Tibial-plateau-leveling osteotomy

And we've got a couple of papers that we'd like to look at.

One of them is about the carbon footprint of a TPLO and also of carbon footprint in veterinary care within a referral setting.

So there's good evidence for us to have a look at.

How can we all improve in this area? What can we learn? So there's plenty for us to get our teeth into.

So, Cara, could you talk us through this one a little bit?

Yeah, absolutely.

She looked at 10 TPLO procedures in two UK referral hospitals and did a broader procedural footprint than just consumables.

So, it included travel of staff and also owners to the hospitals themselves, the pharmaceuticals, how much volatile anaesthetic use was being used, the single-use consumables, energy and waste products.

She came from a slaughterhouse in Busan that we rescued two years ago.

And she recently had a double patella leg surgery and a TPLO, which is basically like a ACL injury.

Oh, that's great.

So we've been nursing her back to health for like the past couple months.

can't be the machine Pilates.

It's essentially like yoga, but like puppy Pilates sounds better.

And believe it or not, I have a program in my training facility is how I rehabbed my buddy who had TPLO.

Florida's the best weather.

So first and foremost, you've got to control the pain.

Part of that that I think we need to recognize is there could be things that are still driving more pain, right? Like if, let's say you've got a post-op TPLO.

Let's say this patient had surgery and they're still dealing with a lot of that learned behavior, right? Like their stifle hurt for quite a while.

Maybe it took a while for them to get into surgery.

They had the TPLO.

Now the stifle is stable.

So in our minds, okay, the stifle's stable.

to check it out i love that we have so many lecturers that have contributed to the library over the years because i feel like everyone brings a different a little bit of a different perspective different clinical experience that just makes a huge difference ultimately at the end of the day so thank you um all right my last question for you if there was one thing that you wish every veterinary rehabilitation professional understood about pain and the brain what would that be

And so I decided to just start one myself.

The last thing I wanted to be is a TPLO factory.

And I've been an academician my entire career.

So I'm trying to create this hybrid.

There's a lot of surgery that can be done extremely well that way.

And then, you know, there's also, you know, the specialist level and more complicated things tend to come to us.

But it's, you know, used to be the case that we'd get lots and lots of TPLOs to do.

But actually, in many ways, I think as much something the sort of way it's priced in specialist practice and so on has meant that a lot of that has gone to the middle tier now.

Oh, girl.

TPLO for dog people.

Eight-week checkup, so she's doing well.

She's doing good.

So like when people remember to like when you take your ACL, human medicine usually takes some of your hamstring or something else and stitches it in place to replace it.

Dogs, we do a surgery most of the time called a TPLO.

Yes.

Where we eliminate the need for the ACL essentially and we balance out the knee.

Months.

She just got TPLO surgery on Thursday of this week.

So we are rehabbing her as we speak.

She was running for Hall of Fame.

And I remember probably 10, 15 years ago, it was like partial tear, complete tear, let's just do surgery.

I think as this evolved and we realized this wasn't just these acute traumatic tears that even with stabilizing surgery, whether you're doing a lateral suture or a TPLO or a TTA, yeah, you're addressing that cranial tibial thrust, but none of the operations are addressing the synovitis.

None of them are addressing the inflammation, that underlying inflammatory cause.

And so I think with the progression of physical therapy and rehab and the sports medicine board that was created, there are lots of other options.

And that helps.

A recent paper that just came out showed that, hey, do we even have to deal with the meniscus at all at surgery? Let's not even open the joint and look.

We'll just go ahead and do the TPLO or the TTA, which, again, is a little controversial.

But I know a lot of surgeons that are doing that.

Well, let’s look at the studies.

For TPLO, tibial plateau leveling osteotomy, we’re cutting the bone, rotating it, major trauma.

But bandaging did not reliably decrease swelling at twenty-four or forty-eight hours compared to unbandaged dogs.

That is going to shock a lot of people listening to this.