ABSTRACT
OBJECTIVE: To evaluate the effectiveness of a novel crescent-shaped tibial plateau-leveling osteotomy (TPLO) saw guide (crescent guide) to assist with saw control in novice participants. STUDY DESIGN: Ex vivo study. SAMPLE POPULATION: Synthetic bones (n = 54) and medium sized dog pelvic limbs (n = 36). METHODS: The 6 participants (interns and residents) without any prior experience performing a TPLO each performed 9 osteotomies on synthetic tibia models, and 6 osteotomies in cadaveric limbs of medium-sized dogs. Osteotomies made with the crescent guide were compared with those made with a standard jig and a radial saw guide with a jig. Osteotomy angulation, distance of eccentricity (DOE), and medial tibial cortical damage (synthetic bone models only) were measured from calibrated photographs. Participants rated their experiences with each technique. RESULTS: There was no difference in the DOE, coronal or axial osteotomy angulation between the 3 alignment devices for synthetic bone models or cadavers. Average medial cortical damage with the crescent guide (3.8 ± 7.3 mm2 ) was lower than with the radial guide (35.7 ± 27 mm2 ) and standard jig (51.2 ± 63.2 mm2 ) guides (P = <.01). Five of 6 participants preferred the crescent guide over the standard jig and radial guide. CONCLUSION: There was no difference in accuracy of osteotomy positioning but using the crescent guide resulted in lower cortical damage and more favorable participant perceptions. CLINICAL RELEVANCE: The crescent guide may improve control of the radial saw during TPLO in novice surgeons but does not appear to aid accurate osteotomy positioning.
Subject(s)
Anterior Cruciate Ligament Injuries , Dog Diseases , Osteotomy , Animals , Anterior Cruciate Ligament Injuries/veterinary , Cadaver , Dog Diseases/surgery , Dogs , Extremities , Hindlimb , Humans , Osteotomy/methods , Osteotomy/veterinary , Stifle/surgery , Tibia/surgeryABSTRACT
OBJECTIVE: To report the outcomes and complications associated with antibiotic-impregnated calcium sulfate beads for prevention and treatment of orthopedic-related surgical site infection (SSI) in companion animals. STUDY DESIGN: Retrospective case series. ANIMALS: Client-owned cats (n = 2) and dogs (n = 14). METHODS: Medical records of 16 cases in which implantation of antibiotic-impregnated calcium sulfate beads was performed for the prevention or treatment of SSI were reviewed. Information collected included signalment, prior surgery, reason for bead placement, antibiotics used, bacterial culture results, and clinical outcomes. RESULTS: Surgical site infection resolved in six of 10 animals treated therapeutically and did not occur in six of six animals treated prophylactically. Susceptibility of the causative bacteria to the antibiotic implanted was confirmed in five of six cases with resolved SSI treated therapeutically but in only one of four cases with unresolved SSI treated therapeutically. Complications directly related to bead placement were evident in only one case in which beads extruded from external skeletal fixator pin tracts 7 days after implantation. At final follow-up, 11 of 12 animals without SSI had satisfactory limb use and no clinical, cytologic, or radiographic evidence of infection. CONCLUSION: Implantation was well tolerated. Resolution of SSI was inconsistent; however, when bacteria were susceptible to the antibiotic implanted, SSI resolved in all but one case. CLINICAL SIGNIFICANCE: Antibiotic-impregnated calcium sulfate beads could be considered for prevention or treatment of orthopedic SSI in small animals. A prospective clinical study is required to obtain additional information, including the value of preoperative bacterial culture.
