Feasibility of Tibial Plateau Levelling Osteotomy without Perioperative Antimicrobial Prophylaxis: A Retrospective Cohort Study of 108 Dogs

The aim of this study was to evaluate the feasibility and safety of tibial plateau levelling osteotomy (TPLO) in dogs without perioperative or postoperative antimicrobial prophylaxis. Retrospective cohort study of 108 dogs. Seventeen dogs (15.7%) developed a surgical site infection (SSI) during follow-up, with a 90-day SSI rate of 11.1%. No catastrophic complications occurred. Younger age and postoperative licking behaviour were associated with increased SSI risk, while sex, neuter status, body weight, anaesthesia duration, and implant coating were not. Surgical site infections were strongly linked to implant removal (p < 0.001). Compared to published TPLO cohorts receiving antimicrobial prophylaxis, the overall SSI rate was significantly higher (p = 0.019) but remained within reported ranges. The SSI rate observed in dogs undergoing TPLO without perioperative antimicrobial prophylaxis in this cohort was higher than rates reported in the existing literature. However, no catastrophic postoperative complications were documented during the available follow-up period. These findings provide descriptive outcome data for TPLO performed without perioperative antibiotics and suggest clinical feasibility under the conditions studied. Prospective trials with standardized follow-up, documentation of licking behaviour, strict adherence to the Centers for Disease Control and Prevention SSI definitions, assessment of intraoperative contamination and long-term outcomes are warranted to guide safe antimicrobial omission in TPLO.