Late osteomyelitis associated with TPLO implant in a dog complicated by Acinetobacter spp.
Case report
DOI:
https://doi.org/10.31533/pubvet.v20n5e1951Keywords:
Bacterial biofilm, orthopedic surgery, orthopedic implants, bone infection, antimicrobial resistanceAbstract
Tibial plateau leveling osteotomy (TPLO) is widely used for the treatment of cranial cruciate ligament rupture in dogs. Despite its high success rates, implant-associated infectious complications may occur, including late-onset presentations. This report describes the case of an 8-year-10-month-old female Newfoundland dog weighing 56 kg that developed implant-associated osteomyelitis six years after undergoing TPLO in June 2019. In February 2026, implant removal, including the plate and screws, was performed, and samples were collected for bacterial culture. Postoperatively, the patient developed a deep surgical site infection characterized by partial wound dehiscence, exudate formation, and the need for surgical reintervention for drainage. Bacterial culture identified multidrug-resistant Acinetobacter spp., showing susceptibility only to carbapenems and aminoglycosides. Significant clinical improvement was observed after antimicrobial escalation to meropenem combined with appropriate surgical management. This case highlights the challenges involved in managing late implant-associated osteomyelitis and reinforces the importance of bacterial culture and aggressive surgical intervention in infection control.
References
Apelt, D., Kowaleski, M. P., & Boudrieau, R. J. (2007). Effect of tibial plateau leveling osteotomy on cranial tibial thrust. Veterinary Surgery, 36(4), 332–340.
Bach, M., Villanova Júnior, J. A., Tasqueti, U. I., Pimpão, C. T., Prado, A. M. B., & Michellotto Júnior, P. V. (2015). Estudo retrospectivo de cães portadores de ruptura do ligamento cruzado cranial: 32 casos (2006 a 2012). Semina: Ciências Agrárias, 36(3), 1409–1418. https://doi.org/10.5433/1679-0359.2015v36n3p1409.
Bergh, M. S., & Peirone, B. (2012). Complications of tibial plateau levelling osteotomy in dogs. Veterinary and Comparative Orthopaedics and Traumatology, 25(5), 349–358. https://doi.org/10.3415/VCOT-11-09-0122.
Brady, R. A., Leid, J. G., Calhoun, J. H., Costerton, J. W., & Shirtliff, M. E. (2008). Osteomyelitis and the role of biofilms in chronic infection. FEMS Immunology and Medical Microbiology, 52(1), 117–134. https://doi.org/10.1111/j.1574-695X.2007.00357.x.
Brady, R. S., Leid, J. G., Costerton, J. W., & Shirtliff, M. E. (2006). Osteomyelitis and biofilm infections. Veterinary Clinics of North America: Smal Animal Practice, 36(1), 117–134.
Chagas, T. P. G. (2015). Caracterização de Acinetobacter spp. multirresistentes produtores de carbapenemases, dos tipos OXA e NDM, isolados de diferentes regiões do Brasil.
Clark, C. H. (1977). Toxicity of aminoglycoside antibiotics. Modern Veterinary Practice, 58(7), 594–598.
Costerton, J. W., Cheng, K. J., Geesey, G. G., Ladd, T. I., Nickel, J. C., Dasgupta, M., & Marrie, T. J. (1987). Bacterial biofilms in nature and disease. Annual Review of Microbiology, 41, 435–464. https://doi.org/10.1146/annurev.mi.41.100187.002251.
Evason, M., Stull, J. W., Pearl, D. L., Peregrine, A. S., Jardine, C., Buch, J. S., Lailer, Z., O’Connor, T., Chandrashekar, R., & Weese, J. S. (2019). Prevalence of Borrelia burgdorferi, Anaplasma spp., Ehrlichia spp. and Dirofilaria immitis in Canadian dogs, 2008 to 2015: a repeat cross-sectional study. Parasites & Vectors, 12(1), 64. https://doi.org/10.1186/s13071-019-3299-9.
Fitzpatrick, N., & Solano, M. A. (2010). Predictive variables for complications following TPLO. Veterinary Surgery, 39(4), 481–488.
Flesher, K., Beale, B. S., & Hudson, C. C. (2019). Technique and outcome of a modified tibial plateau levelling osteotomy for treatment of concurrent medial patellar luxation and cranial cruciate ligament rupture in 76 stifles. Veterinary and Comparative Orthopaedics and Traumatology, 32(01), 26–32.
Fossum, T. W. (2021). Cirurgia de pequenos animais (3ed.). Elsevier Editora.
Gieling, F., Peters, S., Erichsen, C., Richards, R. G., Zeiter, S., & Moriarty, T. F. (2019). Bacterial osteomyelitis in veterinary orthopaedics: Pathophysiology, clinical presentation and advances in treatment across multiple species. Veterinary Journal, 250. https://doi.org/10.1016/j.tvjl.2019.06.003.
Johnson, K. A. (2013). Piermattei’s Atlas of Surgical Approaches to the Bones and Joints of the Dog and Cat, Fifth Edition. In Piermattei’s Atlas of Surgical Approaches to the Bones and Joints of the Dog and Cat, Fifth Edition (5th ed.). Saunders. https://doi.org/10.1016/C2009-0-41718-5.
Kowaleski, M. P., Apelt, D., Mattoon, J. S., & Litsky, A. S. (2005). The effect of tibial plateau leveling osteotomy position on cranial tibial subluxation: An in vitro study. Veterinary Surgery, 34(4). https://doi.org/10.1111/j.1532-950X.2005.00051.x.
Lamounier, A. R., Soares, J. O., Lage, M. H. H., & Melo, V. S. C. (2023). Osteoartrose de quadril em cães e gatos: Revisão. PUBVET, 17(2), 1–13. https://doi.org/10.31533/pubvet.v17n02a1347.
Nanda, A., & Hans, E. C. (2019). Tibial Plateau Leveling Osteotomy for Cranial Cruciate Ligament Rupture in Canines: Patient Selection and Reported Outcomes. Veterinary Medicine: Research and Reports, Volume 10, 249–255. https://doi.org/10.2147/vmrr.s204321.
Oliveira, A. R., Maria, T., & Sousa, F. (2023). Osteotomia niveladora do platô tibial para tratamento de ruptura do ligamento cruzado cranial: Relato de caso. PUBVET, 17(3), 1–4. https://doi.org/10.31533/pubvet.v17n03a1357.
Peleg, A. Y., Seifert, H., & Paterson, D. L. (2008). Acinetobacter baumannii: Emergence of a successful pathogen. Clinical Microbiology Reviews, 21(3), 538–582. https://doi.org/10.1128/CMR.00058-07.
Piermattei, B. D. L., & Flo, G. L. (2009). Ortopedia e tratamento das fraturas dos pequenos animais (3 ed.). Editora Manolo.
Reif, U., Hulse, D. A., & Hauptman, J. G. (2002). Effect of tibial plateau leveling on stability of the canine cranial cruciate-deficient stifle joint: An in vitro study. Veterinary Surgery, 31(2). https://doi.org/10.1053/jvet.2002.31041.
Salme, D. P., Curti, C., Curti, M., Fuck, E. J., Fuck, E. T., Salamão, A. P., Nascimento, G., & Garcia Filo, S. P. (2018). Osteotomia de nivelamento do platô tibial para o tratamento da ruptura bilateral do ligamento cruzado cranial em cão: Relato de caso. Revista de Ciência Veterinária e Saúde Pública, 5(2). https://doi.org/10.4025/revcivet.v5i2.41794.
Slocum, B., & Slocum, T. D. (1993). Tibial plateau leveling osteotomy for repair of cranial cruciate ligament rupture in the canine. The Veterinary Clinics of North America. Small Animal Practice, 23(4), 777–795. https://doi.org/10.1016/S0195-5616(93)50082-7.
Tatarunas, A. C., Matera, J. M., Miglino, M. A., Pinto, A. C. B. C. F., Lorigados, C. A. B., & Gomes, L. F. F. (2019). Estudo da técnica intracapsular assistida por artroscopia para o tratamento da ruptura do ligamento cruzado cranial em cadáveres de cães. Ciência Animal Brasileira, 20, 1–14. https://doi.org/10.1590/1089-6891v20e-47857.
Thrall, D. E. (2019). Diagnóstico de radiologia veterinária. Guanabara Koogan S.A.
Weese, J. S. (2015). Management of orthopedic implant infections. Veterinary Clinics of North America: Small Animal Practice, 45(2), 361–376.
Zimmerli, W., & Sendi, P. (2017). Orthopaedic biofilm infections. APMIS, 125(4). https://doi.org/10.1111/apm.12687.
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