A prime concern for large breed dogs is to have as fast a recovery from surgery as possible so that it can start SHARING its weight between its two hind legs. This is SO important because up to 60% will rupture their opposite cruciate ligament within a few months of injuring its first one, and the BEST way of minimising this risk is to share its hind body weight between both hind legs.
Unfortunately almost all large breed dogs have had previous, and often multiple, small sprain injuries to BOTH hind leg cruciates - sometimes without the owners being truly aware of these injuries. This causes signs of arthritis in the stifles (knees) but ALSO weakens, and slightly stretches, the ACL leading to a high risk of hyper-rotation of the knee with its twisting movements during normal activities. Hyper-rotation causes tightening and increased strain on the ACL and PCL (Posterior Cruciate Ligament), leading to an eventual rupturing of the ACL or bothe ACL and PCL.
Isometric cruciate surgery gives a comparatively speedy recovery and return to weight sharing on the hind legs when compared to all other cruciate repair surgeries. The immediate stabilization of the damaged knee joint also minimizes a patient going on and subsequently injuring its medial meniscus (the joint cartilage many humans damage!). The bone-cutting techniques, TPLO, TTO, MMP and TTA, all leave the joint without any mechanical stabilzation but rely on a change in the positional and thus functional mechanics in the knee that then reduces the reliance on an ACL substitute stabilization under restrained activities - and thus commonly end up tearing their medial meniscus joint cartilage due to lack of mechanical stabilzation.
The surgery uses a permanently placed VERY STRONG fiber, Ligafiba 500 Lb, which has a breaking strain of 227 KILOGRAMS … and it is DOUBLED!!! The positioning is such that it most accurately approximates the function of the ACL, both preventing the forward instability of the tibia, and also some inward rotation of the tibia. Stabilizing the knee joint is the most important way of preventing rapid development or progression of osteoarthitis and meniscal cartilage damage (if it hasn't already been injured), and minimizing joint pain. As mentioned, it also helps reduce the liklihood of injuring the opposite knee ACL due to ongoing favouring of the sore knee.
All Veterinary Specialists in Australia recommend TPLO procedures. None appear to perform Isometric surgery in medium and large breed dogs. Studies in America indicate the benefits of the Isometric technique (Called "Tight Rope") when complared to the TPLO and TTA surgeries. I advise you Read the American Univeristies Study.
All dogs that have an ACL injury, or any other signs of arthritis, are advise to have ZYDAX injection courses every 6 months.