By the Walking Paws Rehab team. Reviewed by Dr. Danyel Wynn, DVM, CCRT.
A TPLO (tibial plateau leveling osteotomy) is the most common surgery for a torn cranial cruciate ligament in dogs, and it is the surgery we see most often at our Boulder and Denver clinics. The procedure itself takes about an hour. The recovery takes about three months, and what happens during those months has as much to do with the final result as the surgery does. This is the timeline we walk families through, week by week, so you know what is normal, what to watch for, and when your dog can get back to being a dog.
Every dog is different, and your surgeon’s written protocol always comes first. Use this as a map, not a schedule.
Days 1–3: Home from the hospital
Your dog will come home sore, groggy, and probably not using the leg much. That is expected. The first job is pain control and protecting the incision: give medications exactly as prescribed, keep the cone on, and confine your dog to a crate or a small room with non-slip footing. Bathroom trips are on a short leash, and stairs are off limits. Icing the knee for 10 to 15 minutes a few times a day helps with swelling. Some bruising down the inside of the leg is normal in the first week; a hot, weeping, or opening incision is not, and warrants a call to your surgeon.
We typically see TPLO patients for their first rehab visit around day three or four. At that visit we are not building strength. We are managing pain and swelling with laser therapy and gentle manual work, checking the incision, teaching you how to help your dog stand and walk safely, and setting up the first few home exercises.
Weeks 1–2: Protect and calm
Most dogs start touching the toes down within the first week and are putting some weight on the leg by the end of week two. Walks are still short, slow, and leashed: five minutes, a few times a day, on flat ground. No running, jumping, or playing with other dogs, even if your dog seems to feel fine. The bone cut from the surgery has not begun to heal yet, and the plate is doing all the work.
Rehab in this phase focuses on passive range of motion (gently flexing and extending the knee), weight-shifting exercises so your dog remembers the leg exists, and continued laser over the joint and incision. Sutures or staples usually come out at 10 to 14 days.
Weeks 2–6: Restore motion and begin loading
Once the incision is fully healed, the underwater treadmill becomes the centerpiece of most TPLO recoveries. Walking in chest-deep water lets your dog use the leg with a normal gait while the water carries part of their weight, and the resistance rebuilds the thigh muscle that shrinks noticeably in the first weeks of rest. Sessions start short and slow and lengthen each week.
At home, leash walks stretch to 10, then 15, then 20 minutes. We add controlled exercises: sit-to-stand repetitions, slow figure-eights, standing on a cushion for balance. By week six most dogs are walking without an obvious limp, which is exactly when owners are tempted to let them off leash. Please don’t. The bone is still healing.
Weeks 6–8: The recheck
Your surgeon will take X-rays somewhere around eight weeks to confirm the bone has healed across the cut. This is the milestone that determines how quickly the rest of recovery moves. If the bone looks good, activity restrictions begin to lift. If healing is slower, and it sometimes is in older or larger dogs, the surgeon will extend the restricted period and we adjust the rehab plan to match.
Weeks 8–12: Rebuild strength
With the bone healed, rehab shifts to real strength work: hills, cavaletti poles, longer treadmill sessions, and balance exercises that make the muscles around the knee do their job. We measure thigh circumference at each visit and compare it to the other leg; the goal is symmetry. Walks can become longer and include gentle inclines. Short, controlled off-leash time in a fenced yard is often allowed toward the end of this phase, but ball-chasing and dog-park wrestling still wait.
Months 3–6: Return to normal life
What “normal” looks like
Most dogs are cleared for full activity between three and four months after a TPLO, and by six months the operated leg is usually as strong as the other side. Active and working dogs benefit from a few extra weeks of sport-specific conditioning before going back to hiking, agility, or long fetch sessions. Many of our patients come in for a final evaluation at this point so we can check gait and strength one more time and send you home with a maintenance program.
Protecting the other knee
Roughly half of dogs who tear one cruciate ligament will eventually tear the other. Keeping your dog lean, keeping the hind-end muscles strong, and avoiding weekend-warrior activity spikes are the best protection we know of. The exercises you learned during rehab are the same ones that protect the other leg.
When to call us
Call your surgeon or us right away if your dog suddenly stops using the leg after having used it, if the knee becomes hot or swollen, if the incision opens, or if your dog seems to be in more pain instead of less. Setbacks happen, and most are manageable when they are caught early. As our FAQ explains, a complication is a reason to see us sooner, not later.
Starting rehab after a TPLO
You do not need a referral to book with us, and we coordinate with every surgical practice on the Front Range. Read more about our post-surgical rehabilitation program, our approach to CCL injuries, or schedule a consultation at our Boulder or Denver clinic. Call or text (720) 639-3924.