TPLO complications: implant infection
5-year-old Labrador Retriever, 34 kg, that underwent TPLO 8 weeks ago. For the past 10 days it has had a purulent draining tract over the plate and the lameness has worsened. Radiographs show the osteotomy healing, stable implants and a mild periosteal reaction.
What is the most appropriate management?
chevron_right Show answer and explanation
A. Remove the plate immediately, even though the osteotomy has not healed
Removing a stable implant before healing can cause the osteotomy to fail. While the bone heals, the plate is still needed.
B. Take a deep sample for culture and sensitivity, treat with the appropriate antibiotic and remove the plate once the osteotomy has healed if infection persists
Correct. Bacteria form biofilms on the implant and infection often does not fully resolve until it is removed. It is therefore kept while the bone heals and then removed. Culture is key given how common meticillin-resistant Staphylococcus pseudintermedius is.
C. Empirical amoxicillin-clavulanate for 7 days without culture
Implant infection requires culture, given the risk of resistant bacteria, and longer treatment. A short empirical course favours relapse and resistance.
D. It is a normal reaction to the suture material and resolves by itself
A purulent draining tract with worsening lameness and periosteal reaction indicates deep infection until proven otherwise.
lightbulb Key takeaway
Other TPLO complications: tibial tuberosity fracture (more likely if it is left narrow or in simultaneous bilateral surgery), patellar ligament desmitis, late meniscal tear and implant failure. A sudden deterioration in the first weeks warrants radiographs.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.