There are different surgery type options depending on the circumstances and the size of the dog. I'm assuming you're looking at the tibial plateau leveling osteomy, which literally cuts into and changes the way the forces are applied on the bone. It's a big surgery that's usually for larger animals (think horses) and doesn't always make sense for dogs in my opinion.
Another technique is where they basically use fishing line and some hardware to tie the tibia and femur together. This works pretty well for smaller dogs (<45-60 lbs I believe). There is also a new and improved method of this called Orthozip, which I elected to have done on my geriatric retriever (she was 12 at the time and around 65-70lbs). It basically uses orthopaedic screws in the tibia and femur and then a far higher tensile strength line ties between them. Anyway, it's been about a year since the surgery and she's doing about as good as you can expect a 13 year old golden retriever to be doing. I'd go looking around at different vets because they don't all charge the same or recommend the same procedures.
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