Luxating Patella in Dogs: Painful but Treatable

What is a Luxating Patella?

Patellar luxation is a common musculoskeletal disease commonly seen in many dog breeds. Before we try and figure out what exactly is a luxating patella, we must first familiarize ourselves with the anatomy and biomechanics of the stifle (knee) joint.

To keep things simple dogs have a kneecap that’s highly moveable this—the patella. This kneecap fits comfortably in the groove of the femur bone (Patellofemoral groove) and when a dog flexes or extends it’s knee, then the kneecap slides up and down.

Patella luxation simply means that the kneecap is no longer able to slide across this groove, therefore, the kneecap has become dislocated.

Medial Luxating Patella in a Nutshell

A luxating patella can be classified as either medial or lateral. Now, this just indicates the direction in which the kneecap may be sliding. So, if a dog’s patella is sliding on the inner aspect of the knee then this is considered a medial luxation patella.

Luxating Patella in Humans

A dislocated patella can also be found in humans, however, in the case of our species, this is often referred to as Patellar subluxation which occurs as a result of injury or patellar dislocation. What’s the difference between the two?

From a medical perspective, patella dislocation refers to the “complete” dislocation of the kneecap from the joint. Whereas, patella subluxation refers to a partial dislocation.

Luxating Patella in Cats

Cats can also be prone to patellar luxation. This may also be caused either by injury or is congenital.

Luxating Patella in Dogs

Patellar luxation is most prevalent in small dogs, but it has been increasing in large dogs as well. The most common form of patella luxation is medial luxating patella.

Possible Causes of Dog Luxating Patellas

A luxating patella may be commonly caused by poor nutrition,  injury,  or it may be present at birth (congenital).

Genetics

Medial patella luxation is strongly associated with skeletal deformities, this is therefore considered congenital, therefore it is not recommended that owners breed from these dogs. Skeletal deformities include an improver alignment of the quadriceps muscle, malformed trochlea ridges, tibial tuberosity may be misaligned, and hypoplasia of the medial femoral condyle.

Poor Nutrition

Dogs who have poor nutrition and are overweight, are at risk of developing joint problems associated with the kneecap—this is due to an increase in pressure on the joint capsule and knee joint.

Too Much Exercise or Stress on Joints During Puppyhood

The two main causes of a luxating patella may be either the dog is born with it (congenital) or the dog is prone to getting it in the future (genetic). Very rarely could intensive exercise during puppyhood cause joint problems. The reason it may be suggested is that certain dog breeds may grow faster than average, therefore it is possible that too much exercise may negatively impact bone growth,

Medical Conditions

Cranial cruciate ligament rupture or pain has been commonly associated with patella luxation.

Luxating Patella Dog Symptoms

Before treatment options are considered, veterinarians will often conduct a physical exam in order to determine the severity of the luxating patella. The severity of patella luxation is often divided into four grades which include:

 Grade 1: Dogs with grade 1 luxation do not experience severe pain. While their kneecap does slide out of place, it can actually easily manipulate (massaged) back into place without surgical intervention.

Grade 2:  Dogs with grade 2 luxation often feel pain when their patella falls out of place, these dogs also may develop associated problems such as arthritis. Despite this, the patella can be massaged back into place—temporarly!

Grade 3: Dogs with grade 3 luxation will constantly remain in pain and can develop severe arthritis. The kneecap will slide outside the groove most of the time, but fortunately, it can be manipulated back into place. 

Grade 4: The patella cannot be physically manipulated back into place, therefore the dog will have a “bow-legged” appearance and will remain constantly in pain.

Common symptoms associated with patella luxation include:

• A popping noise may be heard in the dog’s knee
• The dog will avoid bearing weight on the affected leg
• The dog will be in pain
• Abnormal gait

Which Dogs Are Prone to develop Luxating Patellas?

Unfortunately, if you own a small or toy dog then you’re in for a real problem. It seems as though luxating patellas are most commonly seen in small breed dogs. This includes:

• Pomeranian
• Chihuahua
• Pekingese
• Miniature Poodle
• Yorkshire terrier
• Toy Poodle
• Basset Hound
• Boston terrier
• Lhasa Apso
• Shih Tzu
• Carin Terrier
• Cocker Spaniel
• Papillon
• American pit bull terrier

Now, recent research has indicated that even large dogs can be quite prone to developing luxating patellas. Large breeds at risk of patella luxation include the:

• The Great Pyrenees
• Labrador
• Golden Retriever
• German Shepherd
• Newfoundland
• Cane Corso
• Great Dane

Luxating Patella? Yorkies Know All About It

A luxating patella as mentioned is quite prevalent in small dogs such as Yorkies! In one study, it was found that 26% of Yorkies were affected by Patella Luxation.

Treatment Options for a Luxating Patella in Dogs

There are many treatment options available for a luxating patella. Here, we will go through the most common treatment methods performed in veterinary medicine.

Quadriceps femoris realignment surgery: The goal here is to actually move part of the tibial tuberosity towards the tibia bone itself, here veterinarian surgeons aim to reposition the patella bone with the groove within the femur. This procedure of realignment is referred to as tibial tuberosity transposition.

Deepening the Trochlea groove: As the name suggests, here surgeons will simply deepen the groove at which the patella may be sliding against.

Femoral osteotomy surgery: During this surgery, the femur bone is cut above the knee joint, and restabilized with pins and screws.

Now, the actual process of surgery can be quite complicated and will require the use complex of veterinary equipment, including advanced veterinary surgery tables

Now, if your dog has grade 1 or grade 2 patella luxation, then your veterinarian may simply recommend non-surgical methods of treatment. The most common methods include a knee brace, supplements, and physical manipulation.

Luxating Patella Treatment: Non-Surgical

Perhaps All Your Dog Needs is a Luxating Patella Dog Brace

Canine knee braces are a common method of treatment, that are often used to stabilize the stifle joint. Knee braces are an alternative to surgery and they can help with all sorts of problems, including cranial cruciate ligament rupture.

The Dog Knee Brace for Luxating Patella

Dog knee braces can be quite beneficial for dogs suffering from a luxating patella. Canine knee brace by neoprene is a knee brace available for purchase without a veterinary prescription. But, it is important to remember, that you need to consult your veterinarian in order to properly diagnose and grade your dog’s patella luxation.

Look into Luxating Patella Dog Supplements

It’s plausible to suggest that proper minerals and nutrients are essential for bone health. This means that you should look into supplementing nutrients that will ensure your dog has proper collagen synthesis, a supply of antioxidants, and proper bone growth.

Give Your Dog a Luxating Patella Massage

Massaging your dog’s knee joint can also be a great way to move the patella back into correct position. This will not only improve the mobility of your dog, but it will also decrease any pain and stiffness your dog may have. Talk to your vet on how you can manipulate your dogs patella.

When Luxating Patella Treatment Requires Surgery: What You Should Know

Many severe cases of patella luxation will require surgery, so here we have listed all you need to know about the costs of surgery. Remember, that the surgery itself is not the only cost you should expect. Remember, that the post-op care can be quite expensive too, this may involve, hydrotherapy, physiotherapy, vet visit check-ups, and medication.

Patellas Don’t Come Cheap! Luxating Patella Surgery Cost

The cost for treating a luxating patella will depend on many factors such as the region you live in, the individual veterinary prices, and the grade or type of luxating patella.  In general, you can expect to be quoted anywhere starting from $1,980 for a unilateral medial patella luxation or $2,980 for a bilateral medial patella luxation.

Luxating Patella Surgery Cost 2015 vs Luxating Patella Surgery Cost 2016

The cost of a luxating patella surgery for the years 2016 to 2017, can be estimated between $2,300 to $2,700 if the dog is less than 40 lbs.  Now, the cost of a luxating patella surgery during the year 2015 to 2016 is estimated to be about the same as well.

Luxating Patella Dog Surgery Costs and Pet Medical Aid

Pet medical aid simply refers to the “pet insurance” plans that are available to help you cover the costs of a luxating patella surgery. Some, insurance companies quote that the average cost of the surgery can be anywhere between $1,500 to $3,000 depending on your dog’s size and severity.

Know the Risks! When Luxating Patella Surgery Costs More than Money

Orthopedic surgery can get quite expensive for pet owners! This is because orthopedic surgery is not only complicated, but any post-op care will require patience and owner compliance.  Any surgery—be it the soft tissue or musculoskeletal, can be risky! Potential risks that can occur with orthopedic surgery include:

• migration of surgical implants—that is, the pins used to stabilize the tibial tuberosity, can migrate to the wrong spot.
• Anesthesia complications are a common risk
• Surgical infection
• An inability for the dog to completely recover

The Luxating Patella Surgery Success Rate

In 2016, a study looked at the overall outcomes of grade 4 medial patellar luxation surgery. They concluded that the generalized success rate for luxating patella surgery is 93%

Luxating Patella Surgery Recovery Time

With proper care and exercise, pets can begin properly using their recovering leg within 6 to 8 weeks of surgery.

Poor Pup! Medially Luxating Patellas are No Fun!

Medial Luxating Patellas are more commonly seen in veterinary practice as opposed to lateral patella luxation. The medial luxating patella is prevalent in 98% of small breeds, while lateral luxating patella may be slightly more common in large dogs. Regardless, veterinarians and researchers strongly believe that any medial luxating patella problems are strongly associated with skeletal deformities.

3 Tips to Help Speed Up Luxating Patella Dog Surgery Recovery

1. Post surgery improves your dog’s diet by providing nutrient-rich food high in vitamins and minerals.
2. Avoid intensive exercise and activity. Your dog needs time to rest and recover, keep walking to a minimum, don’t allow your dog to run or jump up onto places.
3. Invest time in physiotherapy and hydrotherapy. Exercising your dog in water will allow pressure to be taken off their joints.

Ways to Avoid Patellar Luxation

The only real way you can avoid patellar luxation is to simply not breed dogs who carry the genes for this disorder. Patella luxation is strongly genetically linked, therefore some dogs may simply be born with it. Now, if you’ve got a pooch who is classed as an “at-risk” dog, then the best thing you can do is to:

• prevent your dog from getting overweight
• feed your dog healthy food
• Avoid intensive physical activity

Luxating Patella In Dogs Can Be Painful but treatable

Patella luxation is a common problem seen in a handful of dog breeds. However, the disease is treatable and does have a success rate of over 90%. Remember, if you think your dog has patella luxation then talk to your vet about the treatment options available to you.