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  • Tips for TPLO Radiographs | Cave Veterinary Specialists

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 (aging) 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 leg in natural position
  • 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
  • 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 leg is in 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 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 tail under the non interest limb if 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