Timing of and risk factors for deep surgical site infection requiring implant removal following canine TPLO

Authors
Renee A McDougall, Daniel I Spector, Robert C Hart, David L Dycus, Hollis N Erb
Journal
Vet Surg. 2021 Apr 7. doi: 10.1111/vsu.13634.

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.