CC BY-NC-ND 4.0 · VCOT Open 2023; 06(01): e14-e21
DOI: 10.1055/s-0043-1761601
Clinical Communication

One-Stage Revision with Cage Replacement as Treatment for Refractory Infections after Tibial Tuberosity Advancement in 7 Dogs

David Onis
1   AniCura Dierenziekenhuis Drechtstreek, Dordrecht, the Netherlands
Henrik Wagter
2   AniCura De Tweede Lijn, Zwolle, the Netherlands
Boris Serck
1   AniCura Dierenziekenhuis Drechtstreek, Dordrecht, the Netherlands
Erik G.H. Wouters
1   AniCura Dierenziekenhuis Drechtstreek, Dordrecht, the Netherlands
› Author Affiliations
Funding None.


The aim of this article was to report surgical and medical management, and to evaluate complications and outcome of dogs treated for refractory infection after tibial tuberosity advancement (TTA) with a one-stage revision surgery consisting of implant removal and replacement of a TTA cage. It was a retrospective case series. Seven cases were included in this study. Loss of advancement of the tibial tuberosity or tibial crest fractures did not occur in any case. One-stage revision surgery was successful in 5/7 cases (71%) with good long-term outcomes. Persistent infection resulted in removal of the replaced new cage in 2/7 cases (29%), of which one was associated with septic arthritis caused by multi-resistant bacteria. One-stage revision with immediate replacement of a new TTA cage successfully prevented loss of advancement of the tibial tuberosity and tibial crest fractures in this short case series. Further studies investigating possible improvements in the treatment protocol for refractory infection after TTA are warranted.

Publication History

Received: 29 August 2022

Accepted: 11 December 2022

Article published online:
10 February 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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