Left TPLO for Cranial Cruciate Ligament Rupture in a Labrador Retriever
Reed Mobile Veterinary Surgery · Left Pelvic Limb · Primary Surgery
Case Summary
A 6-year-old female spayed Labrador Retriever presented with left pelvic limb lameness consistent with cranial cruciate ligament (CCL) rupture. Conservative management had not resolved the lameness. Left TPLO was performed on 10/16/24 in approximately 70 minutes.
Simini Protect Lavage was applied for 60 seconds at the end of surgery prior to final lavage. The incision was closed with an intradermal barbed suture and tissue glue. The patient had incisional dehiscence on post-operative day 1 due to licking without a cone collar, requiring emergency wound closure. At 8-week recheck, radiographs confirmed complete bone healing with no signs of infection around the implants.
Clinical Presentation
History and Physical Findings
The patient presented in mid-August 2024 with left pelvic limb lameness. Orthopaedic examination was consistent with cranial cruciate ligament rupture. The patient had been managed with carprofen and gabapentin with only partial improvement, and lameness did not resolve. Radiographs supported the clinical diagnosis of CCL rupture. Pre-operative bloodwork was unremarkable.
Fig. 1 — Pre-operative lateral radiograph, left rear extremity. Findings consistent with cranial cruciate ligament rupture. Surgical stabilisation indicated.
Fig. 2 — Pre-operative pelvis VD view. Used to assess overall hindlimb alignment and confirm surgical planning for left TPLO.
Surgical Protocol
TPLO and Closure
Left TPLO was performed on 10/16/24. The procedure was routine and lasted approximately 70 minutes. An LC-DCP plate was applied to stabilise the tibial plateau osteotomy. Prior to final lavage and closure, Simini Protect Lavage was applied for 60 seconds. The incision was closed in layers with an intradermal Quill Monoderm barbed suture and tissue glue, with no external sutures placed.
| Step | Description |
|---|---|
| 01 | General anaesthesia induced. Left stifle prepared and draped. Perioperative cefazolin administered IV |
| 02 | Standard TPLO approach. Tibial plateau osteotomy performed and rotated to neutralise cranial tibial thrust |
| 03 | TPLO plate applied and secured. Osteotomy position confirmed |
| 04 | SiminiSimini Protect Lavage applied for 60 seconds at end of surgery, prior to final lavage and closure |
| 05 | Layered closure performed. Intradermal closure with Quill Monoderm barbed suture and tissue glue. No external sutures placed |
| 06 | Patient recovered and discharged the same evening. Cefpodoxime prescribed for 5 days. Carprofen and gabapentin continued |
Fig. 3 — TPLO incision site at post-operative day 1 following self-trauma from licking without a cone collar. The wound was lavaged with saline and closed with skin staples at the emergency clinic.
Simini Protect Lavage was applied at the end of surgery for 60 seconds prior to final saline rinse and closure, consistent with the standard TPLO closure protocol. Simini reduces bacteria, biofilms, and resistant bacteria at the surgical site. No change to the existing antibiotic or surgical protocol was required.
Outcomes
Follow-Up and Radiographic Assessment
Skin staples were removed at approximately 2 weeks post-surgery and the incision was healing well. Recheck radiographs at 8 weeks showed complete bone healing consistent with clinical union. No signs of lucency around the implants were present.
Staple Removal
Skin staples removed. Incision healing well. No signs of infection at the surgical site.
Complete Bone Healing
Complete bone healing confirmed at the osteotomy site. No periimplant lucency. Consistent with clinical union. No pain, swelling, or discharge.
This case includes a confounding variable in the form of an extended antibiotic course following incisional dehiscence. This is acknowledged by the treating surgeon. It represents single-surgeon clinical experience.
Follow-Up Timeline
Post-Operative Course
Surgery Day
Left TPLO performed, approximately 70 minutes. Simini Protect Lavage applied 60 seconds at closure stage. Intradermal closure with barbed suture and tissue glue. Discharged same evening. Cefpodoxime 5 days, carprofen, gabapentin prescribed.
Incisional Dehiscence (Day 1)
Patient presented to ER after licking without cone collar. Wound lavaged with saline and closed with skin staples. Cefpodoxime extended to cover staple removal date.
Staple Removal (2 Weeks)
Skin staples removed. Incision healing well. No signs of infection. Cefpodoxime continued by family vet for one further week given dehiscence history.
Radiographic Recheck (8 Weeks)
Complete bone healing at osteotomy site confirmed. No periimplant lucency. No pain, swelling, or external signs of infection. Clinical union achieved.