TPLO Plate System

The Surgical Technique for Tibial Plateau Leveling Osteotomy with InternalBrace™ Ligament Augmentation

SURGICAL TECHNIQUE

© 2017 Arthrex, Inc. All rights reserved. VLT1-00053-EN_A

Laser line assists in proper placement

Designed to be less prominent under the skin

Locking TPLO Plate with InternalBrace™ ligament augmentation option

New shape and additional features designed to facilitate optimal plate positioning

Locking screws proximally and distally

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A tibial plateau leveling osteotomy (TPLO) is performed with or without a standard TPLO jig and an appropriately sized saw blade. The osteotomy is secured using a Kerschner wire (K-wire) placed across the tibial tuberosity.

After placing the plate in the center of the proximal fragment, the proximal K-wire is inserted.

After aligning the plate with the tibial diaphysis, the distal K-wire is inserted to secure the plate.

To properly align the TPLO plate, the proximal screw holes are placed in the center of the proximal fragment. The distal portion of the plate is placed in the center of the distal fragment and the laser lines are aligned with the osteotomy.

Tibial Plateau Leveling Osteotomywith Internal Brace™ Ligament Augmentation

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The Locking Screws are placed in the proximal fragment. After removing the distal K-wire, the compression screw is tightened by hand.

A cortex screw is inserted in compression position. This screw should be left slightly loose, but in contact with the plate. Use drill guide and appropriate drill bit to drill hole in the compression position.

The Locking Drill Guide is used to drill the hole and to measure its depth to the appropriate length. A depth gauge is used to gain a more accurate measurement.

TPLO

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After tightening the compression cortical screw, the Locking Screws are inserted in the distal holes and the jig is removed.

The caudal aspect of the lateral femoral condyle is exposed. Drill holes for SwiveLock® anchor using the appropriate size bit.

After all screws are placed, make sure all are tightened by hand with screwdriver and the K-wire is removed.

Tap the lateral femoral drill hole for Swivelock using appropriate size tap to create threads for anchor to be inserted.

Surgical Technique

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After exposing the tibial tunnel starting point behind the LDE groove, the tip of the aiming guide is placed in the suture hole of the plate and drill guide sleeve is cinched into place to secure drill guide to tibia. Drill 0.049” K-wire for tibial tunnel, lateral to medial, making sure K-wire exits near open hole in TPLO Plate. Remove Drill Guide after properly placing K-wire.

After placing the 0.049” K-wire, a 2.5 mm cannulated drill bit is used to create the tunnel.

TPLO

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The 2.0 mm FiberTape® suture is looped through the suture hole on TPLO Plate and shuttled through the tibial tunnel using the nitinol suture passer.

Pull both limbs of the FiberTape suture taut and lay over the predrilled hole in femur. With marking pen, mark the location of the center of the hole on the FiberTape suture (inset).

Slide eyelet of anchor over mark created in Step 16. Pull both limbs of FiberTape suture up shaft of SwiveLock® anchor and mark the location of laser line on suture.

Move the eyelet to the mark on the FiberTape suture created in Step 17 and advance the anchor and suture into the F2 tunnel. If necessary, use a mallet to advance the eyelet into the tunnel until the tip of the anchor is at the entrance of the femoral hole.

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If the joint is secure, advance the anchor fully into the tunnel. Unwind the #2 suture around the handle of the inserter and pull the driver out of the anchor. Cut the excess suture flush at the anchor. Remove #2 suture by pulling on 1 strand.

Cranial view. Medial view.

Surgical Technique

Surgical Technique

Product and Ordering Information:

TPLO Locking Plate, 3.5 mm, Standard, Left VAR-4035S-L TPLO Locking Plate, 3.5 mm, Standard, Right VAR-4035S-R TPLO Locking Plate, 3.5 mm, Small, Left VAR-4035SM-L TPLO Locking Plate, 3.5 mm, Small, Right VAR-4035SM-R TPLO Locking Plate, 3.5 mm, Broad, Left VAR-4035B-L TPLO Locking Plate, 3.5 mm, Broad, Right VAR-4035B-R

3.5 mm Low-Profile Nonlocking Screws, Stainless Steel, Cortical:

Nonlocking Screw, 3.5 mm x 16 mm VAR-8835-16 Nonlocking Screw, 3.5 mm x 18 mm VAR-8835-18 Nonlocking Screw, 3.5 mm x 20 mm VAR-8835-20 Nonlocking Screw, 3.5 mm x 22 mm VAR-8835-22 Nonlocking Screw, 3.5 mm x 24 mm VAR-8835-24 Nonlocking Screw, 3.5 mm x 26 mm VAR-8835-26 Nonlocking Screw, 3.5 mm x 28 mm VAR-8835-28 Nonlocking Screw, 3.5 mm x 30 mm VAR-8835-30 Nonlocking Screw, 3.5 mm x 32 mm VAR-8835-32 Nonlocking Screw, 3.5 mm x 34 mm VAR-8835-34 Nonlocking Screw, 3.5 mm x 36 mm VAR-8835-36 Nonlocking Screw, 3.5 mm x 38 mm VAR-8835-38 Nonlocking Screw, 3.5 mm x 40 mm VAR-8835-40 Nonlocking Screw, 3.5 mm x 42 mm VAR-8835-42 Nonlocking Screw, 3.5 mm x 44 mm VAR-8835-44 Nonlocking Screw, 3.5 mm x 46 mm VAR-8835-46 Nonlocking Screw, 3.5 mm x 48 mm VAR-8835-48 Nonlocking Screw, 3.5 mm x 50 mm VAR-8835-50

3.5 mm Low Profile Locking Screws, Stainless Steel:

Locking Screw, 3.5 mm x 16 mm VAR-8835L-16 Locking Screw, 3.5 mm x 18 mm VAR-8835L-18 Locking Screw, 3.5 mm x 20 mm VAR-8835L-20 Locking Screw, 3.5 mm x 22 mm VAR-8835L-22 Locking Screw, 3.5 mm x 24 mm VAR-8835L-24 Locking Screw, 3.5 mm x 26 mm VAR-8835L-26 Locking Screw, 3.5 mm x 28 mm VAR-8835L-28 Locking Screw, 3.5 mm x 30 mm VAR-8835L-30 Locking Screw, 3.5 mm x 32 mm VAR-8835L-32 Locking Screw, 3.5 mm x 34 mm VAR-8835L-34 Locking Screw, 3.5 mm x 36 mm VAR-8835L-36 Locking Screw, 3.5 mm x 38 mm VAR-8835L-38 Locking Screw, 3.5 mm x 40 mm VAR-8835L-40 Locking Screw, 3.5 mm x 42 mm VAR-8835L-42 Locking Screw, 3.5 mm x 44 mm VAR-8835L-44 Locking Screw, 3.5 mm x 46 mm VAR-8835L-46 Locking Screw, 3.5 mm x 48 mm VAR-8835L-48 Locking Screw, 3.5 mm x 50 mm VAR-8835L-50

Accessories:

TPLO Caliper VAR-4000-CAL Guidewire w/Trocar Tip, 0.092” AR-8967K Guidewire w/Trocar Tip, 0.062” AR-8941K Guidewire w/Trocar Tip, 0.045” AR-8933K Osteotomy Guide Pin, 3.0 mm AR-13303-3.0 Drill Guide, Nonlocking AR-8943-14 Drill Guide, Locking VAR-4035DG Drill Bit, 2.8 mm VAR-4035D Drill Bit, 2.5 mm VAR-8943-30 Depth Device, low profile, 2.7 mm/3.5 mm/4 mm AR-8943-15 Hexalobe Driver, T15 AR-8941DH Screwdriver, T15 Hexalobe AR-8943-10 Locking Bending Guide, 3.5 mm (Plate Holder) VAR-8954-07 Screw Holding Forceps AR-8941F TPLO Screw Set, 3.5 mm VAR-4035S-SC TPLO Screw Case, 3.5 mm VAR-4035SC-01 Aiming Guide VAR-2810 Guidewire, 0.049” VAR-8920P Cannulated Drill, 2.5 mm AR-8737-09 SwiveLock® Tap, 4.75 mm AR-2324PTB SpadeTip Drill Bit VAR-1927D Suture Passing Wire VAR-1255-08 SwiveLock Anchor, 4.75 mm (5 pack) VAR-2324PSLC FiberTape® Suture (6 pack) AR-7237

TPLO Locking Plates

Left: VAR-4035S-L Right: VAR-4035S-R

This is not veterinary advice and Arthrex recommends that veterinarians be trained in the use of any particular product before using it in surgery. A veterinarian must always rely on his or her own professional clinical judgment when deciding whether to use a particular product.

A veterinarian must always refer to the package insert, product label and/or Directions For Use before using any Arthrex product. Products may not be available in all markets because product availability is subject to the regulatory or veterinary practices in individual

markets. Please contact your Arthrex representative if you have questions about availability of products in your area.

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© 2017 Arthrex, Inc. All rights reserved. VLT1-00053-EN_A

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