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Comparing Implant Removal Rates After Tibial Plateau Leveling Osteotomy Performed on a Mobile Service versus in a
Shantavia N Hayes1, Ashley L Franklin1, Samuel P Franklin1
1Kansas City Canine Orthopedics, Kansas, United States, Shawnee.
Objective:
The aim of this retrospective cohort study was to compare implant removal rate after tibial plateau leveling osteotomy (TPLO) was performed by a single surgeon on a mobile service versus in an orthopaedic exclusive surgical centre ("in-centre").
Study Design:
Records for 916 TPLO performed either on a mobile basis or in-centre were reviewed including whether the implants were subsequently removed. Marginal logistic regression model was used to compare implant removal rates between the two cohorts and based upon type of skin closure (skin sutures vs. intradermal closure).
Results:
On univariate analysis dogs having TPLO on a mobile basis had significantly higher odds (odds ratio [OR]: 6.5; 95% confidence interval [CI]: 2.1-19.6; p = 0.001) of having their implants removed (4.4%, 15/341) compared with dogs having TPLO in-centre (0.7%, 4/575). Dogs with intradermal skin closure had significantly higher odds (OR: 6.3; 95% CI: 1.5-26.8, p = 0.010) of having their implants removed (3.3%, 17/518) compared with dogs having skin sutures (0.5%, 2/398). However, on multivariable analysis, only location (OR: 27.3; 95% CI: 1.7-449.1; p = 0.021) and not suture (OR: 6.1; 95% CI: 0.6-61.0; p = 0.130) had a significant effect on implant removal rate.
Conclusion:
There was a significantly higher risk of implant removal when TPLO was performed on a mobile basis in comparison to TPLO performed in an orthopaedic exclusive surgical centre.