• Tips for TPLO Radiographs | Cave Veterinary Specialists

Tips for TPLO Radiographs

Tibial Plateau Levelling Osteotomy (TPLO) is a surgical procedure used to treat cranial (or anterior) cruciate ligament rupture in the knee joints of dogs.

Common causes for cruciate rupture

Chronic conditions:

  • Degeneration (ageing) of the ligament
  • Obesity/poor physical condition
  • Skeletal shape/conformation of the dog
  • Genetics
  • Breed

Acute:

  • Trauma such as twisting knee when jumping for a ball/toy

Pre-surgery a series of radiographs are needed. The surgeon will then use these radiographs to measure the correct angle and plate needed for a successfully surgery.

List of equipment

Radiography marker and position aids list:

  • Left and right markers
  • Ruler
  • Radiographic reference ball OR radiographic measurer (used for all orthopaedic radiographs)
  • Sandbags
  • Blue wedges of different shapes and sizes
  • Small foam blocks
  • Swabs
  • Ties (only when a patient is anaesthetised)
  • Elastoplast (only when a patient is anaesthetised)
  • Omnifilm tape

Pre-surgery radiographs

Lateral position

  • Ensure that the stifle and hock are collimated into the area of interest. Please keep  the leg in a natural position
  • Place an appropriate-sized plate under the limb of interest
  • Centre on stifle
  • Collimate to include mid-femur and hock joint
  • Sandbag the limb not being radiographed out of the way of the beam
  • Use a blue flat triangular wedge under the hip/pelvis
  • Left or Right marker
  • Radiographic reference ball (place the ball at the level of the joint)
  • You may or may not need a small foam block or some swabs to lay under the hock so it elevates the tibia/fibular parallel to the stifle
  • Ensure the leg is in a natural position

tplo feb22 image1          tplo feb22 image2

Caudocranial position

  • Place patient on their front, hind limbs extended
  • Place appropriate-sized plate under the limb of interest
  • Centre on stifle
  • Collimate to include all of mid femur and hock joint
  • Place the non-interest limb onto wedges (this should help tilt the limb of interest into a more central position)
  • Place a large blue triangular wedge/ big sandbag on the opposite side as this will help keep the patient in a central position
  • Left or Right marker
  • Radiographic reference ball (place the ball at the level of the joint)
  • Use omnifilm to tape patient’s tail out of the way or tuck the tail under the non-interest limb if the tail is long enough

tplo feb22 image3          tplo feb22 image4

POST TPLO radiographs

Lateral position

  • Ensure that the stifle and hock are collimated into the area of interest.
  • Place appropriate sized plate under the limb of interest
  • Centre on stifle
  • Collimate to include mid femur and hock joint
  • Sandbag the limb not being radiographed out of the way of the beam
  • Blue flat triangular wedge under the hip/pelvis

Left or Right marker

  • Radiographic reference ball (place the ball at the level of the joint)
  • You may or may not need a small foam block or some swabs to lay under the hock so it elevates the tibia/fibular parallel to the stifle

These are guidelines and you may need more or less of the position aids as each patient will be different.

tplo feb22 image5