Our 240 lb Mastiff tore his CCL (ACL equivalent for people). We were scared that he would not be able to ever walk right again. We met with Dr. Rizzo as our 2nd opinion and she explained everything to us, including the various procedure options. We decided on the TPLO procedure. After a few months of recovery our boy is back to playing, regular walks and we can't tell a difference. The TPLO surgery isn't cheap but we wanted our boy to be back to himself. It was VERY comforting to have a place that could handle the giant breeds (we have 2 english mastiffs). We can recommend Dr. Rizzo without any reservation.