What is Patellar Luxation?
If your dog’s patellar luxation is congenital (present at birth), the affliction may not be noticed until about six weeks of age because it can be mistaken for clumsiness or slow learning. Developmental luxation is usually thought to be from hereditary ligament or skeletal conformation and will be evident as your puppy ages. Any kind of injury to the leg such as a fracture or sprain, can cause immediate patellar luxation that is obvious right away.
The most commonly affected breeds of dog include the Shih Tzu, Toy Poodle, Chihuahua, Maltese, Pomeranian, Yorkshire Terrier, Japanese Chin, Beagle, Pekingese, Basset Hound, Chow Chow, Cocker Spaniel, Australian Shepherd, Chinese Shar Pei, Lhasa Apso, Shiba Inu, and Dachshund. Some large breeds that are affected include St. Bernards, Huskies, Boxers, Malamutes, Akitas, Golden Retrievers, and Labrador Retrievers.
A patellar luxation is a common disorder in which the kneecap is displaced or dislocated from the knee joint where it belongs. This may be a condition the dog has when born (congenital) or may develop later in life (developmental). Although trauma to the knee can cause patellar luxation, it is usually hereditary in nature and affects toy breeds most often.
However, other breeds have been reported as having patellar luxation as well. This condition causes mild to severe pain, depending on which grade of luxation your dog has. Unless it is caused by an injury, the grade starts at 1 (mild) and progresses to 4 (severe) without treatment. If it is caused by an injury, it can start at any grade, depending on the severity of the injury. Patellar luxation is almost always in the rear legs and will cause lameness eventually without treatment, causing a skipping type gait.
Symptoms of Patellar Luxation in Dogs
The symptoms of patellar luxation depend on the cause and the grade of the condition. Most commonly, the signs include:
- Limping
- Abnormally carrying leg or legs
- Inability to bend the knee
- Pain when moving the leg
- Will not run or jump
- Refusing to exercise
- Swelling
- Weak legs
- Crying out in pain when used or manipulated
Types
A patellar luxation comes in four different grades depending on severity. These grades include:
- Grade 1 – Minimal lateral deviation, no cracking sounds, slight rotation of the tibia, and returns to the original position after extension
- Grade 2 – Up to 30 degrees of torsion in the tibial crest, frequently moves from its intended position, almost permanently luxated, very difficult but possible to move patella back in place
- Grade 3 – Flattened knee joint, permanently luxated with a tibial crest of 30 to 50 degrees, still usable but held in a partially flexed position
- Grade 4 – Permanently luxated with up to 90 degrees deviation, knee joint is flat or convex, unable to use the leg normally
Causes of Patellar Luxation in Dogs
The cause of patellar luxation includes:
- Congenital – Present at birth
- Developmental – Develops over time but is considered to be a hereditary deformity or weakness in the ligaments or bones in the knee
- Traumatic – Results from an injury or accident that damages the knee ligaments or bones
Diagnosis of Patellar Luxation in Dogs
If this is a congenital condition, your puppy will probably be diagnosed at his first appointment with your veterinary professional. However, in the case of hereditary or traumatic patellar luxation, the condition will make itself known when it is at a high enough grade. A physical examination will be performed right away, which will likely include auscultation, palpation, vital signs, lameness assessment, and behavioral analysis.
Be sure to tell the veterinarian if your pet has been sick or injured recently and if you have given him any medication, even if it is an herbal supplement. Some medications can affect the symptoms and may not interact well with the drug your veterinarian proposes to use for treatment. The veterinarian will run some blood tests such as a blood count and chemical analysis as well as radiography like x-rays, CT scans, ultrasound, and an MRI.
Treatment of Patellar Luxation in Dogs
To treat your dog for patellar luxation, the grade and your dog’s health will be taken into consideration. Surgery is the most obvious and commonly chosen treatment, but the veterinarian may try a leg brace or bandage, cage rest, and medication instead.
Surgery
The operational technique depends on the grade of the condition and the results vary depending on the cause of the patellar luxation. The veterinarian may choose to use fascial release incisions on the side of the knee or knees affected, soft tissue realignment, inserting pins into the tibia to create a fixed position, or bone shaping to deepen the groove of the femur.
Medication
Steroids, NSAIDs, and narcotics can be given for pain and inflammation. In addition, there are supplements such as glucosamine, Vitamin C, Vitamin E, and collagen injections that may be helpful for pain.
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Recovery of Patellar Luxation in Dogs
Your dog’s prognosis is good but depends on the grade of the patellar luxation. In very severe cases, the limb may need to be amputated to stop the pain. Mild to moderate cases are treated with surgery or medication and should return your dog to normal health in no time at all.
Patellar Luxation Questions and Advice from Veterinary Professionals
Peekapoo
Madeline
8 Years
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My pet has the following symptoms:
Limping
Our peekapoo had surgery 7 months ago for a grade III/IV patella luxation. She was off her feet for the 8 weeks required, then slowly returned to normal. She started limping yesterday and it is evident that it is the same leg that she had surgery on. Can this re-occur?
May 2, 2018
0 Recommendations
The condition may recur but it is uncommon, but since it is the same leg as the surgery I would recommend that you visit your Veterinarian for an examination to determine if there is a recurrence or not. Regards Dr Callum Turner DVM
www.acvs.org/small-animal/patellar-luxations
May 3, 2018
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Labrador Retriever
Dash
1 Year
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My pet has the following symptoms:
Limping
Is patellar luxation genetic? We raise labrador retrievers and one of the puppies we bred was diagnosed with this condition. Both parents are OFA certified. Neither of the parents show any signs of having this condition. What information you can give me would be much appreciated.
Thank you
May 1, 2018
0 Recommendations
There is evidence that patellar luxation is hereditary, however it isn’t fully understood; I’ve provided two links below for further information on this. It is recommended that affected dogs are not bred however, if other pups from the same parents are also affected you shouldn’t breed them either; there is debate in the breeding community about how to manage this, if you are a member of a society I would recommend reaching out to them regarding their guidelines. Regards Dr Callum Turner DVM
www.ncbi.nlm.nih.gov/pmc/articles/PMC1524842/
www.acvs.org/small-animal/patellar-luxations
May 2, 2018
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Chihuahua
Finn
14 Weeks
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Our 1 year old chihuahua had surgery (depending of the groove) to correct Grade II/III patellar luxation, which he got when he slipped and fell down the stairs. It has been 6.5 weeks since the surgery. At week 3 we noticed that he skipped a step when he was trotting on our hardwood floor. This happened twice. He passed the 4 week checkup (with XRays) fine and we were told to increase his activity gradually from week 6 on. Since then he has been bunny-hopping more when trotting on our hardwood floor. The bunny-hopping now is worse than it was when we took him in for surgery. Is it likely that he has luxated his patella again? If so - what are the treatment options? We will be taking him to his surgeon for his 8 week checkup March 1, but we are really worried at this point and we would like an independent opinion. Thank you so much for your help with Finnie!
Feb. 18, 2018
1 Recommendations
Without examining Finn I cannot say whether or not there is a recurrence of the luxation or if any suture or implants failed; you should reduce Finn’s activity for now since he is bunny hopping and I would recommend visiting the Surgeon sooner if possible to examine him to determine a course of action. There are different surgical options, but it is dependent on the specific issue; deepening the groove, repositioning of tibial crest or fixation of soft tissues may be used but are done on a case by case basis based on the observation of the Surgeon. Regards Dr Callum Turner DVM
www.acvs.org/small-animal/patellar-luxations
www.fitzpatrickreferrals.co.uk/orthopaedic/patellar-luxation/
Feb. 18, 2018
Thank you very much, Dr. Turner. Your suggestions are very helpful. We'll reduce Finnie's activity and try to get him in for his checkup sooner.
Feb. 18, 2018
Finn's Owner
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Boxer Pug
Boomer
3 Years
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My pet has the following symptoms:
Holding Leg Up
Boomer has had mild Patellar Luxation since he was young (he is 3.5). About 2 years ago we had some issues, he lost weight and has had no problems since. He got wrapped around his leash and whipped back around a few days ago at the beach and is having issues in one knee again. Today, the vet (new vet)said he is level 3. I am going to get a 2nd opinion but is is possible to have NO issues for 2 years and suddenly he is at a level 3?? TIA!
Jan. 23, 2018
Answered by Dr. Michele K. DVM
0 Recommendations
Thank you for your email. The grades of patellar luxation depend on the stability of the ligaments involved in stabilizing the knee. If he damaged those ligaments, it is possible that the knee is less stable at this point, and may have moved to a point where surgery might be recommended. It never hurts to have a second opinion, but that might be what is happening with him at this point. I hope that everything goes well with him.
Jan. 24, 2018
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