What is Luxating Patella in Small-Breed Dogs? Cause, Diagnosis, and Treatment

Luxating patella. When I first started fostering with OC Pom Rescue, I had no idea what this ailment was. I remember typing this phrase into the text box in my foster group message and Siri said I spelled it wrong. "Luxating? What even does that mean?"

Fast forward four years, and I can confidently say that I know how to spell this word and I can also say that yes, your dog will be okay and the recovery is not as bad as it sounds.

Luxating means "dislocate," like your dog's knee may be stuck in the luxated (or dislocated) position.

Sounds pretty bad, doesn't it? When I first learned about luxating patella, I had a crazy amount of questions: Is this a breeding issue? Are the dogs not supposed to be this small? Are they able to go for long walks or jump up on the couch? Is this a common problem in small dogs or did I just agree to foster a dog that will never get adopted?

What is luxating patella?

Luxating patella, a common orthopedic condition in dogs, particularly affects small breeds. It involves the dislocation or the "popping out" of the kneecap (patella) from its normal position in the groove of the thigh bone (femur). This can cause pain and mobility issues in dogs in certain cases, typically the high grades, like 3-4.

How do I know if my dog has luxating patella?

You may notice a "skip" when your dog is walking or they may temporarily run on three legs before returning back to walking normally on all four legs. This skip indicates that the patella popped out, and when they return to their normal walk or run, the knee cap has returned to its normal place.

In some cases, the dog may have a bowlegged stance, a hunched lower back, or there is a regular cracking or popping noise when the knee bends. How this ailment displays itself can really depend on the severity. In some cases, you might not really notice that your dog has patella problems until you get an x-ray or the problem worsens with age and activity.

How does a veterinarian diagnose luxating patella?

Luxating patella is diagnosed through a physical exam and x-rays. The "grade" of the luxating patella severity is as follows:

Grade 1:

• Physical Examination: The kneecap dislocates with manual pressure but returns to its normal position immediately when released. It's often found incidentally during a veterinary exam.

• X-ray Findings: X-rays may not show significant changes in Grade I cases. The diagnosis is primarily based on the veterinarian's physical manipulation of the knee joint.

Grade 2:

• Physical Examination: The kneecap can be manually dislocated and remains out of place until manually adjusted. Lameness is usually intermittent.

• X-ray Findings: X-rays might show mild changes in the structure of the knee joint, such as a shallow groove where the patella rests. The displacement of the patella might be visible when the knee is in a certain position.

Grade 3:

• Physical Examination: The kneecap is often out of its normal position and requires manual manipulation to return to the groove in the femur. Dogs often experience chronic discomfort and lameness.

• X-ray Findings: X-rays are likely to show more pronounced structural abnormalities, like significant shallowness of the femoral groove, misalignment of the patella, and changes due to repeated luxation.

Grade 4:

• Physical Examination: The kneecap is permanently dislocated and cannot be manually repositioned. Dogs experience significant pain, limited mobility, and reduced quality of life.

• X-ray Findings: X-rays will show severe abnormalities in the structure of the knee joint. The patella is visibly out of place, and there are often major changes in the shape of the femoral groove and the alignment of the knee joint.

The best way to diagnose the grade is through X-rays or advanced imaging so the veterinarian can exactly pinpoint how dislocated the knee cap is in relation to the notch on the femur.

How is luxating patella treated?

Non-surgical treatments are typically recommended for dogs with Grade I and mild Grade II patellar luxation. These treatments include:

• Medications: Anti-inflammatory drugs to reduce pain and inflammation.

• Weight Management: Keeping the dog at a healthy weight to reduce stress on the joints.

• Exercise Restriction: Avoiding or lessening activities that could exacerbate the condition, like jumping or running. Controlled leash walks are often recommended.

• Physical Therapy: Can include range of motion exercises, muscle strengthening exercises, and other rehabilitation techniques.

• Joint Supplements: Like glucosamine and chondroitin, which may support joint health.

Surgery is often recommended for more severe cases (usually Grade III and Grade IV) and involves various procedures to correct the anatomical abnormalities. The type of surgery depends on the specific abnormalities present in the dog's knee joint.

• Recession Sulcoplasty: To deepen the groove in which the patella sits if it's too shallow.

• Tibial Tuberosity Transposition: Moving the point of attachment of the patellar ligament on the tibia to realign the patella.

• Soft Tissue Reconstruction: To correct imbalances in the supporting structures around the patella.

• Lateral Imbrication: Tightening the tissues on the outside of the knee joint.

How long is recovery, if my dog needs luxating patella surgery? What does recovery include?

The recovery process and duration vary depending on the specific procedure performed and the dog's overall health. Typically, dogs are up and back walking in about a month, sometimes sooner. Their age and motivation to walk also contribute to the timeline.

General guidelines for recovery include:

• Immediate Postoperative Care: Dogs often need to stay at the hospital for a short period immediately following the surgery. Pain management is a critical component during this time.

• Activity Restriction: Initially, strict rest is required, usually involving confinement to a crate or small room to prevent jumping or running. This period can last from a few weeks to a couple of months, depending on the severity of the surgery.

• Physical Therapy: Rehabilitation exercises and physical therapy are important for recovery and may start a few weeks after surgery.

• Follow-up Visits: Regular check-ups with the vet are necessary to monitor the healing process.

• Long-term Care: Even after recovery, ongoing management such as weight control and avoiding strenuous activities might be necessary to prevent recurrence.

The prognosis post-surgery is generally good, with many dogs returning to normal activity levels. The prognosis post-surgery is generally good, with many dogs returning to normal activity levels.

Having a dog with luxating patella is not the end of the world.

Especially dogs with low grade luxating patellas, they can have a normal life with no problems. If you see that they are irritated by their knee, then let them rest because the activity they are doing may be too strenuous. Repeated knee cap "pops" or visible pain should be addressed by a veterinarian for recommended treatment. Early diagnosis and treatment are key to managing the condition effectively. Each dog is unique, and the severity of the condition, along with the dog's breed, age, and overall health, will influence the treatment and prognosis.