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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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Sanders BD, McDonald-Lynch M, Kruse MA. Influence of antiseptic lavage during tibial plateau leveling osteotomies on surgical site infection in 1422 dogs. Vet Surg 2024; 53:167-174. [PMID: 37935116 DOI: 10.1111/vsu.14050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/03/2023] [Accepted: 10/18/2023] [Indexed: 11/09/2023]
Abstract
OBJECTIVE To determine the influence of preclosure antiseptic versus saline lavage on surgical site infections (SSI) in dogs following tibial plateau leveling osteotomy (TPLO). STUDY DESIGN A multicenter retrospective study. SAMPLE POPULATION Dogs treated with TPLO (n = 1422) between December 2019 and October 2021. METHODS The medical records of dogs treated with TPLO were reviewed for preclosure antiseptic lavage or saline irrigation. Additional collected data included signalment, unilateral or bilateral TPLO, postoperative administration of antimicrobial medications, antibiotic agent, surgeon, and development of SSI within 90 postoperative days. Eleven factors were analyzed for association with SSI using univariate and multivariate analysis. RESULTS Data were collected from the records of 519 dogs treated with antiseptic lavage and 903 dogs treated with saline lavage during TPLO. Surgical site infections were diagnosed more frequently in dogs that received preclosure antiseptic lavage (77/519, 14.84%) than those with saline irrigation (80/903, 8.86%) (p = .001). Single session bilateral TPLO increased the odds of SSI by 2.5x (p = .004). The odds of SSI increased by 11% (p = .001) for every 5 kg increase in bodyweight. Postoperative administration of antimicrobials decreased the risk of SSI (p = .008). CONCLUSION The preclosure antiseptic lavage tested here did not decrease the incidence of SSI after TPLO. CLINICAL SIGNIFICANCE The results of this study do not provide evidence to support preclosure antiseptic lavage during TPLOs.
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Potamopoulou M, Brown G, Whitelock R. Correlation between the Insertion Side of a Transcondylar Screw for the Surgical Management of Humeral Intracondylar Fissures in Dogs and the Incidence of Postoperative Surgical Site Infection. Vet Comp Orthop Traumatol 2023; 36:311-316. [PMID: 37160257 DOI: 10.1055/s-0043-57223] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVE An increased rate of surgical site infection (SSI) following treatment of canine humeral intracondylar fissure (HIF) with a lateromedially (LM) placed transcondylar screw (TCS) compared with a mediolateral (ML) TCS has been previously postulated. We hypothesized that the direction of insertion of the TCS would not affect the incidence of postoperative SSI. STUDY DESIGN It was single-centre retrospective study. Dogs with HIF confirmed by computerized tomography, treated by TCS placement (between 2008 and 2019) and with a minimum follow-up of 12 weeks, were included. The following data were recorded: signalment, presenting clinical signs, direction of placement and size of the utilized TCS, surgical and anaesthetic times, concurrent surgical procedures, presence of concomitant elbow pathology, perioperative and postoperative antibiotic usage and postoperative complications. Recorded data were analysed with a multinomial logistic regression model with a p-value less than or equal to 0.05. RESULTS Thirty-five dogs (46 elbows) met the inclusion criteria. Median clinical follow-up interval was 52 weeks. Seven of thirty-one elbows with a ML TCS, and 4/15 elbows with a LM TCS developed SSI. Four of nine dogs that underwent bilateral single-surgery TCS placement developed SSI unilaterally. CONCLUSION No significant difference was shown in short-term SSI occurrence between the ML and the LM direction of placement of the TCS.
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Affiliation(s)
| | - Gordon Brown
- Grove Orthopaedic Referrals, Fakenham, United Kingdom
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Motz AK, St. Germaine LL, Hoffmann DE, Sung J. A retrospective evaluation of the effect of oclacitinib (Apoquel) administration on development of surgical site infection following clean orthopedic stifle surgery. PLoS One 2023; 18:e0289827. [PMID: 37556416 PMCID: PMC10411735 DOI: 10.1371/journal.pone.0289827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/25/2023] [Indexed: 08/11/2023] Open
Abstract
The aim of this study was to determine the effect of oclacitinib (Apoquel) on development of surgical site infections in canines following clean orthopedic stifle surgery. Medical records of dogs undergoing unilateral, clean orthopedic stifle procedures were retrospectively examined for development of post-operative surgical site infections. Data collected for statistical analysis included age, sex, body weight, current medications, anesthesia and surgery times, white blood cell count, and neutrophil count. Surgical site infections were identified in 8.7% (34/390) of stifle procedures- 8.0% (29/364) in dogs not treated with oclacitinib and 19.2% (5/26) in dogs treated with oclacitinib (p = 0.053). There was a significant difference in development of surgical site infection in dogs with longer anesthesia times (p = 0.003) and higher body weights (p = 0.037). Dogs being treated with oclacitinib at the time of clean, orthopedic stifle surgery did not have a significantly higher incidence of surgical site infections. However, client education regarding risk of infection and increased patient monitoring post-operatively are recommended, especially in patients with increased body weight or longer anesthetic times.
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Affiliation(s)
- Alyssa K. Motz
- Surgery Department, Veterinary Specialists & Emergency Services, Rochester, NY, United States of America
| | - Lindsay L. St. Germaine
- Surgery Department, Veterinary Specialists & Emergency Services, Rochester, NY, United States of America
| | - Daniel E. Hoffmann
- Surgery Department, Veterinary Specialists & Emergency Services, Rochester, NY, United States of America
| | - Jed Sung
- Surgery Department, Veterinary Specialists & Emergency Services, Rochester, NY, United States of America
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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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Pagès G, Hammer M, Grand JG, Irubetagoyena I. Long-term outcome of tibial plateau leveling osteotomy using an antimicrobial silver-based coated plate in dogs. PLoS One 2022; 17:e0272555. [PMID: 35960740 PMCID: PMC9374240 DOI: 10.1371/journal.pone.0272555] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 07/21/2022] [Indexed: 11/21/2022] Open
Abstract
Objectives To evaluate long-term outcome using the BioMedtrix™ TPLO Curve® plate in dogs with cranial cruciate ligament disease (CrCLd) treated by tibial plateau leveling osteotomy (TPLO). Study design Retrospective case study. Animals Dogs (n = 323, 337 stifles). Methods Medical records were searched for dogs presented with CrCLd and treated by TPLO with the BioMedtrix™ TPLO Curve® plate for 3.5 mm screws between March 2018 and December 2020. Tibial plateau angles (TPA) were measured on preoperative, postoperative, and follow-up radiographs. Changes in TPA between postoperative and follow-up radiographs (ModTPA) were calculated. Radiographic bone healing was scored. Complications were evaluated. Surgical site infections (SSI) were compared to a control group of dogs treated with the Synthes™ TPLO plate between January and December 2017. Owners of both groups were contacted by telephone at least 1 year postoperatively. Results The BioMedtrix™ group was composed of 237 dogs (248 stifles), the control group was composed of 86 dogs (89 stifles). In the BioMedtrix™ group, radiographic follow-up was performed at a median of 48 days. Average ModTPA was 1.2°. Bone healing was graded as complete, good, poor, and none in 18%, 62%, 20%, and 0%, respectively. At a median of 786 days postoperatively, minor and major postoperative complications were observed in 6 (2.4%) and 32 (12.9%) cases in this group, respectively. During the first year following the surgery, 23 (9.3%) and 12 (13.5%) cases suffered a SSI, of which 12 (4.8%) and 7 (7.9%) had their implant explanted in the BioMedtrix™ group and the control group, respectively. There was no significant difference between groups for SSI and implant explantations (p = 0.31 and p = 0.29, respectively). Conclusion The BioMedtrix™ TPLO Curve® plate provided a reliable fixation system for osteotomy healing after TPLO. Bone healing and long-term complication rates were similar to previous studies using other implants. SSI rates were similar between the BioMedtrix™ group and the control group. The antimicrobial HyProtect® coating of the plate did not reduce SSI in this study. Clinical significance The BioMedtrix™ TPLO Curve® plate can be safely used for TPLO. The value of the antimicrobial HyProtect® coating of the plate may be questioned, as SSI rate was not lower in this study compared to the control group or previous reports.
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Affiliation(s)
- Geoffrey Pagès
- Surgery Department, Centre Hospitalier Vétérinaire Aquivet, Eysines, France
- * E-mail:
| | - Meike Hammer
- Surgery Department, Centre Hospitalier Vétérinaire Aquivet, Eysines, France
| | | | - Iban Irubetagoyena
- Surgery Department, Centre Hospitalier Vétérinaire Aquivet, Eysines, France
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Updates in the Use of Antibiotics, Biofilms. Vet Clin North Am Small Anim Pract 2022; 52:e1-e19. [DOI: 10.1016/j.cvsm.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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McCarthy DA, Granger LA, Aulakh KS, Gines JA. Accuracy of a drilling with a custom 3D printed guide or free-hand technique in canine experimental sacroiliac luxations. Vet Surg 2021; 51:182-190. [PMID: 34562025 DOI: 10.1111/vsu.13721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 08/12/2021] [Accepted: 08/26/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To improve the accuracy of drilling during the repair of sacroiliac luxations (SILs) with a 3D-printed patient-specific drill guide (3D-GDT) compared to free-hand drilling technique (FHDT). STUDY DESIGN Blinded, randomized, prospective ex vivo study. SAMPLE POPULATION Sixteen canine cadavers (20-25 kg). METHODS Dorsal, bilateral SILs were created. Pelvic CT was performed pre- and post-drilling. The FHDT was drilled followed by 3D-GDT. CT and 3D measurements of craniocaudal and dorsoventral angles were compared between FHDT and 3D-GDT, as well as deviations of entry and exit points relative to optimal trajectory. RESULTS Mean craniocaudal and dorsoventral angles for both CT- and 3D-measured 3D-GDT (CT 4.2 ± 3.9° and 3.9 ± 3.2°, respectively; 3D 5.1 ± 5.1° and 2.8 ± 2.3°, respectively p = .0006) were lower compared to FHDT (CT 11.8 ± 4.0°, p < .0001 and 8.9 ± 6.1°, p = .01; 3D 12.4 ± 5.9°, p = .0006 and 5.3 ± 5.24°, p = .05). Entry dorsoventral and end craniocaudal, dorsoventral, and 3D linear deviations were reduced with 3D-GDT. Sacral corridor disruption was present in 20% (3/15) for FHDT compared with 0% for 3D-GDT. CT and 3D analyses were in strong agreement (r = 0.77). CONCLUSION Deviations of drill trajectories were minimized relative to optimal trajectories with 3D-GDT compared to FHDT in the dorsoventral and craniocaudal planes. CLINICAL SIGNIFICANCE The use of 3D-GDT improves accuracy of sacral drilling compared with FHDT in canine cadavers. These results justify further evaluation in a clinical, prospective study.
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Affiliation(s)
- Daniel A McCarthy
- Laboratory for 3D Printing and Regenerative Medicine, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA.,Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
| | - L Abbigail Granger
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Karanvir S Aulakh
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
| | - J Alberto Gines
- Laboratory for 3D Printing and Regenerative Medicine, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA.,Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
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McDougall RA, Spector DI, Hart RC, Dycus DL, Erb HN. Timing of and risk factors for deep surgical site infection requiring implant removal following canine tibial plateau leveling osteotomy. Vet Surg 2021; 50:999-1008. [PMID: 33826172 DOI: 10.1111/vsu.13634] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 03/10/2021] [Accepted: 03/24/2021] [Indexed: 11/29/2022]
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.
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Affiliation(s)
- Renee A McDougall
- Department of Surgery, The Animal Medical Center, New York, New York, USA
| | - Daniel I Spector
- Department of Surgery, The Animal Medical Center, New York, New York, USA
| | - Robert C Hart
- Department of Surgery, The Animal Medical Center, New York, New York, USA
| | - David L Dycus
- Department of Surgery, Veterinary Orthopedics and Sports Medicine Group, Annapolis Junction, Maryland, USA
| | - Hollis N Erb
- College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
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Budsberg SC, Torres BT, Sandberg GS. Efficacy of postoperative antibiotic use after tibial plateau leveling osteotomy in dogs: A systematic review. Vet Surg 2021; 50:729-739. [PMID: 33709459 DOI: 10.1111/vsu.13603] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 12/30/2020] [Accepted: 01/03/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE A systematic review of published data to determine whether postoperative antibiotic use after tibial plateau leveling osteotomy (TPLO) decreases infection rates. STUDY DESIGN Systematic review. METHODS A broad bibliographic search was performed in three online databases through March 2020 for publications on postoperative antibiotic use after TPLO in dogs. Search terms included dog, canine, TPLO, tibial plateau leveling osteotomy, infection, antibiotic, and antimicrobial. Articles that met inclusion criteria were evaluated for level of evidence (LoE) by a modified Oxford Level of Evidence (mOLE) and GRADE (Grading of Recommendations, Assessment, Development and Evaluation) classification and evaluation. RESULTS Thirteen studies met the inclusion criteria. Effect of antibiotic use was the primary question in four studies. Among those, 50% (2/4) were assigned a mOLE of 1b and a GRADE of moderate, while the other 50% (2/4) were assigned a mOLE of 4b or 4c with a GRADE of low. The two studies with the highest LoE did not provide evidence of the benefit of antibiotic usage. Results of only one study provided evidence to support the use of postoperative antibiotics. The remaining nine studies provided evaluation of antibiotic use secondarily and were all assigned a low LoE. Among these, 78% (7/9) provided evidence to support the use of postoperative antibiotics. CONCLUSION We found little evidence to support the use of postoperative antibiotics to reduce the risk of surgical site infections in dogs after TPLO. The answer to this clinical question is complicated by the lack of prospective studies and inconsistent treatment protocols in the evaluated studies. CLINICAL SIGNIFICANCE The clinical impact of postoperative antibiotic administration on infection rates after TPLO is uncertain.
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Affiliation(s)
- Steven C Budsberg
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia.,Department of Comparative Physiology and Pharmacology, University of Georgia, Athens, Georgia
| | - Bryan T Torres
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, Missouri
| | - Gabriella S Sandberg
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia
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Marin K, Unis MD, Horgan JE, Roush JK. Risk factors for short-term postoperative complications in the 8 weeks after tibial plateau leveling osteotomy in dogs weighing less than 15 kilograms: A retrospective study. PLoS One 2021; 16:e0247555. [PMID: 33630887 PMCID: PMC7906318 DOI: 10.1371/journal.pone.0247555] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 02/09/2021] [Indexed: 11/19/2022] Open
Abstract
The purpose of this retrospective study was to evaluate the risk factors for short-term postoperative complications in the 8 weeks after unilateral tibial plateau leveling osteotomy (TPLO) for cranial cruciate ligament rupture in small dogs weighing less than 15 kg. Medical records were retrospectively reviewed for 90 dogs weighing <15 kg that underwent medial parapatellar arthrotomy with inspection of the meniscus and TPLO performed by the same surgeon between January 2012 and December 2017. The overall complication rate was 4.44% (4/90 dogs). There were four cases of partial incisional dehiscence, none of which required surgical revision. Complications were significantly more likely in dogs that had undergone placement of a 2.4-mm TPLO plate. Overall, the complication rate was less than that in previous studies of dogs weighing > 15kg. In this study, patients in which 2.4-mm TPLO plates were used were more likely to develop postoperative complications. Dogs weighing <15 kg that underwent TPLO had good short-term outcomes with minimal complications. In our study, the overall complication rate after TPLO in dogs weighing <15 kg is less than that historically reported in heavier dogs. Our data suggests that TPLO is a safe treatment option in small dogs with cranial cruciate ligament rupture.
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Affiliation(s)
- Karen Marin
- LeadER Animal Specialty Hospital, Cooper City, Florida, United States of America
- * E-mail:
| | - Marcos D. Unis
- LeadER Animal Specialty Hospital, Cooper City, Florida, United States of America
| | - Jason E. Horgan
- LeadER Animal Specialty Hospital, Cooper City, Florida, United States of America
| | - James K. Roush
- Department of Clinical Sciences, Kansas State University, Manhattan, Kansas, United States of America
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Peress R, Mejia S, Unis M, Sotgiu G, Dore S, Bruecker K. Comparison of Intra- and Postoperative Complications between Bilateral Simultaneous and Staged Tibial Plateau Levelling Osteotomy with Arthroscopy in 176 Cases. Vet Comp Orthop Traumatol 2020; 34:91-98. [PMID: 33129211 DOI: 10.1055/s-0040-1716682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to compare the resulting short-term complications after simultaneous (SIM) or staged (ST) tibial plateau levelling osteotomy (TPLO) in patients that presented with bilaterally torn cranial cruciate ligaments. STUDY DESIGN This was a retrospective study. MATERIALS AND METHODS Medical records of dogs diagnosed with bilateral cranial cruciate ligament disease that underwent bilateral SIM or ST TPLO surgery with arthroscopy (2005-2015) were reviewed to evaluate the intra- and postoperative complications. Data were analysed and major and minor complications were compared between the two groups. RESULTS A total of 176 client-owned dogs (352 stifles) that had TPLO performed bilaterally with SIM or ST procedures were included for analysis. The overall complication rate was 47.5% for the SIM group and 19.5% for the ST group. The incidence of major complications was 10.1 and 3.8% in the SIM and ST groups respectively. Minor complications were 38.4 and 15.6% in the SIM and ST groups respectively. Tibial tuberosity fractures requiring revision were noted in 2% of the SIM group and none of the ST group. CLINICAL SIGNIFICANCE Although no significant difference was noted in major complication rate or tibial tuberosity fractures in our cohort of patients, a Type II statistical error was found. The complication rate in the SIM group is numerically greater by a factor of 2-3× or more for nearly all categories. Surgeons should consider the risks and benefits of SIM versus ST procedures as well as relevant individual patient and client factors before electing either alternative.
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Affiliation(s)
- Raz Peress
- Surgery Department, Leader Animal Specialty Hospital, Cooper City, Florida, United States
| | - Sebastian Mejia
- Surgery Department, Leader Animal Specialty Hospital, Cooper City, Florida, United States
| | - Marcos Unis
- Surgery Department, Leader Animal Specialty Hospital, Cooper City, Florida, United States
| | | | - Simone Dore
- Surgical and Experimental Sciences, Sassari, Italy
| | - Kenneth Bruecker
- Veterinary Medical and Surgical Group, Ventura, California, United States
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