Long-term outcome of tibial plateau leveling osteotomy using an antimicrobial silver-based coated plate in dogs

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.