Complications and meniscal injury risks after TPLO surgery in 1000

Abstract

OBJECTIVE: To evaluate risk factors for complications, including meniscal injury and infection, after tibial plateau leveling osteotomy (TPLO) in dogs. STUDY DESIGN: Retrospective case series. SAMPLE POPULATION: Dogs (n=1000; 1146 stifles) with cranial cruciate ligament (CCL) rupture that had TPLO. METHODS: Medical records (January 2004-March 2009) were reviewed for dogs operated sequentially by medial arthrotomy with instrumented meniscal inspection (IMI) and TPLO by a single experienced surgeon. Multiple logistic regression models were used to evaluate independent contribution of risk factors to the recorded complications. RESULTS: Overall complication rate was 14.8%, of which 6.6% were major complications. Incidence of primary meniscal injury (PMI) was 33.2%, and subsequent meniscal injury (SMI) 2.8%. Postoperative infection occurred in 6.6% dogs. Bilateral CCL rupture was diagnosed in 14.6% dogs and no statistically significant complication incidence difference was recorded for simultaneous or staged bilateral surgical procedures. Administration of postoperative antibacterial therapy and being a Labrador reduced infection incidence, whereas increased body-weight and being an intact male increased infection risk. Increased body-weight and complete (versus partial) CCL rupture were significant predictors of overall complications. CONCLUSIONS: Incidence of SMI recorded in this study is similar to that reported previously involving arthroscopic meniscal inspection at time of TPLO. Infection was the single most important complication and antibiotic therapy was protective. Complication rate did not differ between bilateral simultaneous or staged procedures. CLINICAL RELEVANCE: Complication rate after TPLO with arthrotomy and IMI is lower than previously reported, bilateral simultaneous TPLO is reasonable, and incidence of major complications compares favorably with general orthopedic procedures.