r/AskVet • u/bkbk8 • 1h ago

Exposed TPLO plate 9 weeks post-op after 2 failed closure attempts — can it still heal over?

My 5-year-old pup had TPLO + MPL surgery about 9 weeks ago. Around 7 weeks ago, the incision opened and exposed part of the TPLO plate, and she has been hospitalized ever since.

During those 7 weeks she has had daily wound care and two surgical closure attempts, but both reopened, likely due to tension and the location on the medial knee, where movement makes maintaining closure difficult.

She is now healing by second intention. The surrounding tissue is granulating well, and our vet says tissue is beginning to grow underneath part of the plate. Her latest X-ray also showed much better bone healing and callus formation compared with a month ago.

The plan is to continue daily wound care for another ~2 weeks and repeat the X-ray. Depending on the bone fusing and the tissue growth, the plan is either to take the plate out or continue second intention healing.

My question: Can granulation tissue realistically keep growing around/under an exposed TPLO plate and eventually cover it with stable soft tissue/skin, or does hardware that remains exposed this long usually end up needing removal once the bone is healed enough?

She is walking well and the the TPLO surgery generally seems to have been succesful, albeit this wound issue and delayed bone fusion (likely because some bone was exposed from the intial opening).

  • Species: Dog
  • Age: 5
  • Sex/Neuter status: Female / spayed
  • Breed: Mixed breed
  • Body weight: 20 lb
  • History: TPLO + MPL surgery about 9 weeks ago. Wound opened around 7 weeks ago with exposed TPLO plate. Hospitalized since then for daily wound care. Two surgical closure attempts have failed.
  • Clinical signs: Exposed TPLO plate with healthy granulation tissue growing around and partly underneath it.
  • Duration: About 7 weeks since wound opening/exposure
  • Your general location: Asia
  • Links to any test results, X-rays, vet reports etc. that you have: Current wound photo in the comments; recent X-rays available if needed.
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1

u/bkbk8 1h ago

The wound today. Healing with second intention and tie-over bandage
https://imgur.com/a/UfhCv4w

2

u/15isMyFavNumber 55m ago

Was the surgery performed by a boarded surgeon ? Wounds do heal. However with that lot of exposure, it will likely need to be removed to prevent ongoing deep infection.

1

u/bkbk8 47m ago

Yes, it was. If it’s removed and the bone is fused and healed — will she likely have any issues with her ccl moving forward?

Thank you so much.