How much will a TPLO surgery for my dog cost?  How much should I expect to spend on a TPLO repair?

TPLO, also known as Tibial Plateau Leveling Osteotomy, is a CCL repair technique through which the veterinary surgeon alters the head of the tibia and plates it to create a new joint angle.  Simply put – your veterinarian will re-invent your dog’s injured knee joint to provide increased stability through changing the way the top and bottom of the leg meet at the knee joint.  This is the most invasive, and requires the most surgical skill, of all the surgical cranial cruciate ligament repair options; it is also the most expensive.  In this article we will break down an actual TPLO cost estimate and explore the cost of choosing this type of CCL repair surgery for your dog.

Below is the estimate I received for my dog to undergo TPLO surgery. 

A few things to note before going into the details of the invoice:

1)  My dog in an American Bulldog weighing roughly 90 pounds (normal weight), and is 5 years old.

2)  He is in good health with no pre-existing conditions that would complicate anesthesia or surgery.

3)  This estimate, although some of the information has been blacked out to protect privacy, is from a speciality veterinary clinic with veterinary surgeons who specialize in cranial cruciate ligament repair surgeries in dogs.

4)  I live in Southern California, and this estimate is from a veterinary office in that area.

Here is the estimate I received for a TPLO CCL repair.  The low end of the estimate was $3,892.79 and the high end of the estimate was $4,03.58 for TPLO surgery.

I will go line by line to go over the charges included in the cost of TPLO surgery.  For smaller animals some of the values will be less, and accordingly for larger dogs.  Hopefully this invoice will give you a basic picture of what you can expect to pay for a TPLO, and where all of the money goes.

EST TPLO Surgery Med/Large – $0 – Just tells us what type of estimate we are looking at.

CBC and Chemistry Profile – $163.80 – Basic blood panel the veterinarian will want to run prior to surgery to determine if you dog is fit to be put under anesthesia and to rule out any other complications.  One way we could have saved money here was to have our dog’s regular vet perform this blood panel at a lower price than to have it done at the speciality clinic.

Radiograph, 2 Views – $224.70 – This is the x-rays that need to be performed prior to the TPLO so the surgeon is able to properly manipulate the tibia during surgery to create the desired angles.  These will need to be performed somewhere prior to TPLO, and some veterinarians will want to do the xrays themselves.

Radiology Interpretation – $45.68 – Fee charged for processing and reading the x-ray.

Catheterization, Intravenous – $94.00 – This fee is for the placement and maintainence of an IV catheter while your dog is undergoing and recovering from TPLO surgery.  Your dog will be given IV fluids and possibly medications through this catheter during the duration of surgery and post operative hospitalization.

Epidural Injection – $86.52 – Local anesthetic (pain relieving medication) will be injected into the lumbosacral (in the spine) space of your dog prior to surgery.  Depending on what types of medication(s) your veterinarian uses this can help to alleviate pain after surgery, and desensitize the effected site during surgery.

Surgery Room Use – $113.82 – Fee for using the Operating Room space to perform the TPLO.

TPLO Inhalant Anesthesia – $306.34 – Cost of putting your dog under gas anesthesia for the time required to perform the TPLO procedure.  This is used in conjunction with the epidural anesthesia.

Surgical Anesthesia Level 1 – $294.00 – Fee for dog to be put under anesthesia and monitored during TPLO surgery.

Surgical Supplies, Orthopedic – $358.05 – Cost for instruments to be used during surgery; this does not include the cost of the actual TPLO implant.

TPLO Surgical Implants, Med/Large – $358.05 – Cost of TPLO implant plates to be placed on the bone during surgery.

TPLO Surgeons Fee – $974.40 – Price veterinary surgeon charges to perform TPLO operation.

Radiograph, Post Op – $192.52 – Cost of x-ray to be taken following surgery to check placement of implant and knee joint angles.

Elective Ortho Hospitalization, General – $138.92 – Cost of overnight hospital stay following TPLO repair surgery.

Fluids – IV, Inital 24 Hours – $0-$190.31 – This would depend on whether or not your dog was being cared for at the hospital post operatively, and how much fluids your pet required.

Misc. Medications, Orthopedic - $450 – This includes prescription medications given to your pet post operatively and those sent home with you during the post operative period.  They would include a sedative (Acepromazine), pain relief (Tramadol), anti inflammatory (Rimadyl), and an antibiotic(Cephalexin), and possibly other medications at your veterinarian’s discretion.

Fentanyl, 75 mcg patch – $65 – Pain relief patch that will be placed in your pet to control post operative discomfort.

Buster Collar, Clear – $25.26 – Collar to be placed on your dog during the post operative period to prevent them from ripping out their stitches or injuring the surgical site.

Included:  X-ray at 8 weeks to check the post operative recovery and  misc. sedative (not sure if this is sedative used during the surgery itself or the sedative medication to take home with you following TPLO surgery).

Also included are all of the post operative recheck visits, but be aware that if you pet develops any complications related to the surgery you will be required to pay for any additional expenses incurred.

What is the Actual Cost of TPLO Surgery? is a post from: Dog Knee Injury

The newest surgical technique to repair torn cranial cruciate ligaments in dogs is the tightrope procedure.  Tightrope CCL is an extracapsular technique which uses lateral suture stabilization in conjunction with a virtually indestructible material called FiberTape for knee joint stabilization.  The Fiber Tape is placed in the dog’s knee through a few small incisions, mostly done arthroscopically, which create tunnels through the bone, and is considered to be one of the least invasive surgical approaches to canine cruciate injury repair. 

Unfortunately, not every dog is a good candidate for the tightrope procedure.  Below you will find some general criteria that excludes certain dogs from tightrope surgery.  Remember – This list is in no way conclusive or exhaustive, your veterinarian will take into consideration many factors including your dog’s age, weight, health history, onset of injury, and physical conformation when making a treatment recommendation for your pet.

Who is not a Candidate for Tightrope CCL Repair?

1)  Dogs weighing less than 30-40 pounds.

2)  Dogs (and people) that cannot follow a physical rehabilitation protocol after surgery.

3)  Canines with limb deformities of any kind.

4)  Dogs with a steep tibial plateau, usually an angle of more than 30 degrees.

Is My Dog a Candidate for Tightrope Surgery? is a post from: Dog Knee Injury

Possible complications associated with Tibial Plateau Leveling Osteotomy (TPLO):

• Anesthetic death (very rare)
• Poor healing of the bone and/or breakage of plates and screws
• Straining of patellar ligament
• Fracture of tibial crest
• Blow-out fracture of the tibial plateau (requires re-operation)
• Loosening of screws and shifting of tibial slope
• Shifting of bones
• Arthritis
• Tearing of meniscus
• Allergic reaction to sutures
• Seroma formation
• Bleeding or bruising of the surgical site
• Implant failure
• Deep infections of the bone, joint or implant
• Angular/Torsional limb deformity

TPLO Complications is a post from: Dog Knee Injury

How the TPLO procedure is performed:

First, the torn ends of the cranial cruciate ligament will be completely removed by the surgeon. Next, the medial and lateral meniscus cartilages will be examined for any signs of damage. The medial meniscus is damaged in about 50% of dogs with CCL ruptures, and the damaged meniscal cartilage will also be removed so as to not hinder the healing process or cause any additional discomfort. Your dog’s veterinarian will take care to remove only the parts of the meniscus that have been damaged as a result of the unstable femur bone pinching the meniscus during normal activity. Studies have shown that dogs with partial menisectomies have less arthritis than dogs with complete meniscus removal.

TPLO Surgery Procedure is a post from: Dog Knee Injury

There are a few different surgical options for dogs with canine cruciate injuries, and not all veterinarians are trained in each procedure. It is important to find out from your vet what procedures they perform, and ask for referrals to specialists if you would like more information on a different type of procedure. There are vets the specialize in orthopedics and, if possible, it is preferable to choose a physician with this type of experience. Be sure to read up on each of the 4 surgical procedures before talking to your veterinarian about which one he/she recommends.

Surgical Repair Techniques for CCL Repairs:

1. Traditional Repair or Extracapsular Imbrication Technique – A leader line is woven in a figure-eight pattern through the joint beginning at the outer aspect of the femur to the tibial crest. The heavy suture will eventually be replaced by scar tissue providing support for the joint.
2. Tibial Plateau Leveling Osteotomy or TPLO – The head of the tibia is surgically altered and plated to create a new joint angle and prevent the femur from sliding off of the tibia. This procedure is an invasive on and involves cutting and plating of bone; it is associated with a higher rate of complications than the other surgical options.
3. Tibial Tuberosity Advancement or TTA – This is very similar to TPLO, yet considered to be less invasive, and involves stabilization of the stifle joint by cutting the bone and changing the angles of the knee.
4. Fibular Head Transposition – The head of the fibula is rotated and the lateral collateral ligament is moved in such a way that it mimics the cruciate ligament. The new positioning of the fibula is held in place using pins and wires. This procedure is not done very often and you may have a hard time finding a veterinarian that will actually perform it.
5. Tightrope Repair – An extracapsular technique using the lateral suture stabilization (LSS) procedure in conjunction with a material called FiberTape to provide bone to bone stabilization.   Similar to traditional repair, the joint will form scar tissue, but the Fibertape will also provide support for a greater length of time.
   

Surgical Repair Options for Cranial Cruciate Ligament Repair is a post from: Dog Knee Injury