Cranial cruciate ligament disease is a common cause of hindlimb lameness in dogs. Some dogs respond well to conservative management, while others may benefit from surgery. Knowing when to consider a TPLO surgery referral can help veterinary teams choose the right next step for a suitable patient.
TPLO, or tibial plateau levelling osteotomy, is an established surgical treatment for cranial cruciate ligament disease. It changes the mechanics of the stifle joint so the dog can bear weight without relying on the damaged ligament.
When Should a Dog Be Considered for TPLO Referral?
A dog may be suitable for surgical assessment when it has ongoing lameness, pain, or instability linked to cranial cruciate ligament disease.
Common signs include:
- Persistent hindlimb lameness
- Difficulty getting up or climbing stairs
- Reduced activity or reluctance to exercise
- Pain around the stifle joint
- Muscle loss in the affected hindlimb
- Stiffness after rest
- A positive cranial drawer or tibial thrust on examination
Not every dog with a cruciate injury will need TPLO surgery. The decision depends on the individual patient, clinical findings, imaging, and overall health.
A referral can be useful when the diagnosis is clear, but the case would benefit from additional orthopedic assessment and surgical planning.
What Should Be Assessed Before TPLO Surgery?
A thorough orthopaedic examination helps determine whether surgery is appropriate. The veterinary surgeon may assess the degree of lameness, stifle stability, muscle condition and the dog’s general health.
Radiographs can also help assess the stifle and support surgical planning. The tibial plateau angle is particularly important when considering TPLO.
The meniscus should also be considered. Dogs with cranial cruciate ligament disease can develop a meniscal injury, which may cause ongoing pain if left untreated.
The dog’s age, size, activity level, and other health conditions also form part of the decision. A suitable surgical plan should take the whole patient into account rather than focusing only on the injured ligament.
TPLO Surgery and Other Surgical Options
TPLO is one of several surgical options for cranial cruciate ligament disease. Other procedures include TTA and lateral suture techniques. Each method has its own indications, benefits, and limitations.
For some dogs, TPLO may offer a suitable way to manage stifle instability, particularly where the patient’s size, activity level, and joint condition make it an appropriate choice.
A referral allows the case to be reviewed on its own clinical merits. The aim is not to recommend one procedure for every patient, but to identify the most suitable approach for that individual dog.
When Should a Veterinary Team Make a Referral?
A referral may be worth considering when a dog has confirmed or suspected cranial cruciate ligament disease and the veterinary team would like additional surgical input.
This may include cases with:
- Persistent or worsening lameness
- Significant stifle instability
- Suspected meniscal injury
- Difficult diagnostic findings
- Concerns about the most suitable surgical technique
- A need for additional orthopaedic surgical expertise
Early discussion can also help with planning. It gives the referring veterinary surgeon an opportunity to review the case, discuss imaging and consider the practical requirements before surgery.
What Happens During a TPLO Referral?
The referral process should be straightforward. The referring veterinary surgeon can discuss the patient’s history, examination findings, and diagnostic results with the surgical team. The case can then be reviewed to decide whether TPLO is appropriate and what further assessment may be needed.
For suitable cases, Dr. Shahar Somer provides peripatetic surgical support and can carry out the procedure within the patient’s usual veterinary setting where appropriate.
The primary veterinary team remains involved in the patient’s care. This supports clear communication before surgery and helps with ongoing postoperative care.
You can learn more about TPLO surgery for dogs and the surgical support available through OrthoPet Pro.
Discuss a Potential TPLO Case
If you are managing a dog with cranial cruciate ligament disease and would like additional surgical input, a referral discussion can help clarify the available options.
OrthoPet Pro provides peripatetic veterinary surgical support across Kent, Essex, Sussex, and Greater London. Dr. Shahar Somer works with referring veterinary teams to assess suitable cases and plan appropriate surgical care.

