Patella Luxation In Dogs: Kneecap Condition Causes & Treatment Options

The patella is the scientific name for the knee cap, which sits in a little groove at the top of the tibia (shin). A luxating patella slips in and out of this groove, dislocating and stopping the knee from bending properly. Not only does this cause lameness, but it can also cause pain and arthritis.

In most cases, the patella luxates towards the inside of the leg (termed ‘medial luxation’), but it can also luxate towards the outside of the leg (‘lateral luxation’).

Patella luxation is usually a genetic condition and typically affects small breeds such as Miniature and Toy Poodles, Yorkshire Terriers, Pomeranians, Pekingese, Chihuahuas, Boston Terriers, Jack Russell Terriers, and Staffordshire Bull Terriers. Cats can also be affected.

What Are Signs Of Patella Luxation?

Patella luxation is usually characterized by ‘hopping’ and ‘skipping’ — where a dog holds the affected leg up for a few steps when walking/running and then uses it normally again. Usually, only one leg is affected, but in some cases, both are affected, which can lead to a ‘bunny hopping’ movement or a generally stiff and awkward gait.

What Causes Patella Luxation In Dogs?

Because this condition is more common in certain breeds, we know a genetic component. However, a lot of it depends on how different bones form and grow in these breeds. Dogs with luxating patellas often have the following bone abnormalities:

• Shallow trochlear groove – This groove is where the patella should sit in a normal knee, and the patella should be able to slide up and down in it as the leg bends. If this groove is too shallow, the patella can easily slip in and out of it.
• Medially placed tibial crest – The patella sits within a tendon called the patella tendon. In some dogs, the bit of bone where this tendon attaches to the shin bone isn’t in the correct position. This causes the tendon to be pulled to one side, increasing the chance of the patella slipping out of place.
• Bowed femur – In some breeds, the femur (thigh bone) is bow-shaped or curved slightly, which can contribute to the condition.

What Should I Do If My Pet Has Patella Luxation?

Patella luxation is a very common condition, usually affecting smaller breed dogs. You’ll usually notice symptoms of patella luxation, like bunny hopping, when the dog is still quite young.

Not only is patella luxation uncomfortable and painful for animals, but it can also lead to arthritis in the knee joint. Symptoms of arthritis include lameness, stiffness, and a reluctance to exercise, although these signs may not happen until the dog is older.

If you think your pet has symptoms of patellar luxation or is experiencing problems with their mobility, then it’s important to get them checked over by a veterinarian as soon as possible.

How Is Patella Luxation In Dogs Diagnosed?

Your veterinarian will not only talk to you about your dog’s symptoms, but they will also assess your dog’s walking and running to see how they move.

Sometimes, the vet can feel the patella luxating when they examine your pet – it may pop in and out of its usual position as the vet is manipulating and feeling it, or they may find it in a permanently dislocated position. A set of X-rays, usually taken while the animal is under sedation, helps the vet in diagnosing the condition.

The degree to which the patella luxates is graded according to a system. The grade determines the severity of the condition and helps guide treatment options.

The grading system for patellar luxation:

• Grade 1 – the knee cap can be luxated with manual pressure but is usually within the groove
• Grade 2 – the knee cap spontaneously luxates and causes a skipping lameness when it does
• Grade 3 – the knee cap is permanently luxated but can be manually replaced into the groove
• Grade 4 – the knee cap is permanently luxated and cannot be manually replaced into the groove

Depending on the facilities available at your veterinary clinic, your vet may refer your pet to see an orthopedic specialist. If you visit a specialist, they will assess your pet again in further detail. They may need to carry out further imaging, such as a CT scan or repeat X-rays, to help them formulate a suitable treatment plan for your pet.

How Do You Treat A Dog With A Luxating Patella?

A grade 1 or 2 can usually be monitored with no treatment. The severity of any lameness or skipping is taken into consideration, and some animals with a grade 2 may be offered treatment.

For animals with a grade 3 or 4 luxating patella, treatment is required to alleviate pain and correct their lameness, enabling your pet to continue to exercise normally and comfortably in the long term. Over time, your pet’s condition could deteriorate and worsen, so it’s really important that even if your pet has previously been diagnosed with a low grade, you get regular veterinary checkups. Patella luxation can also lead to cruciate rupture, which may cause a sudden worsening of symptoms.

Surgical Treatment For Patella Luxation

In very young animals, a luxating patella may be monitored while they grow, as it can be risky and potentially damaging to perform surgery on growing bones.

Surgery is usually recommended for animals with grade 3 or 4 patellar luxation in order to correct it and prevent long-term pain and discomfort. There are several surgical options available, and your vet will discuss these with you and make a decision based on your pet’s individual case. The surgery aims to restore the bones, joints, and tendons to a more normal alignment.

This may include:

• Deepening of the groove in which the patella sits and slides.
• Moving part of the shin bone so that the tendon is straighter and tighter (called ‘tibial crest transposition’).
• In severe cases, the femur may need to be cut and a plate placed to straighten it. This corrects any bowing.

All surgical procedures have pros and cons, and your vet will discuss the different options as well as the risks and benefits with you in the decision-making process. It is also important to remember that these are complex and intricate surgical procedures that can only be performed by specialist vets.

Recovery From Patella Luxation Surgery

For pets who have surgery, the recovery time is generally around 8-10 weeks. Your surgeon will go through this with you, but there is usually an initial period of complete rest for around six weeks. During this time, your pet needs to be on crate rest, with no exercise at all, and on the lead for all toilet breaks. This is to allow the tissues to heal and reduce the risk of complications after the operation.

It is normal for your pet to experience some swelling and bruising, which normally goes down after a few days. After this period of rest, your veterinarian will give you a strict plan for a controlled reintroduction to exercise and will also recommend hydrotherapy or physiotherapy for your pet to help them regain their strength.

How Much Does Luxating Patella Surgery Cost?

The cost of luxating patella surgery depends on the procedure and the area you live in but likely ranges from $1,000 to $4,000. However, some or all of this cost might be covered by pet insurance, so you should check your policy details and any exclusions. If you can’t afford luxating patella surgery right away, you should still talk to your vet — they may know of cheaper alternatives or be able to offer a non-surgical option in the meantime.

Pet Insurance For Proactive Support

Once your dog has been diagnosed with a luxating patella or any health concern, it is too late to get it covered by pet insurance. However, by finding the right insurance for your dog at a young age, before they have a pre-existing condition, you can properly manage your finances in times of pet emergencies like this one. And even if your dog has already been diagnosed with a luxating patella, who’s to say what health emergency you may face next? Now is the time to consider pet insurance so you never have to choose between your beloved furry friend and your wallet. 

Non-Surgical Treatment

Most dogs and cats are prescribed pain relief medication, as it is a painful condition. This might include NSAIDs (non-steroidal anti-inflammatory drugs), paracetamol, mild opioids, or other types of pain relief. Some animals need to stay on this medication long-term.

Physiotherapy can play a very important and beneficial role in recovery from surgery or non-surgical management. Physiotherapy can help to strengthen the muscles that prevent the patella from slipping. This helps to keep your pet active and comfortable. Controlled exercise can also be beneficial for many patients, as rest and restricted exercise allow the tissues to heal after a flare-up. Over-exercise can cause further pain and discomfort, so it’s important to help your pet build up its strength over time.

Will My Dog Be Okay If He Has Patella Luxation?

Regardless of whether or not your pet needs to have surgery, patella luxation is something that your pet can live a happy and comfortable life with as long as they receive appropriate treatment.

For dogs with a high-grade condition requiring surgical treatment, the success rate is good. There is a small risk of complications with every surgical procedure, which your vet will discuss with you. Very few animals require further surgery and go on to experience very few issues. However, dogs who have suffered from luxation are more likely to develop osteoarthritis at an earlier age.

Dogs and cats with low-grade luxation who do not require surgery are also able to continue to live active and happy lives, although they may need to remain on anti-inflammatory medication long-term. Some animals benefit from regular physiotherapy or hydrotherapy sessions to keep them strong and active. Flare-ups of lameness and pain are common and are usually treated with a period of rest and pain relief medication.

Final Thoughts

Patella luxation is a common condition, especially in small-breed dogs. It causes an on-off hopping lameness that looks as though dogs are skipping. While it may look silly, it’s important to remember that this is painful for them. If you suspect your dog has this condition, you should talk to your vet right away – medication, physiotherapy, or surgery may be recommended to help your dog live a happy and comfortable life.