I've never experienced knee surgery, but many people have on YT with great success. It's a long drive for you, but my vet, Dr. Wen, in Westhampton, might be able to honestly access if there is anything that can be done to alleviate the pain other than surgery. I've seen so many success stories over the years with acupuncture and other treatments. He combines conventional Western medicine and Chinese therapies. To me, he's a miracle worker. I live only 22 miles from him, but he has patients from much greater distances. You might also try the hospital at the link below, especially if surgery is necessary, but I can't personally vouch for them. I teach not far from you at Wheatley.
I hope you are able to find help with your little girl. My first Yorkie many years ago had luxating patellas, and surgery was not recommended for her. I wish she had someone treating her as much as I trust Dr. Wen.
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