Infected Post-TPLO Plate Removal in an Australian Bulldog
Canberra Animal Referral Hospital · Revision Surgery · Implant-Associated Infection
Case Summary
An 8-year-old male Australian Bulldog presented to Canberra Animal Referral Hospital with a post-operative infection at the site of a TPLO performed 3 months earlier at another clinic. Clinical assessment indicated implant-associated infection requiring plate removal. The plate was surgically removed, the wound site was lavaged with Simini Protect Lavage, and the patient recovered well. At follow-up, the wound showed no discharge and the patient reported no pain.
Clinical Presentation
History and Physical Findings
The patient presented 3 months following a tibial plateau levelling osteotomy (TPLO) performed at a referring clinic. The presenting complaint was signs consistent with post-operative infection at the surgical site. Implant-associated infection following TPLO is a recognised complication, and clinical assessment indicated that plate removal was necessary to resolve the infection.
The degree of skin and soft tissue compromise visible at presentation indicated established infection around the implant site. The decision was made to proceed with plate removal and wound lavage.
Fig. 1 — Clinical presentation. Skin and soft tissue compromise at the TPLO implant site 3 months post-operatively, referred from another clinic with established implant-associated infection.
Surgical Protocol
Plate Removal and Wound Lavage
The patient was prepared for general anaesthesia and the infected TPLO site was surgically approached. The plate and associated hardware were removed. Simini Protect Lavage was applied to the wound site following plate removal to reduce residual bacterial burden prior to closure.
| Step | Description |
|---|---|
| 01 | General anaesthesia induced. Surgical site prepared and draped |
| 02 | Surgical approach to the TPLO plate site |
| 03 | Infected bone plate and associated hardware identified and removed |
| 04 | SiminiSimini Protect Lavage applied to the wound site following plate removal to reduce residual bacterial burden |
| 05 | Wound closed in layers. Post-operative wound management initiated |
Fig. 2 — Simini Protect Lavage, sterile 20 ml vial. Applied at the wound site following plate removal.
Fig. 3 — Intraoperative view. TPLO plate being removed from the infected site. Simini lavage applied immediately following hardware removal.
In this case, Simini Protect Lavage was used during revision surgery for an implant-associated infection following TPLO. Implant surfaces are a recognised site for biofilm formation, and resistant bacteria are a significant challenge in post-operative orthopaedic infections. Simini reduces bacteria, biofilms, and resistant bacteria at the wound site. This case demonstrates use in a revision context where bacterial burden and biofilm are expected to be high.
Outcomes
Clinical Results and Recovery
The patient recovered well following plate removal and wound lavage. At post-operative follow-up, the wound was clean with no signs of ongoing infection.
No Wound Discharge
No wound discharge noted at follow-up. The surgical site was clean and healing without signs of persistent or recurrent infection.
No Pain Reported
No pain reported at follow-up. The patient was comfortable and weight-bearing on the operated limb, consistent with resolution of the implant-associated infection.
Clinical Timeline
Post-Operative Course
Primary TPLO (Referring Clinic)
Tibial plateau levelling osteotomy performed at another clinic. Bone plate and hardware placed.
Presentation with Infection
The patient presented to Canberra Animal Referral Hospital 3 months post-TPLO with clinical signs of implant-associated infection at the surgical site. Plate removal indicated.
Plate Removal and Simini Lavage
Infected TPLO plate surgically removed under general anaesthesia. Simini Protect Lavage applied to the wound site following hardware removal. Wound closed in layers.
Follow-Up
Wound clean with no discharge. No pain reported. Patient made a full recovery.