TPLO risks, complications and success rates

EMReviewed by Eben Martin, Veterinary Surgeon · Updated August 2026

TPLO has a high success rate: the large majority of dogs return to good or excellent function, and owner satisfaction in published studies is consistently strong. The honest counterweight is a complication rate that is not zero: minor issues like swelling or seroma are reasonably common, and a smaller number of dogs have complications that need further treatment or revision surgery.

The complications that actually matter

  • Infection: the most common serious complication; usually managed with antibiotics, occasionally needing implant removal once the bone has healed
  • Meniscal injury later on: a knee that recovered well and then goes suddenly lame may have torn the meniscus, which needs a second, smaller procedure
  • Implant irritation or failure: uncommon, more likely in very active dogs or if confinement fails
  • Fracture of the healing bone: rare, and the reason the confinement rules are not negotiable

What failure really means

Most so called failures are not the dramatic collapse owners imagine. They are an infection that needs a plate out, a meniscus that tears months later, or a recovery that stalls at 80 percent instead of reaching 95. Almost all have a next step. Before surgery, the two best questions you can ask a clinic are: what is your complication rate, and what happens, and what does it cost, if my dog is one of them. A confident clinic answers both without flinching, and some back it with a written guarantee period.

Anaesthesia, honestly

Modern veterinary anaesthesia is very safe for healthy dogs, and death under anaesthesia is genuinely rare. Risk rises with serious heart, kidney or airway disease and in very old patients, which is why pre anaesthetic assessment matters and why it is fair to ask who is monitoring the anaesthetic and how.

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Common questions

Do the implants need to come out later?

Usually not. Plates and screws stay for life in most dogs. Removal is only recommended if there is infection or irritation, and only once the bone has healed.

Will my dog get arthritis anyway?

Some arthritis is likely in any knee that has had a cruciate rupture, with or without surgery. Surgery slows its progression and keeps the joint functional; it does not rewind the clock to a factory new knee. Weight control is the single best thing you control.

Is TTA safer or riskier than TPLO?

Both are established, both work in the right hands, and complication profiles differ more by surgeon and case selection than by acronym. The better question for a clinic is which one they do most, and why they recommend it for your dog.

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