Injury of the cranial cruciate ligament remains the most common cause of hind limb lameness in adult large-breed dogs.1 Popular breeds such as Labrador Retrievers and Rottweilers are commonly afflicted with gradual tearing of the cranial cruciate ligament. Return to function is best accomplished through surgical intervention.2–7 Numerous techniques have been described to repair stifle joints that have deficiencies of the cranial cruciate ligament.1,3,5,8 A procedure favored by many small animal surgeons is the TPLO.7,8 This procedure changes the mechanics of the joint whereby cranial translation is converted to caudal translation, the latter of which is then neutralized by the caudal cruciate ligament. To accomplish the procedure, an osteotomy of the proximal tibial metaphysis is performed, and the tibial plateau is then rotated to a new position and stabilized with a bone plate and screws. A commercially manufactured platea has commonly been used for the TPLO stabilization. In the past few years, a possible increase in osteosarcoma in dogs that had undergone a TPLO procedure was suggested in a report.9,11
Furthermore, issues have been raised regarding the quality of that commercially available TPLO plate (ie, it may not meet established specifications, especially standards for surgical implants). For example, investigators in 1 study10 reported that intra- and extracellular particulate debris were detected in tissues samples obtained adjacent to the site of TPLO plates and concluded that this debris and mononuclear cell infiltrates observed were probably the result of corrosion. The same group of investigators also implicated the commercially available TPLO plate as a cause of neoplasia in a dog.11 An additional report12 also revealed an osteosarcoma in the proximal portion of the tibia at the site of a TPLO performed by use of the commercially available TPLO plate. Crevice corrosion has also been reported13 in 7 explanted TPLO plates, and the investigators in that study concluded that the cast implants were inferior to wrought implants because it appeared that surface irregularities and porosity served as initiation sites for observed corrosion defects.
Osteosarcomas related to implants have been associated with chronic low-grade inflammation, most commonly secondary to loosening of the implant, galvanic corrosion, and low-grade infection.14–19 Osteosarcoma in a dog associated with a wrought stainless-steel plate has also been reported20; in that dog, there was no histologic evidence of implant loosening or infection.
In vivo, 316L stainless steel is capable of a small amount of corrosion, but this corrosion can be limited by proper passivation, implant fixation (to minimize fretting corrosion), and use of materials composed of similar metals (to avoid galvanic corrosion).21–24 If longterm implantation of the commercially available TPLO plate results in substantial corrosion, chronic inflammation could result in the development of bone tumors at or near the TPLO site. Therefore, the goal of the study reported here was to determine the microchemical and surface composition of commercially available TPLO plates, particularly as they relate to corrosion, before implantation and after explantation from host dogs.
Tibial plateau leveling osteotomy
Inductively coupled plasma–mass spectrometry
Scanning electron microscopy
Energy dispersive spectroscopy
X-ray photoelectron spectroscopy
TPLO bone plate, Slocum Enterprises, Eugene, Ore.
Omnitrace Ultra high purity HNO3, EM Science, Gibbstown, NJ.
Omnitrace Ultra high purity HCL, EM Science, Gibbstown, NJ.
Academic Water Purifier, Millipore Corp, Billerica, Mass.
Perkin-Elmer DRCII ICP-MS, Perkin-Elmer, Waltham, Mass.
JEOL JSM-6400, JEOL Ltd Tokyo, Japan.
LEO 1530, Leica Microsystems, Bensheim, Germany.
Genesis microanalysis software, EDAX, Mahwah, NJ.
Kratos Axis Ultra XPS, Kratos Ltd, Manchester, UK.
Fisherbrand PTFE Beaker, Thermo Fisher Scientific, Waltham, Mass.
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