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Korytárová N, Kramer S, Harms O, Volk HA. Clinical relevance of positive intraoperative bacterial culture in tibial plateau leveling osteotomy in dogs: a retrospective study. BMC Vet Res 2024; 20:175. [PMID: 38704532 PMCID: PMC11069177 DOI: 10.1186/s12917-024-04007-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 04/04/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Tibial plateau leveling osteotomy (TPLO) belongs to the most frequently used surgical method for the treatment of cranial cruciate ligament rupture in dogs. Surgical site infection (SSI) is one of the possible postoperative complications. The aim of this study was to evaluate the diagnostic value of intraoperative bacterial culture as a tool for the detection of intraoperative bacterial contamination progressing to infection development in canine TPLO. Electronic patient records from dogs who underwent TPLO between January 2018 to December 2020 were retrospectively reviewed. Intraoperative bacterial culture results, used antimicrobial drugs and presence of SSI were recorded. RESULTS Ninety-eight dogs were included in the study. SSI rate was 10.2%. All dogs who developed SSI (n = 10) had negative intraoperative bacterial cultures. None of the dogs with positive intraoperative bacterial culture (n = 6) developed SSI. The most cultured bacteria causing SSI was Staphylococcus pseudintermedius (n = 4). CONCLUSIONS Intraoperative bacterial culture in dogs undergoing TPLO is not suitable as a predictor of surgical site infection.
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Affiliation(s)
- Natália Korytárová
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany
| | - Sabine Kramer
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany
| | - Oliver Harms
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany
| | - Holger A Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany.
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Wemmers AC, Charalambous M, Harms O, Volk HA. Surgical treatment of cranial cruciate ligament disease in dogs using Tibial Plateau Leveling Osteotomy or Tibial Tuberosity Advancement-A systematic review with a meta-analytic approach. Front Vet Sci 2022; 9:1004637. [PMID: 36532339 PMCID: PMC9748159 DOI: 10.3389/fvets.2022.1004637] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/11/2022] [Indexed: 12/17/2023] Open
Abstract
Tibial Plateau Leveling Osteotomy (TPLO) or Tibial Tuberosity Advancement (TTA) are commonly used surgical techniques for correction of cranial cruciate ligament (CCL) rupture in dogs. This systematic review aims to investigate whether one technique is superior to the other. Seventy-two studies on surgical management of CCL rupture have been identified and evaluated in regard of subjective and objective gait analysis criteria, development of osteoarthritis (OA), thigh circumference measurements, goniometry, joint stability, pain and complication rates. Almost half (47.2 %) of the studies were considered of low quality of evidence, leading to high heterogeneity in quality among studies; this posed a major limitation for an evidence-based systematic review of both surgical techniques. Out of 72 studies, there were only eleven blinded randomized clinical trials, of which five were rated with a low overall risk of bias. However, both techniques were considered to be successful management options. Subjective and objective gait analysis revealed no lameness at long-term evaluation for the majority of the patients. However, it appeared that TTA lead to better OA scores up to 6 months postoperatively, while TPLO had a lower rate of surgical site infections. In summary, no method can be clearly preferred, as most of the study evaluated were subpar. Studies with a high level of evidence are therefore urgently needed for such a common surgical procedure.
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Affiliation(s)
- Annika Christina Wemmers
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
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Corr S. Update on the management of canine cruciate disease. IN PRACTICE 2022. [DOI: 10.1002/inpr.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Macrì F, Cicero L, Angileri V, Biondi V, Miele P, Scaletta L, Costa GL, Cassata G, Di Pietro S. Locking compression plates versus locking plates for tibial plateau levelling osteotomy in dogs: progression of osteoarthritis, bone healing score and lameness degree. BMC Vet Res 2021; 17:193. [PMID: 33985504 PMCID: PMC8120732 DOI: 10.1186/s12917-021-02899-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 05/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The partial or complete cranial cruciate ligament rupture is a common skeletal disease affecting the stifle joint in dogs. The tibial plateau levelling osteotomy, performed with several synthesis systems, changed the approach to its treatment in dogs. The aim of this study was to compare two types of fixation implants, locking compression system and locking system, evaluating radiographically the progression of osteoarthritis of the stifle joint in dogs with complete cranial cruciate ligament deficiency treated surgically with tibial plateau levelling osteotomy. Moreover, we evaluated bone healing and lameness scores to show biomechanical effects by the implant used. Twenty-eight dogs, who met the inclusion criteria, were divided into two groups. Group A: 14 dogs treated using locking compression plates; Group B: 14 dogs treated using locking plates. Radiographic osteoarthritis scores were evaluated up to 1 year following tibial plateau levelling osteotomy. At each visit, animals were clinically and radiographically assessed. Each dog was evaluated before (T0) and after two (T2) and twelve (T12) months after the surgery. At T2 the stage of bone healing was evaluated. The clinical follow up was performed before the surgery and at 10, 15 and 20 days after the surgery, grading the lameness at walk and trot. RESULTS An increase in osteoarthritis score at T12 versus T0 in both groups was detected. A decrease of the lameness score was observed in Group A versus Group B. The healing score system at T2 showed a lower score in Group A versus Group B. CONCLUSIONS The osteoarthritis score following tibial plateau levelling osteotomy did not differ when comparing the two different fixation systems. The locking compression system allowed a more rapid functional recovery of the limb and a quicker bone healing than the locking system. Locking compression system should be carefully considered for dogs subjected to tibial plateau levelling osteotomy surgery, because it may reduce the recovery time.
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Affiliation(s)
- Francesco Macrì
- Department of Veterinary Sciences, University of Messina, Viale Palatucci s.n.c, 98168, Messina, Italy
| | - Luca Cicero
- Istituto Zooprofilattico Sperimentale della Sicilia "A. Mirri", Via Gino Marinuzzi 3, 90100, Palermo, Italy
| | - Vito Angileri
- Contrada Torrelunga Puleo, 29, 91025, Marsala, TP, Italy
| | - Vito Biondi
- Department of Veterinary Sciences, University of Messina, Viale Palatucci s.n.c, 98168, Messina, Italy
| | - Piero Miele
- Veterinaria Enterprise Stp S.R.L, via Galvani 33d, 00153, Rome, Italy
| | - Lorenzo Scaletta
- Veterinaria Enterprise Stp S.R.L, via Galvani 33d, 00153, Rome, Italy
| | - Giovanna Lucrezia Costa
- Department of Veterinary Sciences, University of Messina, Viale Palatucci s.n.c, 98168, Messina, Italy
| | - Giovanni Cassata
- Istituto Zooprofilattico Sperimentale della Sicilia "A. Mirri", Via Gino Marinuzzi 3, 90100, Palermo, Italy
| | - Simona Di Pietro
- Department of Veterinary Sciences, University of Messina, Viale Palatucci s.n.c, 98168, Messina, Italy.
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Engdahl KS, Boge GS, Bergström AF, Moldal ER, Höglund OV. Risk factors for severe postoperative complications in dogs with cranial cruciate ligament disease - A survival analysis. Prev Vet Med 2021; 191:105350. [PMID: 33892253 DOI: 10.1016/j.prevetmed.2021.105350] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 04/07/2021] [Accepted: 04/11/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To analyze the effect of surgical technique and other risk factors on severe postoperative complications in dogs with cranial cruciate ligament disease (CCLD). MATERIALS AND METHODS A cohort study of 255 dogs (287 stifles) surgically treated for CCLD at two veterinary university hospitals (2011-2016) was performed. The electronic medical records were reviewed and dog owners and referring veterinarians contacted for additional information. The complications were classified as minor, major and catastrophic, where major and catastrophic were considered severe. A multivariable Cox proportional hazards model was applied to assess risk factors for severe postoperative complications. RESULTS Three surgical techniques were used; lateral fabellotibial suture (LFS, 141 stifles), tibial plateau leveling osteotomy (TPLO, 77 stifles) and tibial tuberosity advancement (TTA, 69 stifles). The most common severe postoperative complications were surgical site infections or complications related to the surgical implant. Severe postoperative complications occurred in 31 % of the stifles treated with TPLO, 22 % of the stifles treated with LFS and 25 % of the stifles treated with TTA. The multivariable Cox proportional hazards model identified surgical technique (p = 0.0258) as a risk factor for severe postoperative complications; TPLO had a significantly lower hazard than LFS (hazard ratio (HR) = 0.37, p = 0.007) when controlling for body weight and age, which also were identified as risk factors (HR = 1.05, p < 0.001 and HR = 0.91, p = 0.047, respectively). CONCLUSION AND CLINICAL RELEVANCE Although TPLO procedures had the highest occurrence of severe postoperative complications, the hazard was lower than for LFS after adjusting for body weight and age. This implies that it is important to consider potential effect-modifiers when comparing postoperative complications after CCLD surgery.
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Affiliation(s)
- Karolina S Engdahl
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, P.O. Box 7054, SE-750 07, Uppsala, Sweden.
| | - Gudrun S Boge
- Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences - School of Veterinary Science, P.O. Box 369 Sentrum, N-0102, Oslo, Norway
| | - Annika F Bergström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, P.O. Box 7054, SE-750 07, Uppsala, Sweden
| | - Elena R Moldal
- Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences - School of Veterinary Science, P.O. Box 369 Sentrum, N-0102, Oslo, Norway
| | - Odd V Höglund
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, P.O. Box 7054, SE-750 07, Uppsala, Sweden
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Maniaki E, Murrell J, Langley-Hobbs SJ, Blackwell EJ. Associations between early neutering, obesity, outdoor access, trauma and feline degenerative joint disease. J Feline Med Surg 2021; 23:965-975. [PMID: 33569999 PMCID: PMC8474300 DOI: 10.1177/1098612x21991456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this case-control study was to identify early-life risk factors associated with the occurrence of owner-reported mobility changes in 6-year-old cats by examining prospective data from a longitudinal cohort study of pet cats, the Bristol Cats study. METHODS Data on potential risk factors were obtained from seven sequential questionnaires completed between the ages of 2-4 months and 5 years. Mobility-related questions from the study questionnaire distributed at the age of 6 years were used to calculate each cat's mobility score. Cats with mobility scores of ⩾2 and 0 were allocated to the case and control groups, respectively, and the cat's status was the outcome variable. RESULTS Of the 799 cats included for analysis, 238 (29.8%) had owner-reported mobility changes. Binomial logistic regression using backwards elimination identified four risk factors for owner-reported mobility changes at 6 years of age: entire neuter status at 6 months of age (odds ratio [OR] 1.97; 95% confidence interval [CI] 1.26-3.07), sustained trauma before 6 years of age (OR 1.85; 95% CI 1.30-2.60), outdoor access at 6 years of age (OR 1.67; 95% CI 0.96-2.90) and overweight/obese status at 6 years of age (OR 1.62; 95% CI 1.13-2.33). CONCLUSIONS AND RELEVANCE Risk factor analysis demonstrated that obesity, outdoor access and a history of trauma may predispose cats to developing owner-reported mobility changes associated with degenerative joint disease, whereas neutering before 6 months of age appears to decrease that risk.
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Affiliation(s)
- Evangelia Maniaki
- Faculty of Life Sciences, Division of Biosciences, University College London, London, UK
| | | | | | - Emily J Blackwell
- Bristol Veterinary School, University of Bristol, Langford, Bristol, UK
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Hagen CRM, Singh A, Weese JS, Marshall Q, Linden AZ, Gibson TWG. Contributing factors to surgical site infection after tibial plateau leveling osteotomy: A follow-up retrospective study. Vet Surg 2020; 49:930-939. [PMID: 32359005 DOI: 10.1111/vsu.13436] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 03/16/2020] [Accepted: 03/26/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To identify factors associated with surgical site infection (SSI) after tibial plateau leveling osteotomy (TPLO). STUDY DESIGN Retrospective case series. ANIMALS Dogs (n = 541) that underwent TPLO (n = 659). METHODS Medical records of dogs that underwent TPLO from 2011-2018 were reviewed. Data collected included perioperative and postoperative antimicrobial administration, stifle inspection, duration of surgery and anesthesia, comorbidities, and development of SSI including timing, microbiological investigation, and implant removal. Referring veterinarians were contacted for all dogs without a recorded return visit. Risk factors for SSI were assessed by using a multivariable logistic regression model built by using a stepwise approach. RESULTS Surgical site infection was documented in 71 of 659 (11%) TPLO, with methicillin-resistant Staphylococcus pseudintermedius accounting for 20 of 71 (28%) infections. Protective factors against SSI included administration of postoperative antimicrobials (odds ratio [OR] 0.263; 95% CI = 0.157, 0.442) and timing of preoperative antimicrobial administration. Preoperative antimicrobial timing was protective against SSI when it was administered more than 60 minutes before the first incision compared with administration within 30 minutes (OR 0.275; 95% CI = 0.112, 0.676) or within 60 minutes (OR 0.419; 95% CI = 0.189, 0.929) of the first incision. CONCLUSION Early administration of perioperative antimicrobials and postoperative antimicrobial administration were protective against SSI after TPLO. CLINICAL SIGNIFICANCE Antimicrobials can influence the risk of SSI after TPLO. Perioperative and postoperative antimicrobial administration timing should be considered to reduce SSI.
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Affiliation(s)
- Chris R M Hagen
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada
| | - Ameet Singh
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada
| | - J Scott Weese
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Canada
| | - Quinn Marshall
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada
| | - Alex Zur Linden
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada
| | - Thomas W G Gibson
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada
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