them over. Combine gates with closed doors or blocked furniture to create a safe recovery zone that’s quiet, has soft bedding, and keeps your dog close to you while staying confined.
Making the Space Safe and Comfortable
Use Non-Slip Floors
Slick floors like tile or hardwood can be dangerous after TPLO surgery. Dogs recovering from surgery may slip easily, which can strain the healing leg or even damage the implant. To prevent falls, cover the floor with non-slip rugs, yoga mats, or rubber-backed runners.
These give your dog better grip when walking or shifting positions. Make sure mats lie flat to avoid tripping. A stable, slip-free surface gives your dog more confidence to move safely and supports better recovery during the early healing stages.
Remove Hazards and Obstacles
To keep your dog’s recovery area safe, remove anything that could cause injury or discomfort. Take away slippery throw rugs, which can slide underfoot. Watch out for sharp corners, unstable furniture, or clutter your dog could bump into or trip over.
Keep electrical cords out of reach and make sure the area is free from chewable or breakable items. A hazard-free zone gives your dog a calm, injury-free space to rest and heal without the risk of accidents or stress.
Prevent Access to Furniture and Stairs
Jumping on or off furniture and climbing stairs is risky after TPLO surgery. These movements can place too much pressure on the healing leg and lead to setbacks. Use baby gates or closed doors to block off stairs and rooms with couches or beds.
If your dog must use stairs to access the outdoors, consider using a ramp or carry them with proper support. Keeping your dog grounded and away from heights protects the surgical site and helps prevent reinjury.
Add Soft Bedding and Essentials
Comfort is key during recovery. Use soft, supportive bedding to cushion your dog’s joints and help them relax. Orthopedic dog beds or thick blankets work well. Place food and water bowls within easy reach, so your dog doesn’t need to walk far.
Keep the area clean by washing bedding often and wiping up spills. Good hygiene prevents infections and keeps the recovery space fresh. A comfortable, well-stocked setup reduces stress, supports healing, and helps your dog feel calm and cared for.
Managing Daily Routines in Confinement
Always Use a Leash Outside the Confinement Area
After TPLO surgery, always keep your dog on a short leash, even indoors, when outside the recovery space. This includes bathroom breaks or short walks across the house. Dogs can get excited quickly and make sudden movements that may harm the healing leg.
Using a leash helps you control their speed and direction. It also prevents jumping, running, or slipping on smooth floors. Calm, guided movement keeps your dog safe and reduces the risk of re-injury during recovery.
Stick to a Strict Potty Schedule
Maintaining a consistent potty routine helps reduce stress for both you and your dog. Take your dog out at the same times each day using a leash. Always go to the same spot, so they recognize it as their bathroom area. Avoid long walks or distractions.
A set schedule helps regulate their body, keeps outings short, and makes it easier to control their movement. Staying consistent also reduces the chances of indoor accidents and supports a calm recovery environment.
Supervise Whenever Out of Confinement
Your dog should never be out of the recovery area without supervision, even for short periods. No off-leash time is allowed during the early weeks. Watch closely for signs of restlessness, like pacing, whining, or sudden bursts of energy.
These can lead to unsafe movement that may damage the healing leg. Always stay nearby and use a leash to guide them. Close supervision ensures your dog stays calm and safe, giving the surgery site time to heal properly.
Final Tips for a Smooth Recovery
A calm mind is just as important as a healing body. Keep your dog mentally calm by creating a peaceful environment with limited noise and stimulation. If needed, you can introduce safe mental enrichment later in recovery, like puzzle toys or slow feeders, but only with your vet’s approval.
If you have concerns about confinement, such as anxiety or restlessness, talk to your vet. They can suggest calming aids, safe adjustments, or behavior tips to help your dog settle.
As your dog heals, you may need to adjust the recovery space. For example, you can allow more room to stretch or reposition food and water bowls as mobility improves. Always make changes based on your vet’s guidance. Recovery takes time, but with patience, proper care, and the right setup, your dog will be on the path to a healthy, active life again.
Read more about:
- TPLO failure symptoms
- Long-term outcomes of TPLO surgery
- Common causes of limping in dogs post-TPLO surgery
- Preparing for your dog’s TPLO surgery
FAQs
How to keep a dog calm after TPLO surgery?
Keep your dog in a quiet, confined space like a crate or small room. Avoid visitors, loud noises, and playtime. Use soft bedding and stick to a calm routine. If needed, ask your vet about safe calming aids or anxiety support during the early recovery period.
Can I leave my dog alone after TPLO surgery?
Yes, but only if your dog is safely confined in a crate or pen where they can’t jump or move around too much. Make sure they have food, water, and can’t reach the incision. Avoid leaving them alone for long periods, especially during the first week.
Can my dog walk around the house after TPLO?
No, free movement around the house is not safe during early recovery. Your dog should only walk on a leash for short bathroom breaks. Letting them walk freely can risk injury, implant damage, or slower healing. Always supervise and limit movement as advised by your vet.
How long is a dog in pain after TPLO?
Most dogs experience some pain or discomfort for the first 7–10 days after surgery. Pain is usually well managed with vet-prescribed medications. If your dog seems uncomfortable beyond that or shows signs of distress, contact your vet for a recheck or medication adjustment.

TPLO
5 min read
How Long Does Swelling Last After TPLO Surgery
Find out how long swelling lasts after TPLO surgery, what’s normal, and when to call your vet for possible infection or complications.
Understanding Swelling After TPLO Surgery
Swelling is one of the most common post-surgical effects after TPLO surgery and a normal response to bone and soft-tissue manipulation. It’s part of the body’s natural repair process, helping deliver immune cells and nutrients to the surgical site. Understanding how much swelling is normal helps you track healing progress and detect problems early.
- Why Swelling Happens: During TPLO surgery, tissues are cut and repositioned around the tibia. The body reacts by sending inflammatory fluids and white blood cells to protect the area, causing temporary puffiness or firmness.
- Healing Function: Controlled inflammation aids recovery by clearing damaged cells and promoting tissue repair. It’s a key part of early bone healing in orthopedic surgeries.
- Types of Swelling: Mild swelling looks soft and reduces within a week with rest and cold compresses. Moderate swelling may cause mild warmth or stiffness but remains non-painful. Severe swelling, redness, or oozing signals infection or internal bleeding and needs urgent veterinary evaluation.
Recognizing normal versus abnormal swelling ensures timely intervention and supports a smoother, safer recovery after TPLO surgery.
Normal Timeline: How Long Swelling Lasts After TPLO Surgery
Mild to moderate swelling is expected after TPLO surgery, as the body responds to tissue trauma and healing begins. Understanding the normal timeline helps you distinguish healthy inflammation from potential complications.
- Typical Duration: Most dogs experience visible swelling for 3–7 days after surgery, peaking around day two or three. It gradually decreases as tissues start healing.
- Improvement Signs: Swelling should reduce noticeably by the end of the first week, with the incision area looking less puffy and the leg regaining flexibility.
- Extended Swelling Causes: Persistent swelling beyond a week may occur if the dog is overactive, licks the incision, or experiences friction from bandages.
- Influencing Factors: Large breeds, older dogs, or those with delayed healing may show prolonged swelling, especially without adequate rest.
- Monitoring Daily: Measuring or photographing the incision area helps track recovery progress and detect abnormal changes early.
As a general rule, swelling should lessen steadily each day. Any worsening or lack of improvement after one week warrants a call to your veterinarian.
What Normal Post-Operative Swelling Looks Like
Recognizing what healthy swelling looks like helps prevent unnecessary concern during your dog’s recovery. Normal post-operative inflammation is mild, symmetrical, and typically improves with basic care.
- Mild Puffiness: A soft, localized swelling around the knee joint or incision area is expected. The tissue may feel slightly firm but not painful when gently touched.
- Slight Warmth and Color Change: A light pink tone and mild warmth indicate good blood flow supporting healing. It should not feel hot or tender.
- Visible Improvement: Swelling starts to subside within several days as fluid drains naturally through the lymphatic system.
- Effect on Movement: Dogs may walk stiffly or limp slightly due to mild discomfort but should still bear some weight on the leg.
- Response to Care: Cold compresses, prescribed anti-inflammatory medication, and controlled rest help visible improvement appear within a week.
These mild signs of swelling represent the body’s healthy inflammatory phase and are an important part of tissue repair after TPLO surgery.
When Swelling Becomes a Concern After TPLO Surgery
While some inflammation is normal, excessive or worsening swelling can signal infection, seroma formation, or implant-related problems. Recognizing warning signs early is critical to prevent complications.
- Heat and Redness: If the surgical area feels hot, reddened, or painful to touch, infection or deeper inflammation may be developing.
- Discharge or Odor: Fluid leakage, pus, or foul smell from the incision suggests bacterial contamination that requires immediate veterinary care.
- Swelling Spreading Up the Leg: Puffy tissue moving toward the thigh or ankle indicates fluid buildup (seroma) or poor lymph drainage.
- Pain and Reluctance to Move: If your dog avoids using the leg, vocalizes when touched, or becomes lethargic, inflammation may be extending beyond normal levels.
- Fever or Appetite Loss: Systemic infection signs, such as fever or lack of appetite, mean urgent medical attention is needed.
Contact your veterinarian immediately if swelling increases after the first week or if any of these red flags appear. Prompt treatment prevents serious post-surgical complications.
Factors That Affect How Long Swelling Lasts After TPLO Surgery
Every dog heals differently, and several factors determine how long swelling persists after TPLO surgery. Paying attention to these variables helps guide proper recovery management.
- Dog’s Size and Age: Larger and older dogs often experience longer healing periods because their tissues repair more slowly.
- Surgical Technique: Advanced surgical precision and proper implant placement reduce post-operative trauma and minimize inflammation duration.
- Implant Type: Stainless steel or titanium plates can influence swelling based on how the body responds to foreign materials.
- Post-Surgery Care: Following activity restrictions, preventing licking, and maintaining crate rest are crucial for controlling inflammation.
- Use of Medication: Anti-inflammatory drugs and prescribed cold therapy shorten swelling duration by controlling tissue fluid buildup.
- Underlying Health: Dogs with obesity, arthritis, or poor circulation tend to show delayed recovery and prolonged swelling.
By understanding these factors, owners can set realistic expectations and work with their vet to customize an effective recovery plan.
How to Reduce Swelling After TPLO Surgery
Proper aftercare plays a key role in controlling swelling and supporting bone healing. Consistent management helps reduce discomfort and speeds recovery.
- Cold Compress Therapy: Apply a cold pack wrapped in a towel for 10–15 minutes every few hours during the first 48 hours to limit inflammation.
- Rest and Confinement: Restrict activity with crate rest or limited movement to prevent fluid accumulation or incision strain.
- Medication Adherence: Use prescribed pain relievers and anti-inflammatory drugs exactly as directed to control swelling from within.
- Incision Protection: Prevent licking or scratching by using an e-collar or surgical suit to keep the wound clean.
- Monitor Bandages: Ensure wraps aren’t too tight, as restricted blood flow can worsen swelling instead of helping it.
With consistent rest, medication, and monitoring, most swelling resolves smoothly, supporting a faster and more comfortable TPLO recovery.
Role of Physical Therapy in Managing Swelling After TPLO Surgery
Physical therapy is an important part of recovery after TPLO surgery, helping to restore mobility and prevent fluid buildup once the incision has healed.
- Timing of Rehabilitation: Gentle range-of-motion exercises usually begin 2–3 weeks post-surgery after your vet confirms bone stability.
- Improving Circulation: Controlled movement promotes lymphatic drainage, reducing swelling while maintaining joint flexibility.
- Muscle Strength Preservation: Gradual exercises prevent muscle loss and stiffness caused by extended rest periods.
- Hydrotherapy Benefits: Water-based therapy supports weightless exercise, improving motion without putting strain on the operated leg.
- Professional Guidance: Rehabilitation should always be supervised by your vet or a certified rehab specialist to prevent overexertion.
Properly timed and guided therapy significantly improves comfort and reduces lingering swelling, ensuring a stronger, more balanced recovery.
When Swelling Reappears Weeks After TPLO Surgery
If swelling returns weeks after TPLO surgery, it often points to secondary issues rather than normal healing. Identifying the cause early ensures timely intervention.
- Implant Irritation: Metal plates or screws can sometimes irritate nearby tissues, especially if the dog resumes activity too soon.
- Overuse or Early Exercise: Premature running, jumping, or playing can trigger soft tissue inflammation and localized swelling.
- Seroma Formation: Fluid pockets under the incision may develop if tissue healing is incomplete or disrupted.
- Infection Recurrence: Bacterial contamination can cause delayed redness, discharge, and swelling weeks after surgery.
- Follow-Up X-Rays: Imaging helps confirm implant stability and bone healing progress if swelling persists unexpectedly.
Recurrent swelling is not typical and requires prompt veterinary assessment to rule out infection, hardware complications, or incomplete bone union.
Conclusion
Swelling after TPLO surgery is normal, but its duration and appearance offer important clues about healing progress. Mild swelling should begin to fade within a week, while redness, heat, or discharge require prompt veterinary attention.
- Normal vs. Abnormal: Healthy swelling is mild, localized, and improves daily; worsening inflammation signals complications.
- Daily Monitoring: Check the incision site every day for color, warmth, or texture changes to catch issues early.
- Vet Check-Ups: Scheduled follow-ups and post-operative imaging confirm bone healing and implant stability.
By staying observant and following your vet’s care instructions, you can ensure swelling resolves safely and your dog recovers comfortably after TPLO surgery.
FAQs
How long should I expect swelling to last after TPLO?
Most swelling lasts between 3 and 7 days after TPLO surgery. It usually peaks within the first 48 hours, then gradually subsides as healing progresses. If swelling persists beyond a week or worsens instead of improving, contact your veterinarian for an examination to rule out infection or fluid buildup.
Is it normal for swelling to get worse at night?
Yes, mild nighttime swelling can occur because your dog moves less while resting, allowing fluids to settle around the surgical site. This should improve by morning or after gentle repositioning. Persistent or painful swelling overnight, however, may indicate inflammation that needs veterinary evaluation.
Can cold compresses help reduce swelling faster?
Cold therapy is highly effective in the first 48 hours after TPLO surgery. Applying a cold compress wrapped in a soft cloth for 10–15 minutes several times daily helps minimize fluid buildup and reduce pain. Always avoid direct ice contact with the incision area to prevent skin irritation.
When should I worry about swelling or redness?
You should be concerned if swelling increases after the first week or is accompanied by heat, redness, oozing, or a bad odor. These may signal infection, seroma, or implant irritation. Immediate veterinary assessment ensures early treatment and prevents more serious complications.
What if my dog starts limping again weeks later?
Limping weeks after surgery may suggest muscle overuse, implant irritation, or delayed healing. Recurring swelling along with limping can indicate inflammation or hardware issues. Schedule a follow-up appointment and, if needed, X-rays to confirm proper bone healing and plate stability.

TPLO
5 min read
10 Essential TPLO Recovery Tips for Pet Owners
Help your dog heal faster after TPLO surgery with these 10 simple, vet-approved recovery tips every pet owner should know
What to Expect After TPLO Surgery
TPLO (Tibial Plateau Leveling Osteotomy) is a surgery used to treat a torn cranial cruciate ligament (CCL) in a dog’s knee. It involves cutting and rotating the top of the tibia to stabilize the joint without needing the ligament.
In the first few days, your dog may have swelling, mild pain, and limited movement. Strict rest is needed during this time. Your vet may also provide pain medication and antibiotics.
In the first few weeks, your dog will start putting more weight on the leg. Short, slow walks and controlled exercises may begin under vet guidance.
By 8 to 12 weeks, most dogs show good improvement, though full bone healing may take up to 4 months.
Every dog heals differently, so regular vet check-ups and follow-up X-rays are important to make sure everything is on track.
Week 1: The Critical Rest Period
1. Keep Your Dog Rested and Safe
The first week after TPLO surgery is all about strict rest. Your dog’s body needs time to start healing the bone and soft tissues. Keep your dog in a crate or a small room with soft bedding to prevent movement.
Avoid stairs, running, or jumping on and off furniture, as these can damage the surgical site. Calm, quiet surroundings help lower stress and reduce the chance of injury. Limiting movement now supports a stronger, smoother recovery later.
2. Manage Pain and Swelling
Your vet will prescribe pain and anti-inflammatory medications—give them exactly as directed to keep your dog comfortable. Never skip doses, even if your dog seems fine. To reduce swelling, use a cold pack wrapped in a towel and gently apply it to the surgical area for 10–15 minutes, 2–3 times a day during the first 48–72 hours.
This helps ease inflammation and supports healing. Always monitor your dog’s response and stop if discomfort increases.
3. Help Your Dog Walk Safely
Only allow your dog to walk when absolutely needed, such as going outside for bathroom breaks. Always use a short leash and walk slowly. You can support your dog’s rear end using a towel or sling under the belly, especially for larger dogs.
This reduces strain on the healing leg. Avoid any sudden movements, pulling, or distractions during walks. Controlled support prevents accidents and keeps pressure off the surgical site while your dog gains confidence in using the leg again.
4. Protect the Surgical Site
To protect the incision, your dog should wear an E-collar (cone) at all times. Licking or chewing at the stitches can lead to infection or wound opening. Check the surgical site daily. Signs of infection include redness, swelling, warmth, discharge, or a bad smell.
If you notice any of these symptoms, contact your vet right away. Keep the area clean and dry—don’t bathe your dog or allow the wound to get wet during this week. Healing starts with protection.
Weeks 2–4: Keeping Recovery on Track
5. Stick to a Calm Routine
During weeks 2 to 4, your dog may start feeling better—but they still need to stay calm. Keep them confined to a crate or small room and always use a leash when taking them outside. Even small bursts of excitement or sudden movements can stress the healing joint.
Try to keep daily routines predictable. Calm, steady days help your dog stay relaxed and reduce the risk of re-injury while the bone and tissues continue to heal.
6. Keep Their Mind Busy
Your dog’s body needs rest, but their brain still needs activity. Use safe, vet-approved chew toys or treat puzzles to keep them mentally engaged. Gentle training with simple commands can also help. Mental stimulation reduces boredom, lowers stress, and can prevent behaviors like barking, whining, or trying to escape confinement.
A mentally calm dog is less likely to make sudden movements, helping their body heal more smoothly during the recovery process.
7. Feed a Healthy Diet
Since your dog’s activity is limited, weight gain can happen quickly. Extra weight puts stress on the healing leg and can slow recovery. Feed a balanced, healthy diet and avoid giving too many treats. Use portion control based on your vet’s advice, and consider switching to a lower-calorie or recovery-specific food if recommended.
Fresh water should always be available. Keeping your dog at a healthy weight supports joint health and makes walking easier as they recover.
8. Create a Healing Environment
Set up a quiet, cozy space for your dog that supports healing. Use soft bedding to cushion their joints and prevent pressure sores. Keep this space away from slippery floors, loud noises, or other pets that may cause stress or excitement.
Avoid busy areas of the home where your dog might feel the need to move around or follow you. A peaceful environment keeps your dog calm, safe, and focused on healing.
After Week 4: Slowly Getting Back to Normal
9. Gradually Increase Movement
After week 4, your dog may start gentle movement, but only with your vet’s approval. Short leash walks and light exercises can begin once healing is confirmed. Signs your dog may be ready include steady walking, good weight-bearing on the leg, and no signs of pain.
Always go slow—avoid running, stairs, or off-leash activity. Controlled movement helps build strength and balance without risking damage to the healing bone or implant. Your vet will guide the right pace.
10. Follow-Up Appointments Matter
Follow-up vet visits are key to a safe recovery. These appointments usually include a physical exam and sometimes X-rays to check how well the bone is healing and if the implant is stable. Your vet will look for signs of infection, swelling, or joint issues like meniscus damage.
They’ll also assess how your dog moves and how much weight they put on the leg. These checkups help decide when to safely increase activity or start physical therapy.
Also read about:
- Common Myths About TPLO Surgery Explained
- TPLO Surgery for Older Dogs: Is It a Worthwhile Option
- Post-Operative Infection in Dogs: Symptoms and Solutions
Conclusion
Recovery after TPLO surgery takes time, patience, and care—but you’re not alone in this journey. The clicking sound you hear may seem worrying, but in most cases, it’s a normal part of healing. With proper rest, safe movement, and regular vet checkups, your dog has a strong chance of making a full recovery.
By following the tips in each stage—from strict rest in week 1 to gentle activity after week 4—you’re giving your dog the best support possible. Watching their behavior, protecting the surgical site, and keeping their mind and body healthy all play a role in a smooth recovery.
Stay consistent, stay observant, and don’t hesitate to reach out to your vet with any questions. With time and the right care, your dog can return to a happy, active life—stronger and healthier than before.
FAQs
How long does TPLO recovery take for most dogs?
Most dogs take about 8 to 12 weeks to recover from TPLO surgery. Full bone healing can take up to 4 months. During this time, rest, follow-up vet visits, and slow return to activity are important to ensure the leg heals properly and gains strength.
Can I leave my dog alone during recovery?
Yes, but only if your dog is safely confined in a crate or small room. Avoid leaving them unsupervised in open spaces where they might jump or move too much. Keep their environment calm and secure to prevent injury during the critical healing period.
What if my dog refuses to rest or stay confined?
If your dog is restless, use calming toys, puzzle feeders, or light training to keep them busy without moving much. Speak to your vet about safe calming aids if needed. Rest is key, so finding ways to reduce energy and stress will help healing.
Is physical therapy needed after TPLO surgery?
Physical therapy isn’t always required but can help many dogs regain strength and movement faster. Gentle exercises, guided walks, or professional rehab sessions improve recovery. Ask your vet if therapy is right for your dog’s age, size, and healing progress.
What signs of infection should I watch for at home?
Watch for redness, swelling, warmth, discharge, or a bad smell at the incision site. Other signs include licking the area, limping, or changes in behavior. If you notice any of these symptoms, contact your vet right away for treatment. Early care prevents bigger issues.

TPLO
5 min read
15 Common Complications After TPLO Surgery in Dogs
Worried about TPLO surgery complications? Discover 15 common risks, from infection to implant failure, learn how to prevent and manage them effectively
TPLO (Tibial Plateau Leveling Osteotomy) is a common surgery used to treat cranial cruciate ligament (CCL) injuries in dogs. It involves cutting and repositioning the tibia to stabilize the knee joint, reducing the need for the damaged ligament. Although TPLO has a high success rate, complications can still occur even with proper surgical technique.
Complications can arise due to factors like a dog's age, weight, overall health, and how well post-operative care guidelines are followed. Older or overweight dogs are at higher risk for delayed healing and implant failure because of increased strain on the joint. Inadequate rest, early activity, or infections can also cause setbacks.
Even with precise bone healing, some dogs may experience swelling, lameness, or implant-related issues. Being aware of these risks helps ensure timely intervention and optimal recovery. Proper monitoring, limited activity, and follow-up evaluations are crucial in reducing post-surgical complications.
TL;DR: Possible Complications After TPLO Surgery
- Immediate complications: Infection, hemorrhage, implant loosening, excessive swelling, or premature suture removal.
- Mid-term complications: Delayed bone healing, seroma formation, nerve damage, tibial tuberosity fractures.
- Long-term complications: Patellar luxation, arthritis, meniscal injuries, persistent lameness, patellar ligament thickening.
- Severe complications: Osteomyelitis (bone infection), implant failure, chronic pain, or non-union of the bone.
Immediate Post-Surgical Complications (First Few Days to Weeks After Surgery)
In the initial days after TPLO surgery, dogs are at risk for complications that can slow healing and cause discomfort. Careful monitoring and early intervention are crucial to ensuring a smooth recovery.
1. Infection at the Surgical Site
Infection is one of the most common early complications after TPLO surgery. It can happen if bacteria enter the surgical site, delaying healing and potentially affecting the implant.
Signs of infection include redness, swelling, warmth around the incision, pus-like discharge, an unpleasant odor, and increased pain or tenderness. Some dogs may also develop a fever or show signs of discomfort, such as excessive licking or reluctance to put weight on the affected leg.
Causes of infection include poor hygiene, contamination during or after surgery, excessive licking of the incision, and improper wound care. Dogs that lick or chew at their stitches introduce bacteria, increasing the risk of infection. Environmental factors, like a dirty bedding area, can also lead to bacterial growth.
Treatment options depend on how severe the infection is. Mild cases may be managed with oral antibiotics and regular wound cleaning using an antiseptic solution. More severe infections, especially those affecting deep tissues or the implant, require veterinary care.
This may include culture testing to identify the bacteria and, in rare cases, surgical removal of infected tissue. Preventive measures, such as using an Elizabethan collar (E-collar) and ensuring proper wound care, are essential to reducing the risk of infection.
2. Bone Infection (Osteomyelitis)
Osteomyelitis is a serious bone infection that affects deeper bone tissue and can compromise the TPLO implant. Unlike surface infections, osteomyelitis can cause long-lasting inflammation, bone damage, and implant failure.
Symptoms include ongoing swelling, increased pain, fever, pus draining from the incision, and slow healing. Affected dogs may become tired and unwilling to use the operated leg. In chronic cases, the infection can spread, causing a more widespread illness.
Risk factors include contamination during surgery, bacteria from an infected wound, or infections related to the implant. Dogs with weak immune systems or those in unclean environments after surgery are at higher risk.
Treatment involves strong antibiotic therapy, often based on bacterial culture results. In severe cases, surgery may be needed to remove infected bone tissue. If the implant is affected, it might need to be removed and replaced once the infection is under control. Early detection and strict hygiene are key to preventing osteomyelitis.
3. Implant Issues (Loosening, Breaking, or Failure)
Implant complications happen when the TPLO plate or screws don't work properly, causing instability in the knee joint. These issues can occur due to too much movement, poor implant placement, or infections that weaken the bone connection.
Signs of implant failure include ongoing limping, pain, swelling around the implant site, and unusual clicking or grinding sounds from the joint. In severe cases, the implant might shift, leading to bone misalignment. Dogs that suddenly become lame after surgery should be checked right away.
Causes include too much activity after surgery, improper bone healing, and mechanical stress on the implant. Infections can also weaken the bone and screws, increasing the chance of failure. Overweight dogs are at higher risk due to more pressure on the joint.
Possible corrective actions depend on how severe the issue is. Minor loosening might be managed with limited activity, while severe cases could need revision surgery to replace or reposition the implant. If there's an infection, the implant may need to be removed, followed by antibiotic treatment before placing a new implant.
4. Premature Suture Removal by the Dog
Dogs often lick or chew their sutures due to discomfort, irritation, or boredom. However, removing stitches too soon can reopen the surgical site, exposing tissues to infection and delaying healing.
Consequences of removing sutures include the wound reopening, a higher risk of infection, and excessive scarring. In severe cases, exposed tissues may dry out or become contaminated, requiring more surgery. If deeper sutures are disturbed, healing can be significantly delayed.
Preventive measures include using an Elizabethan collar (E-collar) to stop licking and chewing. Bandaging might help, but it must be done carefully to avoid moisture buildup, which can lead to bacterial growth. Supervision is crucial, especially in the first two weeks after surgery.
Providing distractions, like puzzle toys or chew treats, can help keep dogs from focusing on their incision. If stitches are removed too soon, a veterinarian should assess the wound immediately to decide if re-suturing or additional wound care is needed.
5. Hemorrhage During or After Surgery
Hemorrhage, or excessive bleeding, can happen during or after TPLO surgery due to blood vessel injury, clotting disorders, or improper post-operative care. While some mild bruising is normal, significant bleeding is a serious issue that needs immediate attention.
Symptoms of post-surgical hemorrhage include excessive blood oozing from the incision, swelling or bruising that gets worse over time, pale gums, rapid heart rate, and lethargy. In severe cases, internal bleeding may cause a swollen abdomen or breathing difficulties.
Causes include surgical trauma to blood vessels, clotting disorders like Von Willebrand’s disease, or post-operative strain on the incision site. Certain medications, such as NSAIDs and steroids, can also affect the ability to clot.
When to seek emergency vet care: If bleeding continues for more than a few hours, if the wound reopens, or if the dog shows signs of weakness and pale gums, immediate veterinary care is crucial. Treatment may involve pressure bandaging, fluid therapy, or surgical intervention to control internal bleeding. Quick action can prevent life-threatening complications and improve recovery outcomes.
Mid-Term Healing Complications (Weeks to Months Post-Surgery)
As the initial healing phase progresses, some dogs may experience complications that affect recovery in the weeks following surgery. Monitoring for persistent swelling, delayed healing, or mobility issues is essential to prevent long-term problems.
6. Swelling and Bruising at the Incision Site
Some swelling and bruising are expected after TPLO surgery as part of the body's normal healing process. Mild swelling around the incision site, along with light bruising, usually goes away within two weeks.
Concerning signs include swelling that doesn't go away or gets worse beyond the expected recovery time, extreme discoloration (deep purple or black bruising), excessive warmth, and increasing pain. These could indicate an infection, hematoma (blood accumulation), or poor circulation.
Managing swelling effectively requires early action. Cold therapy, like applying an ice pack wrapped in a towel for 10–15 minutes several times a day during the first 72 hours after surgery, helps reduce inflammation. After this initial period, warm compresses can be used to promote circulation. Anti-inflammatory medications, if prescribed by a veterinarian, can also help reduce swelling.
Strict rest and avoiding unnecessary movement help prevent further irritation. If swelling worsens or doesn't improve, a veterinarian should check the incision site to rule out complications such as infection or fluid buildup.
7. Seroma Formation (Fluid Accumulation)
A seroma is a fluid buildup under the skin near the surgical site. It can occur due to too much movement, surgical trauma, or minor irritation, which causes leakage from blood vessels and lymphatic tissues. Unlike an infection, a seroma is usually not painful and doesn't show redness or discharge.
It's important to tell the difference between normal swelling and a problematic seroma. A small, soft, and flexible swelling that doesn't cause discomfort is often a harmless seroma and may go away on its own. However, if seromas are large or don't go away, especially if they grow or become painful, a veterinarian should check them. Signs of infection, like warmth, redness, or pus, need immediate attention.
Treatment options depend on how severe the seroma is. Small seromas are usually managed by monitoring and using compression therapy. Reducing excessive movement can help decrease fluid buildup. Large seromas might need to be drained with a sterile needle.
If fluid continues to build up, a drain may be placed to stop further accumulation. Preventing too much movement and ensuring proper rest after surgery can help reduce the risk of seroma formation.
8. Nerve Damage Leading to Limb Numbness
Nerve damage after TPLO surgery is rare but can happen due to surgical manipulation near major nerve pathways. The peroneal nerve, which controls foot and lower limb function, is most at risk during tibial surgery. In some cases, swelling after surgery can also temporarily affect nerve function.
Symptoms of nerve damage include dragging the paw (knuckling), reduced sensation in the affected leg, lack of response to touch, or an unusual way of walking. Dogs may seem unable to place their foot properly on the ground. In severe cases, they may develop muscle wasting due to not using the limb for a long time.
Prognosis and recovery depend on how severe the nerve injury is. Mild nerve compression from swelling often gets better within weeks as the swelling goes down. Physical therapy, gentle massage, and controlled movement exercises can help with nerve recovery.
Severe nerve damage, such as a completely severed nerve, has a poorer outlook and may require assistive devices or surgery. Close monitoring and early rehabilitation improve the chances of functional recovery.
9. Delayed Bone Healing or Non-Union
Bone healing after TPLO surgery usually takes 8–12 weeks, but sometimes healing is delayed or does not happen properly (non-union). Several factors can affect bone healing, including poor nutrition, too much activity, infection, or improper implant placement.
Signs of delayed healing include prolonged limping, ongoing swelling around the surgical site, and discomfort that lasts beyond the expected recovery time. X-rays may show incomplete bone fusion at the osteotomy site, indicating slowed healing. If not addressed, delayed healing can lead to implant failure or instability in the knee joint.
Treatment approaches focus on encouraging bone regrowth. A veterinarian may suggest calcium and vitamin D supplements to support bone health. Strict activity restriction is essential to prevent too much movement at the healing site. If an infection is suspected, antibiotics are prescribed.
In severe cases, additional surgery may be needed to replace hardware, perform a bone graft, or stimulate healing with advanced techniques like bone-stimulating proteins. Early intervention increases the chances of full recovery and proper joint stabilization.
10. Tibial Tuberosity Fractures
A tibial tuberosity fracture is a rare but serious issue that can happen after TPLO surgery. The tibial tuberosity is the bony bump where the patellar tendon attaches, and too much strain can cause it to fracture, especially in large, active dogs or those not properly cared for after surgery.
Symptoms of a tibial tuberosity fracture include sudden pain, reluctance to put weight on the leg, localized swelling, and knee joint instability. Some dogs may walk abnormally or have trouble extending their leg. This fracture is usually diagnosed with X-rays, which show a break near the TPLO osteotomy site.
Treatment depends on the fracture's severity. Minor fractures may heal with strict rest, pain management, and controlled rehabilitation. More severe cases require surgery, which may involve adding screws or wire to stabilize the fracture.
Proper post-operative care, including limited movement and weight management, is crucial to prevent tibial tuberosity fractures. Early detection and appropriate treatment improve recovery and help restore normal joint function.
Long-Term Complications (Months to Years Post-Surgery)
While most dogs recover well after TPLO surgery, some may develop complications months or even years later. These long-term issues can impact mobility and joint health, requiring ongoing management and veterinary care.
11. Patellar Luxation (Kneecap Dislocation)
TPLO surgery changes how the knee works, which can sometimes affect the position of the patella (kneecap). While TPLO stabilizes the knee joint by adjusting the tibial plateau, it may lead to patellar instability, especially in small-breed dogs or those with existing knee issues.
Symptoms of patellar luxation include a skipping gait, where the dog briefly lifts the leg before walking normally again. There may also be sudden pain, occasional limping, or trouble putting weight on the leg. Some dogs might be hesitant to jump or do high-impact activities.
Treatment options depend on how severe the condition is. Mild cases can be managed with physical therapy, exercises to strengthen muscles, and weight management to lessen stress on the knee.
In severe cases, where the patella often dislocates and causes discomfort, surgery may be needed to realign the patellar groove or tighten the soft tissues around the knee. Long-term monitoring and controlled exercise can help reduce the risk of further joint instability.
12. Patellar Ligament Thickening or Desmopathy
After TPLO surgery, the patellar ligament (which connects the kneecap to the tibia) may thicken due to increased stress and changes in the tissue as it heals. This condition, known as desmopathy, is a response to the altered mechanics of the knee and may cause discomfort or limit mobility.
How it impacts mobility: Thickened patellar ligaments can lead to stiffness, a reduced range of motion, and occasional lameness. Dogs might have trouble fully extending the knee or feel discomfort when walking on uneven surfaces. In some cases, ligament thickening can contribute to patellar luxation or chronic pain.
Treatment and management focus on reducing inflammation and keeping the joint flexible. Cold laser therapy, controlled exercise, and joint supplements (like glucosamine and chondroitin) may help maintain ligament health.
In severe cases where thickening causes functional problems, physical therapy, anti-inflammatory medications, or, in rare instances, surgery may be necessary. Gradually returning to activity and avoiding high-impact exercises can help minimize stress on the ligament.
13. Meniscal Injury or Tear
The meniscus is a cartilage structure that cushions the knee joint. While TPLO surgery stabilizes the knee, it does not remove the risk of meniscal injuries. Sometimes, leftover instability or stress from implants can cause the meniscus to wear down or tear.
Symptoms of meniscal damage include a clicking or popping sound when the dog moves, occasional or constant lameness, reluctance to use the affected leg, and discomfort when bending the knee. Some dogs may suddenly experience more pain after initially showing signs of recovery.
Treatment options depend on how severe the tear is. Mild cases might be managed with pain relief, joint supplements, and controlled exercise. However, if a meniscal tear causes ongoing pain and instability, surgery is often needed.
This may involve a partial meniscectomy, where the damaged part is removed, or meniscal repair if the cartilage can be saved. Long-term management includes weight control, low-impact exercise, and joint-protective therapies to reduce stress on the knee.
14. Persistent or Recurrent Lameness
While temporary lameness is expected during TPLO recovery, persistent or recurrent lameness months or years after surgery indicates an underlying issue. Some dogs may initially regain function but later experience setbacks.
When lameness is normal vs. a complication: Mild stiffness after long periods of rest or in cold weather is common in post-TPLO dogs, especially as they age. However, continuous limping, favoring one leg, or worsening mobility suggests a complication such as implant issues, nerve damage, or progressive joint disease.
Common causes include implant loosening, nerve irritation, arthritis, or secondary joint problems like patellar luxation or meniscal injury. Improper post-op rehabilitation can also lead to muscle weakness, causing uneven weight distribution.
Rehabilitation options focus on hydrotherapy, physiotherapy, and pain relief through NSAIDs or joint supplements. Weight control is crucial in reducing stress on the knee. For severe cases, advanced pain management options like platelet-rich plasma (PRP) therapy, acupuncture, or even surgical revision may be necessary.
15. Development of Arthritis After Surgery
Even after successful TPLO surgery, some dogs develop arthritis over time due to joint wear and tear. While TPLO improves knee stability, it doesn't prevent degenerative joint disease (DJD), especially in older or previously injured dogs.
Why arthritis develops: Chronic inflammation, ongoing joint stress, or minor imperfections in bone healing can lead to cartilage breakdown. Dogs with previous CCL damage, obesity, or an uneven gait are at higher risk.
Symptoms include joint stiffness, difficulty getting up, reluctance to move, limping, and swelling around the knee. Dogs may struggle with stairs, hesitate before jumping, or feel discomfort after exercise. Symptoms often worsen in cold weather or after long periods of inactivity.
Long-term management focuses on weight control, joint supplements (glucosamine, chondroitin, omega-3s), anti-inflammatory treatments (NSAIDs, corticosteroid injections), and physical therapy. Low-impact activities like swimming or controlled walks can maintain muscle strength while reducing joint stress.
In advanced cases, regenerative therapies such as stem cell treatment or PRP injections may provide relief. Managing arthritis proactively helps maintain mobility and quality of life for years after surgery.
How to Reduce the Risk of TPLO Complications
Minimizing complications after TPLO surgery requires strict post-operative care, proper wound management, and ongoing rehabilitation.
Following veterinary instructions and ensuring a controlled recovery environment significantly improve surgical outcomes.
Strict post-op care
Strict post-op care is essential in preventing implant failure, infections, and delayed healing. Dogs must have limited movement for the first few weeks, avoiding running, jumping, or sudden movements that can strain the surgical site. A crate or confined space ensures controlled rest, while leash-walks allow gradual reintroduction to activity.
Proper wound care and hygiene
Proper wound care and hygiene reduce infection risks. The surgical incision should be checked daily for redness, swelling, or discharge. Using veterinary-recommended antiseptics and preventing licking (via an Elizabethan collar) are key to avoiding contamination.
Many surgeons now use Simini Protect Lavage, a non-antibiotic surgical lavage, to reduce bacterial contamination and biofilm formation, lowering the risk of post-surgical infections.
Rehabilitation and physical therapy
A well-structured rehabilitation plan is essential for restoring mobility, muscle strength, and joint flexibility after TPLO surgery. Early intervention helps prevent stiffness, muscle atrophy, and long-term mobility issues.
Hydrotherapy (underwater treadmill or swimming) provides low-impact exercise, reducing strain on healing joints while strengthening muscles. Passive range-of-motion exercises improve flexibility, while controlled weight-bearing activities help rebuild strength without overloading the surgical site.
Rehabilitation also includes balance exercises, cold laser therapy, and massage therapy, which aid circulation and reduce post-surgical discomfort. A veterinarian or canine rehabilitation specialist can create a customized recovery plan to ensure optimal healing and long-term joint health.
Lastly, early detection improves recovery. Watching for limping, excessive swelling, or behavioral changes helps identify issues before they get worse.
When to Call Your Vet
Recognizing when to seek veterinary care is crucial for preventing serious TPLO complications. Emergency signs that need immediate attention include excessive bleeding, severe swelling, ongoing pain, fever, an open incision, or a sudden inability to bear weight on the operated leg.
Mild symptoms like slight swelling, occasional limping, or minor wound discharge should still be checked if they persist or get worse. Delayed healing or changes in behavior may indicate an underlying issue.
Regular post-op checkups are important for monitoring bone healing, implant stability, and joint function. Early intervention helps prevent complications, ensuring a smooth and successful recovery for your dog.
Read more about -
- TPLO failure symptoms
- Common causes of limping in dogs post-TPLO surgery
- Before and after TPLO surgery: Dog health & recovery timeline
- TPLO surgery for older dogs: Is it a worthwhile option?
Conclusion
TPLO surgery is very effective for stabilizing a dog’s knee, but complications can occur without proper post-operative care. Understanding potential risks and taking preventive steps can ensure a smoother recovery.
- Strict post-op care – Limiting movement, using an E-collar, and following vet instructions help prevent implant failure and infections.
- Proper wound hygiene – Keeping the incision clean and watching for redness, swelling, or discharge reduces infection risks.
- Early detection of complications – Signs like persistent limping, fever, or swelling should lead to immediate veterinary evaluation.
- Rehabilitation and physical therapy – Hydrotherapy and controlled exercises help with muscle recovery and joint flexibility.
- Regular vet checkups – Routine follow-ups ensure proper bone healing, implant stability, and early complication management.
- Using advanced surgical solutions – Many surgeons use Simini Protect Lavage to reduce infection risks and improve post-surgical outcomes.
- Long-term joint health management – Weight control, joint supplements, and arthritis prevention strategies enhance mobility and quality of life.
By staying proactive and working closely with your veterinarian, you can minimize complications and support your dog’s full recovery after TPLO surgery.
FAQs
What are the long-term complications of TPLO surgery?
Long-term complications can include patellar luxation, arthritis, implant failure, meniscal injuries, and persistent lameness. Some dogs may develop patellar ligament thickening or nerve-related mobility issues. While many dogs recover well, maintaining joint health, weight control, and regular vet checkups helps minimize long-term risks.
What to watch for after TPLO surgery?
Monitor for swelling, redness, discharge, excessive pain, fever, or sudden lameness. Signs of complications include persistent limping, wound infection, delayed healing, or implant issues. If the dog refuses to bear weight or shows increased discomfort over time, a veterinary evaluation is necessary to rule out serious post-surgical issues.
What are the mistakes for TPLO?
Common mistakes include allowing too much activity too soon, neglecting wound care, not using an E-collar, missing follow-up visits, and improper rehabilitation. Failing to restrict movement can lead to implant failure, delayed bone healing, or reinjury. Strict adherence to post-op care reduces these risks.
What is the complication rate of TPLO?
The overall complication rate for TPLO surgery ranges from 10-34%, with most being minor issues like swelling or mild infections. Serious complications, such as implant failure, fractures, or osteomyelitis (bone infection), occur in a smaller percentage of cases. Proper post-operative care significantly reduces complication risks.
Do dogs fully recover from TPLO surgery?
Most dogs fully recover within 12-16 weeks and regain normal mobility. With proper rehabilitation, they can return to an active lifestyle, including running and playing. However, some may develop mild stiffness or arthritis later in life. Regular exercise, weight control, and joint supplements help maintain long-term joint health.




