Comparing Implant Removal Rates After Tibial Plateau Leveling Osteotomy Performed on a Mobile Service versus in a Specialist Orthopaedic Surgery Center: 916 Cases.

TPLO performed on a mobile service carries significantly higher implant removal risk than in a dedicated orthopaedic centre.

This retrospective cohort study evaluated implant removal rates following tibial plateau leveling osteotomy (TPLO) performed by a single surgeon in two distinct settings: a mobile surgical service and an orthopaedic-exclusive surgical centre ('in-centre'). A total of 916 TPLO procedures were reviewed. On univariate analysis, dogs undergoing TPLO on a mobile basis had significantly higher odds of implant removal (4.4%, 15/341) compared to those treated in-centre (0.7%, 4/575), with an odds ratio of 6.5 (95% CI: 2.1–19.6). Intradermal skin closure was also associated with higher implant removal rates (3.3%, 17/518) versus skin sutures (0.5%, 2/398) on univariate analysis. However, multivariable analysis revealed that only surgical location remained a statistically significant predictor of implant removal (OR: 27.3; 95% CI: 1.7–449.1), while suture type did not reach significance (OR: 6.1; 95% CI: 0.6–61.0). The findings suggest that the surgical environment—rather than closure technique—is the primary driver of post-TPLO implant removal risk. Potential contributing factors may include differences in sterility, equipment, staff training, patient monitoring, and postoperative care infrastructure between mobile and dedicated orthopaedic facilities. Clinicians and clients should be counseled about the elevated risk of implant-related complications when TPLO is performed in mobile settings compared to specialist orthopaedic centres.

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