34th Annual Scientific Meeting proceedings

Objectives:

Despite the evolution of commercially available implants to decrease the complication risk after pancarpal arthrodesis (PCA), the postoperative complication rate is high, and implant removal is often required. This study aims to determine the implant removal rate after PCA and investigate factors associated with implant removal.

Methods:

Case records from 52 dogs that underwent PCA at three veterinary centres from 2017 to 2023 were reviewed.  The data collected included signalment, medical history (including contralateral limb status and PCA etiology), surgical techniques, and postoperative follow-up categorized into perioperative (PO), short-term (ST), medium-term, and long-term periods, as well as the time and indication for implant removal. Statistical analysis was performed using univariable logistic regression to identify factors associated with explantation.

Results:

The implant removal rate was 37%. Previous carpal surgery and controlateral affected limb were not associated with explantation. The time to surgical intervention was significantly associated with explantation (p=0.04), with a mean delay of 368.5 days for explant cases compared to 47.5 days for non-explant cases.  A lower PCA angle was significantly associated with explantation (p=0.01), with a median PCA angle for explant cases of 3.6° compared to  6.6° for non-explant cases. PO and ST bacteriological sampling, PO additional antibiotherapy along with ST signs of infection were significantly associated with implant removal (p=0,005, p= 0,03, p=0,009, p=0,001).

Conclusions:

Implant removal following PCA is more common than in other orthopaedic procedures, primarily due to infection-related factors. Timely surgical intervention and careful consideration of the PCA angle during surgery may help lower the risk of explantation.