Stuart attends orthopaedic training: Biocurve TPLO Advanced Workshop

It was fascinating to see how much these techniques have evolved - with smaller, stronger implants and safer, more precise surgical planning for our toy and small-breed patients.

 

Cruciate ligament disease - the “ACL injury” of dogs - isn’t just for Labradors. Terriers, spaniels and bichons are frequent visitors to our orthopaedic theatre. When the ligament tears, the shin bone slides forward and the knee becomes painful, unstable and arthritis develops.

 

Over the years, several surgical options have been developed to solve this problem:

 

TPLO (Tibial Plateau Levelling Osteotomy)

A curved cut and plate change the knee’s mechanics so it no longer slides. The ligament isn’t replaced — the joint is redesigned to work without it.

 

CCWO (Cranial Closing Wedge Osteotomy)

A small wedge of bone is removed from the top of the tibia to reduce the slope and stop the forward slide. It’s particularly useful in toy breeds or dogs with very steep tibial angles.

 

Lateral suture (“fishing-line” repair)

A strong nylon loop placed outside the joint. It can work in very small, quiet dogs but often loosens over time, especially in active pets.

 

Both TPLO and CCWO now have purpose-built “mini” implants for small and toy breeds, allowing safe, stable fixation and faster recovery.

 

Why surgery has changed

In the past, the lateral suture was the go-to choice for small dogs. But research and modern implant design have shown that TPLO and CCWO provide more reliable, long-term stability and less chance of the knee becoming unstable again. They also let us correct other knee problems - like a slipping kneecap (patellar luxation) - at the same time.

 

At Westport, these updates mean we can now tailor cruciate repair precisely to each dog’s shape, size, and lifestyle - giving small dogs the same gold-standard outcomes that large breeds already enjoy.

 

If your dog is limping or struggling to use a back leg, book a cruciate assessment. We’ll examine, image and give you a clear plan - whether that’s TPLO, CCWO, or TTA - so your dog can get back to comfortable, confident movement.