Outcome following removal of TPLO implants with surgical site infection

2013 
Objective: To evaluate the outcome of surgical site infection (SSI) associated with tibial plateau levelling osteotomy (TPLO) implants following treatment by medical management alone or implant removal with or without the administration of antibiotic medication. Animals: Ninety dogs (104 TPLO surgical procedures). Methods: Records of dogs that had undergone TPLO implant removal due to SSI were reviewed. Outcome following treatment with antibiotic medications without implant removal, and treatment with implant removal with and without the administration of antibiotic medications was evaluated. Results: Treatment of SSI with antibiotic medication alone failed in 88.9% (64/72) of the dogs. The clinical signs of SSI resolved in 94.9% (74/78) of the dogs treated with implant removal (with and without the administration of antibiotic medication post-implant removal). The effect of administration of antibiotic medication on outcome of treatment of the SSI by implant removal was not significant. The rate of SSI associated with the Synthes implant was higher than with the Slocum implant, but not the New Generation implant. Conclusion: Implant removal with or without the administration of antibiotic medication post-implant removal for treatment of TPLO SSI provided superior outcome compared to treatment with antibiotic medications without implant removal. Clinical significance: Implant removal should be considered for TPLO SSI that have not responded to appropriate medical management. Further investigation of the various TPLO implants and their effects on postoperative infection rate is warranted.
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