Orthopaedics

Dr. Andrew Sams

Over the last ten years, the advancements in orthopedics for small animals have been significant. In fact, many of the more innovative techniques in human orthopaedics were modeled on procedures now available for dogs and cats. Dr. Sams uses both these newer procedures and more traditional approaches, depending on which technique offers the best solution, as our goal is always to further the comfort of and improve the outcome for every patient.

The following are some of the surgical and regenerative medicine services offered at The Sams Clinic:

Arthroscopy

Arthroscopic Surgery

Arthroscopy is a minimally invasive procedure that uses a very small telescope attached to a bright light source and camera to transmit images from inside a joint to a monitor , where the surgeon views magnified images. When exploring a joint in this manner, subtle lesions can be found that otherwise may go undetected. The surgeon then manipulates small instruments within the joint and treats the problem. After the procedure, the surgeon uses a suture to close the small portals where the arthroscope and instruments entered the joint.

Fracture Repair

The Sams Clinic offers optimal fracture repair utilizing bone plates, intramedullary pins, external fixators, and splints.

Bone Plating

Dr. Sams uses bone plates to repair fractures and straighten limbs and to aid in other surgical procedures that involve cutting a bone and stabilizing it. He anchors the plate to the bone with surgical grade stainless steel screws.

External Fixators

Dr. Sams uses external fixators to repair fractures and straighten limbs and to aid in other surgical procedures that involve cutting a bone and stabilizing it. They are made of rods or rings that go on the outside of the leg and are attached to the bone with pins that enter the bone. External fixators generally cause minimal disruption to the soft tissue, muscle and blood supply and are removed after the surgery site has healed. A specific type of external fixator called a ring fixator is very useful in lengthening bones that are too short and with difficult or non-healing fracture repairs.

Cruciate Repair

Tibial Plateau Leveling Osteotomy (TPLO)

Tibial Plateau Leveling Osteotomy (TPLO) addresses the instability caused by the rupture of a dog’s cranial cruciate ligament. TPLOs yield excellent clinical results, in both partial and complete tears, with the vast majority of dogs returning to very active, comfortable lives. Dr. Sams has performed this surgery for over fifteen years, on over two thousand five hundred patients. Originally, available only for large dogs, new smaller plates make the procedure possible for dogs of all sizes.

This video from DuPuy Synthes provides an overview of the TPLO procedure.

Video Source: DuPuy Synthes Vet; Client Education

Modified D’Angelis

Hip Surgery

Femoral Head Ostectomy (FHO)

This surgical procedure can be done at any age and can provide enough comfort in a dog weighing less than 60–70 lbs to avoid the daily use of anti-inflammatory pain medication, thus avoiding costs and side effects that limit or negate its use. 

Young dogs that do not meet the criteria for Double or Triple Pelvic Osteotomy or Juvenile Pubic Symphysiodesis procedures, or dogs who do not respond satisfactorily to medical treatment alone may benefit from FHO. This technique involves removing the femoral portion of the hip joint (i.e., the ball) to reduce the pain produced by abnormal hip joint contact that wears away the joint cartilage, and the stretching of the soft tissues around the joint due to laxity (Figure 5).

Following an FHO, a “false joint” develops with the muscles around the hip now transferring the forces from the leg to the pelvis during limb movement. The goal of an FHO is to relieve the pain associated with Canine Hip Dysplasia, not to maintain/recreate normal hip function. Two weeks following FHO surgery the puppy/adult dog is encouraged to exercise, often receiving anti-inflammatory drugs daily during the initial 1–2 months post-op. Then these drugs may only be necessary intermittently.

FHO dogs must remain slim throughout their lives and follow a limited exercise program i.e. leash walks and confinement to the yard and house. They cannot be athletic dogs who hunt, do agility, high level obedience, run with their owners, etc. If those activities are what the owner wishes to do with their dog, then a Total Hip Replacement would be necessary.

The above information is sourced and provided by: The American College of Veterinary Surgeons

Stem Cell Therapy

The Sams Clinic offers Vet-Stem®, a procedure that isolates regenerative cells from a sample of an animal’s own fat for treatment of tendons, ligaments and joints. Stem Cell Therapy is NOT to be confused with the controversial use of stem cells derived from human embryos.

Arthritis Management

Osteoarthritis Management

Recently, many advances have been made in the treatment of osteoarthritis in small animals. We favor an approach that combines medication therapy, natural supplements, weight management and physiotherapy. Our goal is to use as little medication as possible while increasing the activity and comfort levels of the patients as we slow the progression of the disease.

Immune Mediated Arthritis

For this type of arthritis, which is caused by the body’s immune system, we use medication to modulate the patient’s immune response. Diagnosis and monitoring of the condition often include testing the joint fluid. In some cases, medication may be tapered off completely or kept at a minimal level.

Orthopedic Oncology

Removing tumors when they affect the bone or originate from the bone can be part of an optimal treatment plan, resulting in the best cure and pleasing cosmetic results. For some tumors, such as osteosarcoma (a tumor that originates in the bone), recent advances in chemotherapy have made it a more rewarding option that can help significantly (Our Clinic does not offer chemotherapy treatments)

Wound Reconstruction & Skin Grafting

For health and cosmetic reasons, tumor removal as well as wounds that damage an area of skin that is too large to heal on its own may call for wound reconstructive techniques. We have excellent success with many techniques, including skin grafts, which involve moving a connected piece of healthy skin to cover and heal the area.