Renee A McDougall1, Daniel I Spector1, Robert C Hart1, David L Dycus2, Hollis N Erb3. 1. Department of Surgery, The Animal Medical Center, New York, New York, USA. 2. Department of Surgery, Veterinary Orthopedics and Sports Medicine Group, Annapolis Junction, Maryland, USA. 3. College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
Abstract
OBJECTIVE: To identify demographic risk factors for deep surgical site infection (SSI) requiring tibial plateau leveling osteotomy (TPLO) implant removal and time to implant removal. ANIMALS: Four hundred and thirty-three dogs that underwent a TPLO (144 that developed a deep SSI and required implant removal, 289 that did not). STUDY DESIGN: Retrospective case-control study. METHODS: Records of dogs undergoing implant removal due to a deep SSI after TPLO between 2006 and 2018 at two referral centers were reviewed. These records were frequency-matched by date to dogs undergoing TPLO that did not require implant removal. Multivariable analyses tested associations between demographics and implant removal as well as timing of implant removal. RESULTS: Deep SSI and implant removal occurred in 144 of 4813 (3.0%; 95% CI: 2.5, 3.5) dogs treated with TPLO. Implant removal was performed at a median of 279 days (range 49-2394 days) postoperatively. Male dogs (OR 1.8; 95% CI: 1.2, 2.7) and German Shepherd dogs (GSDs) (OR 7.4; 95% CI: 2.6, 20.5) were associated with plate removal. Earlier TPLO plate removal was associated with GSDs only (HR 2.4; 95% CI: 1.4, 4.1). CONCLUSION: Implant removal due to SSI after TPLO was uncommon, although male dogs and GSDs seemed predisposed to this complication. SIGNIFICANCE: These demographic risk factors can be used to educate owners regarding perioperative management.
OBJECTIVE: To identify demographic risk factors for deep surgical site infection (SSI) requiring tibial plateau leveling osteotomy (TPLO) implant removal and time to implant removal. ANIMALS: Four hundred and thirty-three dogs that underwent a TPLO (144 that developed a deep SSI and required implant removal, 289 that did not). STUDY DESIGN: Retrospective case-control study. METHODS: Records of dogs undergoing implant removal due to a deep SSI after TPLO between 2006 and 2018 at two referral centers were reviewed. These records were frequency-matched by date to dogs undergoing TPLO that did not require implant removal. Multivariable analyses tested associations between demographics and implant removal as well as timing of implant removal. RESULTS: Deep SSI and implant removal occurred in 144 of 4813 (3.0%; 95% CI: 2.5, 3.5) dogs treated with TPLO. Implant removal was performed at a median of 279 days (range 49-2394 days) postoperatively. Male dogs (OR 1.8; 95% CI: 1.2, 2.7) and German Shepherd dogs (GSDs) (OR 7.4; 95% CI: 2.6, 20.5) were associated with plate removal. Earlier TPLO plate removal was associated with GSDs only (HR 2.4; 95% CI: 1.4, 4.1). CONCLUSION: Implant removal due to SSI after TPLO was uncommon, although male dogs and GSDs seemed predisposed to this complication. SIGNIFICANCE: These demographic risk factors can be used to educate owners regarding perioperative management.