Introduction: Olli is a 4-year-old Saint Bernard that presented with a 6 week history of right hindlimb lameness. Orthopaedic examination revealed right stifle effusion and pain, mild medial buttress, atrophy of the thigh muscles and positive cranial drawer and tibial thrust. He was 3/5 lame and also had hip pain. Neurological exam was normal. A diagnosis of complete cranial cruciate tear was made.
Operative Procedure: The medial tibial slope was measured to be 24 degrees. Olli was taken to surgery where a right TPLO was performed. The joint was examined arthroscopically and the meniscus probed. A large bucket handle tear was identified and removed with an arthroscopic shaver.
A positioning jig is placed on the tibia before a curved osteotomy is made in the proximal tibia with a custom designed saw. The tibial plateau is rotated a predetermined distance to level the slope to 6 degrees and eliminate cranial tibial thrust. The TPLO osteotomy is compressed by a custom TPLO plate.
Pre-operative Analgesia: Olli was premedicated with methadone and acepromazine.
Pre-operative Imaging: Lateral and craniocaudal radiographs of the stifle showed stifle joint effusion, osteophytes on the proximal and distal poles of the patella, femoral condyles and tibial plateau.
Post-operative Imaging: Radiographs confirmed excellent implant positioning and alignment as well as a levelled tibial plateau.
Post-operative analgesia: Post- operatively Olli received injectable carprofen and methadone. He was discharged with oral carprofen and tramadol.
Post-operative Instructions: The owners were instructed to rest Olli for the next 2 weeks. Once his sutures were removed, he began a tailored lead walking plan, gradually increasing his endurance over the next month. Recheck radiographs were made at 6 weeks post-operatively and revealed good healing progression and a stable implant. Olli’s owners were instructed to gradually return him to normal function.
