TPLO — tibial plateau levelling osteotomy — is the gold-standard surgical repair for cranial cruciate ligament rupture in dogs, and one of the most expensive and emotionally significant procedures a client will authorise. With success rates of 90–95% and most dogs returning to near-full function within 10–12 weeks, outcomes are excellent when the recovery protocol is followed. The problem is that recovery spans three months, the most critical decisions happen at home, and owner compliance with activity restriction is notoriously difficult to maintain. The overall complication rate for TPLO sits at 8–11%, with surgical site infection accounting for approximately 5–7% of all cases and implant-associated infection occurring in around 3%. Most of these complications are not inevitable — they’re a compliance and monitoring failure.
Why TPLO follow-up matters beyond the scheduled rechecks
TPLO recovery has a structured recheck schedule built in: day 10–14 for suture removal, week 6 for X-ray, week 8–12 for final X-ray and activity clearance. The problem is the gaps. Between discharge and the day 10 recheck, the dog is at home for two weeks with a newly plated tibia, a healing incision, a cone, and an owner trying to enforce complete rest on an animal that may be feeling significantly better than its bone has healed.
The most common complications that develop in the gap are infection (presenting as swelling, redness, warmth or discharge at the incision), seroma formation, and self-trauma from the dog removing its collar or the owner removing it unsupervised. In approximately 3% of TPLO cases, infection is deep enough to involve the plate and screws — requiring extended antibiotic therapy until bone healing is confirmed by X-ray, and sometimes plate removal. Catching early infection signs at day 5 rather than day 14 changes the treatment trajectory significantly.
Activity restriction failure is the other major risk. Owners who understand the restriction in the clinic often relax it at home when the dog appears comfortable. A dog that runs or jumps in the first 6 weeks post-TPLO risks catastrophic implant failure or tibial tuberosity fracture — complications requiring corrective surgery. A follow-up call that directly asks about activity in the first week is the only mechanism the clinic has to catch this before it becomes a problem.
The TPLO follow-up timeline
| Timepoint | What to check | Red flags |
|---|---|---|
| 48 hours | Incision appearance, pain medication compliance, e-collar status, weight-bearing (partial expected by day 2–3) | Not bearing any weight at all, significant swelling at incision, collar removed |
| Day 5–7 | Incision healing, any swelling or warmth around surgical site, activity restriction adherence | Warmth, redness or discharge at incision — early infection signs that need prompt review |
| Day 10–14 | Confirm suture removal recheck appointment, incision healing on track | Owner unaware of recheck, sutures not removed on schedule |
| Week 6 | Confirm X-ray appointment, activity levels appropriate for stage, physiotherapy if prescribed | Owner has progressed activity without X-ray clearance |
| Week 8–12 | Final X-ray confirmation, return to normal activity clearance | Owner has resumed full activity before bone healing confirmed radiographically |
What to ask owners during TPLO follow-up
- Is [pet name] bearing any weight on the operated leg when walking — even briefly?
- Have you been giving all pain relief and antibiotics exactly as prescribed?
- Is the cone or collar on at all times, including overnight?
- Can you describe how the incision looks — any swelling, redness, warmth or discharge?
- Has the knee area felt warm to the touch compared to the other leg?
- Has [dog name] had any off-lead time, or run or jumped at all since coming home?
- Is he resting comfortably, or does he seem restless and wanting to move around?
- Have you been doing any of the prescribed physiotherapy exercises?
- Do you have your week 2 recheck appointment booked?
- Is there anything you’re unsure about from the discharge instructions?
Common TPLO follow-up mistakes clinics make
Relying on the owner to call if something looks wrong. Owners frequently don’t know what infection looks like in its early stages. Warmth and mild redness at a healing incision feels ambiguous to a non-clinician. A direct question — “does the area feel warm compared to the other leg?” — elicits a much more useful answer than “call us if you’re worried.”
Not following up between the day 10 and week 6 rechecks. This is a six-week gap with no clinic contact. For a dog recovering from major orthopaedic surgery, that’s a long time to be operating on owner compliance alone. A brief call at week 3–4 to check activity adherence and address any questions is low-cost and high-value.
Treating the activity restriction conversation as done at discharge. Owners hear the restriction and agree with it. Two weeks in, when the dog is running to the door and appears completely comfortable, the restriction feels arbitrary. Re-stating the reason — bone has not healed, X-ray at week 6 will confirm it — during a follow-up call recontextualises the instruction at exactly the point owners are most likely to relax it.
How to automate TPLO follow-up without adding to your team’s workload
TPLO recovery is the clearest case for structured, automated follow-up in veterinary practice. The call windows are predictable, the questions are consistent, and the consequences of missing a complication early are significant. Nidana Loop reads the discharge summary and schedules calls at the right recovery windows — 48 hours, day 5–7, and a recheck confirmation before day 10 — automatically. The clinic sees a summary and a flag for anything that needs attention. No manual scheduling, no calls falling through the cracks on busy surgical days.
See how Loop handles TPLO follow-up calls → Book a 20-minute demo
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