A year after TPLO surgery, most dogs regain full mobility. However, if your dog is still limping, it means something is wrong. Some stiffness or mild discomfort might happen after intense activity, but ongoing limping is not normal during recovery.

TPLO (Tibial Plateau Leveling Osteotomy) is a very effective procedure for cranial cruciate ligament (CCL) injuries. It stabilizes the knee and restores function. Most dogs fully recover within six months, though there can be minor differences. If limping continues beyond a year, it might be due to issues like implant problems, arthritis, or muscle atrophy.

While this can be worrying, the good news is that most causes can be diagnosed and treated. Finding out why your dog is limping is the first step to helping them regain comfort and mobility. Let’s look at potential causes and the best solutions.

Common Causes of Limping 1 Year After TPLO Surgery

If your dog is still limping a year after TPLO surgery, there could be several underlying reasons. Here are the most common causes, their symptoms, and how to address them.

1. Arthritis Development in the Affected Joint

Arthritis is a common long-term issue after TPLO surgery due to changes in joint mechanics and natural wear over time. Although TPLO stabilizes the knee, it cannot completely prevent degenerative joint disease (DJD). Inflammation from surgery, altered weight distribution, and existing cartilage damage can lead to arthritis after surgery.

Dogs with arthritis often show stiffness, especially after resting or waking up. They may be reluctant to run, jump, or climb stairs, and their discomfort often worsens in cold or damp weather.

To manage arthritis, veterinarians usually prescribe

• NSAIDs (e.g., carprofen or meloxicam) to reduce inflammation and pain.
• Joint supplements, like glucosamine, chondroitin, and omega-3 fatty acids, can help slow cartilage degeneration.
• Controlled exercise, such as short walks and swimming, strengthens muscles while reducing joint strain.

2. Implant Failure or Loosening

TPLO implants, including plates and screws, are meant to provide lifelong stability, but sometimes they can loosen over time. Too much activity during recovery, improper bone healing, or an unnoticed infection can weaken the implant's hold, causing joint instability and discomfort.

Signs of implant failure include persistent swelling, worsening lameness, and clicking sounds from the knee when the dog moves.

A veterinarian will confirm the diagnosis using X-rays, which can show shifting hardware or bone resorption around the implant. If instability is found, revision surgery may be needed to replace or remove the implant. In mild cases, managing pain and limiting activity might be enough.

3. Meniscal Tears Occurring After Surgery

The meniscus is an important cartilage in the knee that absorbs shock and helps stabilize movement. After TPLO surgery, the meniscus can still tear, especially if there was existing damage or too much stress on the joint during recovery.

Dogs with a meniscal tear often show:

• sudden limping
• reluctance to put weight on the leg
• a distinct clicking sound when walking

A veterinarian will diagnose the condition through joint palpation and confirm it using MRI or arthroscopy.

Treatment depends on the severity. For significant tears, surgical trimming (partial meniscectomy) is the preferred option, while mild cases may be managed with pain relief and restricted activity.

4. Infection at the Surgical Site or Within the Joint

Though rare, infections can develop months after TPLO surgery due to lingering bacteria or implant-related issues. Dogs with an infection may show:

• Swelling around the surgical site
• Increased warmth in the affected area
• Discharge from the incision
• Lethargy or decreased activity
• Fever and overall discomfort

To confirm an infection, vets perform blood tests and a joint fluid culture to identify the bacteria causing it. Treatment usually involves long-term antibiotics, but in severe cases where the implant is affected, surgical removal of the plate and screws may be needed.

To minimize the risk of infection, many surgeons use Simini Protect Lavage during surgery. This non-antibiotic solution helps reduce biofilm formation and bacterial contamination, lowering the likelihood of post-operative infections. Early intervention remains crucial to prevent further joint damage and ensure a smooth recovery.

5. Compensatory Issues Due to Overuse of Other Limbs

After TPLO surgery, dogs often shift their weight to the opposite leg, which can lead to strain and eventually cause lameness in that limb. This overcompensation may result in secondary joint problems, muscle imbalances, and even early arthritis.

Signs include:

• New limping in the opposite leg
• An unusual gait or stiffness after activity

Treatment focuses on physical therapy to strengthen both hind legs evenly, pain management, and adjusting exercise routines to avoid excessive strain.

Using weight distribution tools, like balance exercises and underwater treadmill therapy, can help correct movement imbalances.

6. Swelling and Inflammation Around the Surgical Area

Persistent swelling near the TPLO site may indicate chronic inflammation due to improper healing, excessive scar tissue, or low-grade irritation around the implant.

Symptoms include:

• visible swelling,
• warmth around the joint, and
• discomfort when touched.

To reduce inflammation, cold therapy (ice packs), laser therapy, NSAIDs (carprofen, meloxicam), and gentle massage therapy are effective. If inflammation continues despite treatment, a vet may check for underlying issues like implant irritation or soft tissue damage.

7. Degenerative Joint Disease Progression

Post-surgical joint degeneration (DJD) can occur if cartilage keeps wearing down after TPLO surgery. Unlike normal aging, DJD leads to a gradual loss of mobility due to ongoing joint damage.

Dogs with DJD show signs like slowly developing limping, joint stiffness, and trouble standing up after resting. Managing DJD involves a long-term joint care plan, which includes weight control, joint supplements (glucosamine, MSM, omega-3s), and prescribed pain medications. Alternative therapies such as acupuncture or hydrotherapy may also help improve mobility.

8. Muscle Weakness or Atrophy Due to Limited Activity

If rehabilitation after TPLO surgery was insufficient, muscle loss (atrophy) can occur, causing the affected leg to look thinner and weaker. This imbalance leads to fatigue, poor joint support, and ongoing limping.

Signs include:

• early exhaustion during walks
• uneven muscle mass
• hesitation to fully use the operated leg

The best treatments include hydrotherapy (such as swimming or using an underwater treadmill), strength training exercises, and controlled walks. Gradual rehabilitation helps rebuild lost muscle, ensuring better joint stability and reducing limping in the long term. These should be recommended by your vet.

Recommended Actions & Treatments to Fix Limping

Identifying the root cause of limping is the first step toward effective treatment and long-term mobility improvement. Here are a few possible treatments to address limping:

1. Consultation with a Veterinarian for Proper Diagnosis

Before assuming the cause of limping, it's important to consult a veterinarian. Many post-TPLO complications have similar symptoms, so a thorough examination is needed to ensure the right treatment.

Vets use X-rays to check for implant loosening or arthritis, and joint fluid analysis to detect infections. If a meniscal tear is suspected, an MRI or arthroscopy can provide a clear diagnosis.

For ongoing or severe cases, an orthopedic specialist might be needed, especially if revision surgery is being considered. Early diagnosis helps prevent further joint damage and ensures the best recovery plan.

2. Implementation of Physical Therapy or Rehabilitation Exercises

Physical therapy is crucial for regaining strength and mobility after TPLO surgery. Hydrotherapy, such as swimming or using an underwater treadmill, is a great low-impact exercise that builds muscle while reducing joint stress. Walking on a treadmill under controlled conditions strengthens the leg without too much strain.

Passive stretching helps maintain flexibility and prevents stiffness, especially in older dogs. A veterinary rehabilitation therapist can create a customized program based on the dog's mobility level. Regular, structured movement supports long-term recovery and lowers the risk of compensatory injuries.

3. Use of Medications Such as Anti-Inflammatories or Pain Relievers

Medication is often needed to manage pain and inflammation, especially if arthritis or joint degeneration occurs. NSAIDs like Carprofen and Meloxicam are commonly prescribed to reduce inflammation. If nerve pain is present, Gabapentin or Tramadol might be recommended.

For dogs with ongoing arthritis, Cartrophen injections (Pentosan Polysulfate Sodium) can help slow the disease and improve joint function. Always discuss long-term medication plans with a vet to minimize potential side effects.

4. Weight Management to Reduce Joint Strain

Excess weight puts extra stress on joints, making limping worse and slowing recovery. Keeping an ideal body weight is essential for dogs after TPLO surgery. If weight loss is needed, a low-calorie prescription diet like Royal Canin Satiety or Hill’s Metabolic can be beneficial.

Controlling portions, measuring food intake, and limiting high-calorie treats help prevent unnecessary weight gain. A low-impact exercise plan, including short, controlled walks and swimming, helps maintain muscle without straining the joints. Regular weight checks during vet visits help track progress.

5. Consideration of Joint Supplements Like Glucosamine and Chondroitin

Joint supplements support long-term mobility and help reduce inflammation in dogs after TPLO surgery. Glucosamine and Chondroitin assist in repairing cartilage, while MSM (Methylsulfonylmethane) has anti-inflammatory properties.

Omega-3 fatty acids (fish oil) help lubricate joints and reduce stiffness, and Green-lipped mussel extract offers natural anti-inflammatory benefits. These supplements are not quick fixes but provide long-term support when used with medication and therapy.

Veterinary guidance ensures the right dosage and effectiveness.

6. Regular Veterinary Check-Ups to Monitor Progress

Routine veterinary check-ups help monitor recovery and catch early signs of complications like arthritis, muscle loss, or implant issues. Regular assessments allow for adjustments to pain management, physical therapy, and diet plans.

During each visit, owners should discuss changes in mobility, pain levels, and any new symptoms with the vet.

When to Consider Additional Surgery or Alternative Treatments

In some cases, additional surgery may be needed if the initial TPLO procedure didn't fully solve the problem. Implant failure (loose plates or screws), severe arthritis, or a meniscal tear that wasn't addressed can cause ongoing pain and instability, requiring revision surgery.

Before considering another operation, alternative therapies can help manage pain and improve joint function:

• Stem cell therapy promotes tissue repair and reduces inflammation.
• PRP (Platelet-Rich Plasma) injections enhance healing and support cartilage health.
• Acupuncture is another option that helps with pain relief and improves circulation.

These treatments can be effective in delaying or even avoiding surgery. A consultation with a vet or specialist can help determine the best approach based on your dog's condition.

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Read more about:

• TPLO incision infection symptoms & prevention
• Signs of TPLO failure in dogs
• Staph infection after TPLO surgery
• MRSP infection in dogs: Causes & symptoms
• How to Treat MRSP in Dogs: Best Practices
• Bilateral TPLO Surgery Explained

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Conclusion

Limping a year after TPLO surgery isn't normal, but the good news is it's treatable. As we discussed, the cause could be arthritis, implant issues, muscle weakness, or even a meniscal tear. The sooner you identify the problem, the better your dog's chances of returning to normal.

There are many ways to help, from physical therapy and medications to alternative treatments like PRP injections or acupuncture. But the best first step? A vet visit. They can identify the issue and recommend the right treatment plan.

With proper care, most dogs recover well and stay active for years. So don't wait—your dog's comfort and mobility are worth it.

FAQs

Is it normal for a dog to still limp a year after TPLO surgery?

No, it's not normal for a dog to keep limping a year after TPLO surgery. While minor stiffness can happen, ongoing limping usually points to issues like arthritis, implant problems, or muscle weakness. A vet check-up is recommended to find the cause and decide on the right treatment. Early action can prevent more joint damage and improve long-term mobility.

How do I know if my dog’s TPLO implant is failing?

Signs of implant failure include worsening limping, swelling around the surgery area, and clicking or grinding noises when moving. Sometimes, dogs may feel discomfort when the area is touched. A vet can check implant stability with X-rays. If the implant has shifted or loosened, revision surgery might be needed to restore joint function and relieve pain.

Can physical therapy still help if my dog is limping a year later?

Yes, physical therapy can still help even a year after TPLO surgery. Strengthening exercises, hydrotherapy, and controlled treadmill walking can improve muscle function and joint support. A rehab specialist can create a custom plan based on the cause of the limping. Regular therapy can reduce discomfort, improve mobility, and prevent other injuries.

Are there long-term risks if I don’t address the limping?

Yes, ignoring ongoing limping can lead to worsening arthritis, muscle loss, and more stress on other joints. Dogs might start putting too much weight on the opposite leg, which increases the risk of more injuries. Untreated joint instability can also cause chronic pain and reduced mobility over time. Seeking veterinary advice early can help prevent complications and improve your dog’s long-term quality of life.

What home remedies can I try before going to the vet?

While seeing a vet is best, you can try cold therapy (ice packs) for swelling, gentle massage to ease stiffness, and controlled exercise like short walks. Joint supplements with glucosamine and omega-3s may support joint health. Keeping your dog at a healthy weight also reduces joint strain. However, if the limping continues or gets worse, a vet visit is necessary for proper diagnosis and treatment.

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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 (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.

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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.

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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.

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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?

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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.

1. Strict post-op care – Limiting movement, using an E-collar, and following vet instructions help prevent implant failure and infections.
2. Proper wound hygiene – Keeping the incision clean and watching for redness, swelling, or discharge reduces infection risks.
3. Early detection of complications – Signs like persistent limping, fever, or swelling should lead to immediate veterinary evaluation.
4. Rehabilitation and physical therapy – Hydrotherapy and controlled exercises help with muscle recovery and joint flexibility.
5. Regular vet checkups – Routine follow-ups ensure proper bone healing, implant stability, and early complication management.
6. Using advanced surgical solutions – Many surgeons use Simini Protect Lavage to reduce infection risks and improve post-surgical outcomes.
7. 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.

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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.

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Many pet owners choose Tibial Plateau Leveling Osteotomy (TPLO) to help their dogs regain mobility, but years later, they may question if it was the right decision. The main concerns are about arthritis, implant issues, and long-term joint function.

Studies show that over 90% of dogs regain full limb function within a year, and the long-term results are generally positive. However, mild arthritis is expected, even in successful cases.

Some owners reconsider TPLO because of implant rejection or ongoing lameness, but these cases are rare with proper post-op care. When combined with weight management and physical therapy, TPLO offers lasting relief, often keeping dogs active well into their senior years.

Understanding TPLO Surgery and Its Long-Term Impact

TPLO surgery is designed to stabilize the knee and restore mobility after a cranial cruciate ligament (CCL) tear. Unlike traditional repairs, TPLO permanently changes the knee’s biomechanics by altering the tibial plateau angle, which reduces strain on the joint.

While most dogs regain almost normal function, there are long-term factors to consider. Arthritis develops in nearly all cases, but its severity can vary. Implant wear or loosening is rare but can happen, especially in very active dogs. Another concern is compensatory injury; dogs that undergo TPLO on one leg have up to a 50% chance of tearing the CCL in the opposite knee within a few years.

Despite these risks, long-term studies confirm TPLO’s effectiveness in maintaining mobility and reducing chronic pain. With proper care, many dogs remain active for 8–10 years after surgery.

Long-Term Success Rates and Mobility

For most dogs, TPLO isn't just a short-term solution—it offers long-lasting improvements in mobility, keeping them active well into their senior years.

How Well Do Dogs Recover 5–10 Years After TPLO?

Long-term studies indicate that over 90% of dogs undergoing TPLO surgery regain normal limb function within a year, with sustained mobility for up to 6.8 years post-surgery. Younger dogs (under 5 years) often experience full recovery with minimal arthritis, while older dogs may develop mild stiffness but continue to lead active lives.

A long-term study on large breeds found that 76% showed no significant lameness a decade after surgery.

As Dr. David Dycus, DVM, highlights, managing weight and caring for joints are vital for the best results. He supports a patient-focused approach, stressing the importance of communication and personalized treatment plans to ensure the best quality of life for dogs.

Gait and Limb Function Studies

Long-term studies show that most dogs undergoing TPLO surgery regain almost normal gait and weight distribution within a year, with continued improvements over time. For example, research comparing TPLO to extracapsular repair found that dogs achieved normal limb loading faster after TPLO, with the operated limb functioning similarly to control groups by one year after surgery.

However, subtle changes can persist. Some dogs may slightly favor the surgical leg, especially in colder weather or after long periods of rest. A study evaluating recovery of limb function post-TPLO noted that while significant improvements were observed, certain gait changes could remain, particularly under specific conditions.

These findings suggest that while TPLO effectively restores function, individual variations in recovery and gait adaptations can occur.

Does TPLO Prevent Arthritis in the Long Run?

Arthritis is a common concern after any knee surgery. TPLO helps slow down arthritis by stabilizing the joint and reducing abnormal movement, but it doesn't completely remove the risk. Over time, most dogs develop some arthritis, but it's usually less severe than in knees that are untreated or not properly repaired.

TPLO vs. Other Procedures (TTA, Lateral Suture) for Arthritis Prevention

When comparing surgical options, TPLO has a lower rate of arthritis progression than lateral suture surgeries, which depend on external stabilization that can stretch over time. Studies show that dogs undergoing TPLO have better long-term mobility and less joint inflammation.

When comparing TTA (Tibial Tuber osity Advancement) to TPLO, research suggests similar long-term arthritis outcomes, but TPLO patients usually recover faster and regain function sooner.

No matter the procedure, managing weight, using joint supplements, and engaging in regular low-impact exercise are crucial for slowing arthritis progression.

TPLO Implant Longevity & Failure Rates

One of the main concerns with TPLO surgery is the long-term durability of the metal plate and screws used to stabilize the knee. Although TPLO is meant to be a permanent solution, implant-related issues can occur in a small number of cases.

Do TPLO Plates & Screws Last a Lifetime?

For 90–95% of dogs, TPLO implants stay intact and functional for life. The titanium or stainless steel plates are biocompatible and rarely cause problems. However, implant failure happens in 5–10% of cases, often due to:

• Screw loosening from too much activity or poor bone healing
• Irritation from cold weather or pressure on the plate
• Infection, which may develop months or years after surgery

Signs of implant failure include ongoing limping, localized swelling, or heat around the knee. If problems occur, implant removal or replacement might be needed.

Risk of TPLO on the Opposite Leg

One of the most significant long-term concerns after TPLO surgery is the risk of a cranial cruciate ligament (CCL) tear in the opposite leg. As dogs rely on their healthy leg during recovery, it often takes on more stress, which can speed up ligament wear.

What Are the Chances of Needing TPLO on the Other Leg?

Studies show that 30–50% of dogs need TPLO on the opposite leg within 2–5 years. Risk factors include:

• Obesity, which puts extra strain on joints
• High activity levels, causing wear and tear
• Poor muscle balance, affecting joint stability

To lower the risk, controlled exercise, muscle-strengthening therapy, and strict weight management are crucial. Joint supplements and physical therapy can also help maintain long-term knee health. While a second TPLO might be needed, early intervention and proper care can delay or prevent another surgery.

Long-Term Satisfaction: Are Owners Happy Years After TPLO?

For most pet owners, TPLO surgery is a valuable investment in their dog's mobility and quality of life. Years after the surgery, most report significant improvements in their pet's activity levels, with only a few long-term concerns.

What Pet Owners Say About TPLO Years Later

Studies show that 80–90% of owners are satisfied with their dog's long-term recovery. Many dogs return to running, hiking, and playing without noticeable lameness. However, some owners have concerns, particularly due to:

• Arthritis development, which is common but varies in severity
• Implant issues, such as irritation or the rare need for removal
• A second TPLO surgery, as 30–50% of dogs eventually need the procedure on the other knee

Dogs that undergo structured rehabilitation, maintain an ideal weight, and stay active with controlled exercise tend to have the best long-term results. Proper post-op care and regular vet checkups can maximize mobility and minimize complications, ensuring TPLO remains a lasting solution.

Late-onset lameness & Joint Stiffness

While TPLO provides excellent long-term outcomes, some dogs develop mild lameness or stiffness years after surgery. This can occur due to arthritis progression, muscle imbalances, or implant irritation, even in otherwise successful cases.

Why Do Some Dogs Develop Lameness Years Later?

Several factors contribute to late-onset lameness after TPLO:

• Arthritis progression: TPLO slows but doesn't stop joint degeneration. Over time, cartilage wear leads to stiffness, especially in older dogs.
• Scar tissue formation: Some dogs develop fibrotic tissue around the knee, which reduces flexibility and changes movement patterns.
• Muscle weakness from inadequate rehab: A lack of structured post-surgery rehabilitation can lead to ongoing muscle imbalances, putting strain on the joint.

Solutions for Maintaining Mobility

To reduce long-term stiffness, consistent low-impact exercise (like swimming or controlled walking) is crucial. Joint supplements (glucosamine, omega-3s) can help slow arthritis progression, and regular vet check-ups ensure early detection of any issues.

For dogs showing signs of discomfort, physical therapy and anti-inflammatory management can greatly improve their quality of life.

How Well Does TPLO Hold Up in Active & Working Dogs?

For working dogs, agility competitors, and high-energy breeds, long-term durability is a major concern after TPLO surgery. While the procedure restores knee stability, the intense physical activity these dogs engage in can increase the risk of re-injury and joint strain over time.

Can Working & Sporting Dogs Perform Well After TPLO?

Many agility, service, and hunting dogs successfully return to full activity after TPLO. A study on sporting breeds found that over 80% regained their pre-injury performance levels with proper rehabilitation. However, working dogs face a higher risk of reinjury or implant stress, especially if they resume activity too soon.

Key factors for long-term success include:

• Gradual reconditioning with structured rehab
• Hydrotherapy for low-impact muscle strengthening
• Targeted strength training to prevent imbalances

While some stiffness or mild arthritis may develop over time, most active dogs remain highly functional for 5–10+ years post-surgery with proper care. Regular joint supplements, vet check-ups, and monitored exercise can help protect their long-term mobility.

Comparing TPLO to No Surgery: Is It Worth It?

Some pet owners wonder if TPLO is truly necessary or if their dog could recover naturally. While there are non-surgical options, studies consistently show that dogs undergoing TPLO have better long-term outcomes in terms of mobility, pain management, and quality of life.

What Happens to Dogs Who Don’t Get TPLO?

Without surgery, a cranial cruciate ligament (CCL) tear leads to chronic instability, causing:

• Severe arthritis due to ongoing joint wear
• Chronic pain that worsens over time
• Progressive loss of mobility, often requiring lifelong pain management

Alternatives like bracing, physical therapy, and pain medications can provide some relief but rarely restore full function. A study comparing TPLO to non-surgical treatment found that over 90% of TPLO dogs regained normal mobility, while non-surgical cases had a much higher risk of long-term lameness and reduced activity levels.

When comparing lifespan and activity, TPLO-treated dogs remain more active for longer, often enjoying 5–10+ years of quality mobility post-surgery. For most dogs, TPLO remains the gold standard for CCL injuries.

Does TPLO Surgery Help Dogs Live Longer?

While TPLO is mainly done to restore mobility, its long-term effects can affect a dog’s overall lifespan by improving their quality of life and reducing chronic joint pain.

Longevity & Lifespan Impact

There are no direct studies showing TPLO extends lifespan, but research indicates that dogs with untreated CCL tears have higher risks of arthritis, chronic pain, and reduced activity levels—factors that can indirectly affect longevity. Chronic joint pain leads to less exercise, weight gain, and muscle loss, which may contribute to other health issues like heart disease or metabolic disorders.

In contrast, TPLO restores stable movement, allowing dogs to stay active for years. With proper weight control, joint supplements, and post-surgical rehab, TPLO-treated dogs enjoy a higher quality of life well into their senior years. While the surgery itself doesn’t guarantee a longer lifespan, it significantly improves mobility and comfort, contributing to better long-term health.

Final Thoughts

TPLO is widely seen as the gold standard for CCL injuries, providing strong, lasting mobility improvements for most dogs. Studies show that 85–90% of dogs regain near-normal function after surgery, with benefits lasting well into their senior years.

However, arthritis remains a common concern, even in successful TPLO cases. Implant-related issues, like irritation or screw loosening, happen in a small percentage of dogs (5–10%), but these can often be managed with proper care.

Dogs that undergo structured rehabilitation, maintain a healthy weight, and receive joint supplements tend to have the best long-term results. Regular vet check-ups help detect and address potential issues early.

While TPLO doesn’t eliminate every risk, it significantly improves mobility and quality of life, making it the preferred choice for long-term knee stability. Lifelong joint care is essential for maximizing success.

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