 Obesity, conformation, inflammatory conditions of the joint and genetics are all included under the multifactorial umbrella.Genetic factors are undoubtedly important, which would help explain why certain breeds are predisposed, including Labrador and Golden Retrievers, Mastiffs, Rottweilers, Boxers, Staffordshire Terriers, West Highland White Terriers and Newfoundland dogs.In a Simitri Stable in Stride surgical procedure, unlike tibial-plateau-leveling osteotomy (TPLO) and tibial tuberosity advancement (TTA), no osteotomy (cutting of bone) is required making this a much less invasive procedure.