Is Recheck Radiographic Examination Warranted following TPLO?

Introduction: It is commonly accepted protocol to monitor postoperative recovery following tibial plateau levelling osteotomy (TPLO) with routine, short-term radiographic evaluation; however, there are no evidence-based recommendations regarding when, or if, recheck radiographs should be performed. Since radiographs are not a benign procedure and pose risks to patient and personnel, the necessity should be justified and value optimized. The objective of this study was to determine if routine follow-up radiographs of TPLO patients are indicated. We hypothesized that the findings of routinely scheduled radiographic examinations following TPLO procedures would not change the treatment plan.

Materials and Methods: Medical records of 100 consecutive dogs (short-term group) presenting for routinely scheduled radiographic follow-up between 40 and 60 postoperative days after TPLO were reviewed. Complications identified on physical exam (PE) and radiographic examinations (RE) were recorded. Medical records of 50 randomly selected, nonconsecutive dogs (long-term group) that had short-term and long-term (>6 months) evaluations were reviewed similarly.

Results: Short-term group: 51/100 cases had no complications on PE or RE. Forty-nine cases were diagnosed with minor complications: 44 on RE, 6 on PE and RE, 1 on PE only. Exercise restriction was extended from 6 to 8 weeks in two cases with abnormal RE findings. Long-term group: 2/50 cases had minor complications at long-term RE. No new PE or RE complications had developed between short- and long-term evaluations.

Discussion/Conclusion: Based on these results, it is unlikely that short-term RE will alter treatment course. Further, RE beyond the short-term period is not warranted.

Acknowledgment: There was no proprietary interest or funding for this project.