Luxating Patella in Dogs

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Luxating Patella in Dogs

Luxating patella is a common orthopedic condition that can occur in dogs. In fact, according to the American College of Veterinary Surgeons, (ACVS), the condition occurs in about seven percent of all puppies.

The patella is the kneecap, and if it moves out of its correct alignment, the condition is referred to as luxating patella. Normally, the patella sits in the grove called the tibial crest. This position allows the kneecap to move up and down when the knee is bent. The action of the patella helps guide the movement of the muscles in the lower leg called the quadriceps.

But in some dogs, the patella luxates, which means it moves outside the grove. This dislocation of the patella from its correct position causes the leg to lock up.

 

Causes of Patellar Luxation

In some instances, luxating patella can develop as the result of an injury, such as trauma to the knee. But in other cases, the cause of the condition is not known. It may occur due to a congenital defect.

Congenital defects, which may contribute to luxating patella are thought to involve skeletal abnormalities, such as a long patella ligament, malformation of the tibia and hip dysplasia.

According to the Colorado State University, luxating patella is more common in smaller breeds under 30 pounds including:

When the condition does occur in larger dogs, it tends to be more common in the following breeds:

Symptoms

Depending on the grade, some dogs may not have any symptoms. When symptoms do occur, they may include limping and lameness, which may come and go.  Lameness refers to a disturbance in gait or stance. Lameness may occur because of pain or abnormal anatomy. Dogs with luxating patella may also skip when they run.

According to the Orthopedic Foundation for Animals, one of the most common symptoms is a knock-knee stance. In some cases, your dog may also yelp in pain, especially when the dislocation initially occurs.

Some dogs may shake or hold up their affected leg to lengthen the quadriceps, which helps the patella return to the correct anatomical position. Usually, the more severe the grade of the disorder, the more likely your dog is to have symptoms. For example, dogs who only have symptoms occasionally, may start to have more frequent and consistent symptoms as the condition progresses.

In more severe cases, complications of luxating patella can develop. The pain can become more severe, which limits activity. The cartilage of the knee can wear away resulting in osteoarthritis. Inflammation can also occur, which may breakdown the ligament.

Another potential complication in severe cases is rupture of the cranial cruciate ligament. The dislocation of the patella can lead to changes in the way the knee moves, which stresses the ligament.

 

Diagnosis

Diagnosis sometimes occurs after a routine visit to the vet. During a physical exam, the veterinarian may discover the condition. In other instances, symptoms may be present, which prompt a trip to the vet. The veterinarian will perform an exam and can often diagnose the condition after feeling the unstable kneecap. In some cases, additional tests may be performed preoperatively if surgery is recommended.

X-rays of the knee and possibly the pelvis to determine the extent of the disease and whether hip dysplasia is present may be done. X-rays are generally quick and are painless for your pup. A CT scan is also sometimes used. A CT can provide three dimensional images of the leg and may be helpful, especially if surgery is performed.

Once a diagnosis is made, the condition is usually classified into one of four grades based on the severity. The grades include the following:

  • Grade 1: The patella may be manually moved out of the grove. But it returns to its normal position without intervention.
  • Grade 2: The patella may spontaneously slip out of the grove occasionally or can be manually luxated, but it can be manipulated back into position.
  • Grade 3: The patella remains out of the grove most of the time, but it can be manipulated back into position.
  • Grade 4: The patella is out of the grove all the time and it cannot be manipulated back into position.

Treatment of Patellar Luxation

Not all dogs will who have luxating patella will require treatment. Dogs who do not have any symptoms may just be monitored. Some dogs, especially small dogs, may live a normal life and function fully without treatment.

In other instances, medical management of luxating patella classified as grade one may be an option for dogs who have symptoms. Medical management involves non-surgical approaches to treating the condition.

Medical management may include non-steroidal medication, which treats inflammation and pain. Keeping your dog at a healthy weight to decrease strain on the knee is also recommended. Physical exercises to strengthen the quadriceps may also be an option.

In dogs who have more advanced disease and are classified as having grade two, three and four luxating patella, surgery may be the best treatment option. There are a few different surgical approaches, which may be used. One procedure is referred to as trochlear modification. The procedure involves creating a deeper groove in the femur to hold the patella in place better.

Another surgical approach involves repositioning the patellar ligament and attaching it to the tibia crest on the opposite of the luxation. Keep in mind, if there is underlying damage to the knee due to arthritis, luxating patella surgery does not reverse arthritic changes.

How well a dog responds to treatment may depend on the severity of the disease and the age at diagnosis. Recovery from surgery may also vary based on the type of procedure. In most cases, a dog will use the affected leg well after about six to eight weeks.

Prognosis for most dogs with luxating patella is good. But there are potential risks to surgery. Although anesthesia is usually safe, there is a possibility of complications from the anesthetic. With most surgeries, there is also a risk of infection. If your dog is too active during the recovery time, it’s also possible the repair can breakdown. Following your vet’s post-operative instructions decreases the chances of complications.

 

How Much Is Luxating Patella Surgery for Dogs?

The cost of surgery to correct your dog’s luxating patella depends on the severity of the condition, age and size of your dog and where you live. Veterinary surgery costs vary widely depending on the cost of living in your zip code. With that said here is the average cost for knee surgery for dogs.

Luxating Patella Dog Surgery Cost: $1,500 to $3,000

 

Incidence by Dog Breed

Each dog breed has unique genetic makeup that causes them to be more or less susceptible to patellar luxation. Here is a list of breeds from the Orthopedic Foundation for Animals. You can also visit the American College of Veterinary Surgeons to learn more about luxating patella dog surgery.

BreedAffected# Evaluations
Pomeranian37.2%725
Yorkshire Terrier24.1%643
Australian Terrier18.9%206
Cocker Spaniel13.6%944
Tibetan Spaniel12.4%185
English Toy Spaniel11.5%131
Mi-Ki10.8%222
Boykin Spaniel10.7%280
Japanese Chin9.2%229
Chow Chow8.5%483
Bedlington Terrier8.5%117
Eurasier8.2%73
Portuguese Podengo Pequeno7.4%95
Toy Fox Terrier6.6%212
Scottish Terrier6.5%446
Lowchen6.3%63
Lhasa Apso6.1%132
Chinese Shar-Pei6.0%367
Shiba Inu6.0%1,558
Boston Terrier5.9%2,210
French Bulldog5.8%1,817
Cardigan Welsh Corgi5.7%53
Chihuahua5.7%1,446
Norfolk Terrier5.6%320
Pug5.5%595
Shetland Sheepdog5.5%110
Tibetan Terrier5.4%185
Norwich Terrier5.3%827
Coton De Tulear5.2%1,552
American Eskimo Dog5.1%98
Petit Basset Griffon Vendeen4.9%61
Biewer Terrier4.7%150
Dachshund4.7%494
English Bulldog4.6%1,076
Brussels Griffon4.5%89
Bichon Frise4.5%2,043
Labrador Retriever4.2%909
Silky Terrier4.0%200
Poodle3.9%2,639
Rat Terrier3.9%1,172
West Highland White Terrier3.8%419
Affenpinscher3.8%264
Schipperke3.6%421
Chinese Crested3.4%611
Puli3.3%184
Cairn Terrier3.2%189
Beagle3.1%127
Papillon3.1%1,546
Siberian Husky3.1%64
Havanese3.1%4,915
Maltese2.9%276
Pharaoh Hound2.8%180
Soft Coated Wheaten Terrier2.7%256
Bloodhound2.7%150
Brittany2.6%116
Border Terrier2.5%1,585
Italian Greyhound2.5%808
Keeshond2.4%1,086
Pitbull Terrier2.4%127
Miniature Pinscher2.2%185
Finnish Spitz2.2%89
Havana Silk Dog2.1%238
Cavalier King Charles Spaniel2.1%5,597
English Cocker Spaniel2.0%589
Alaskan Klee Kai2.0%406
Cockapoo1.9%104
Canaan1.9%105
American Hairless Terrier1.9%157
Miniature Bull Terrier1.9%54
Shih Tzu1.9%485
Russell Terrier1.9%103
Wire Fox Terrier1.9%52
Pyrenean Shepherd1.8%111
Norwegian Elkhound1.6%63
Cane Corso1.6%63
Flat-Coated Retriever1.5%2,272
Dogue De Bordeaux1.4%210
Bernese Mountain Dog1.4%146
Akita1.4%956
Boxer1.3%75
English Springer Spaniel1.3%237
Mixed Breed Dog1.3%856
Golden Retriever1.3%833
Smooth Fox Terrier1.2%247
Finnish Lapphund1.2%86
American Pit Bull Terrier1.2%248
Rhodesian Ridgeback1.2%162
Greater Swiss Mountain Dog1.2%498
Australian Shepherd1.2%487
Nova Scotia Duck Tolling Retriever1.1%277
Great Pyrenees1.1%748
Rottweiler1.0%609
Black Russian Terrier1.0%194
Australian Cattle Dog1.0%197
Basenji0.9%351
Miniature Australian Shepherd0.9%427
Parson Russell Terrier0.8%365
American Staffordshire Terrier0.8%383
Newfoundland0.7%1,900
Kuvasz0.7%148
Labradoodle0.7%271
Great Dane0.7%142
German Shepherd Dog0.7%273
Field Spaniel0.7%143
Border Collie0.6%158
Bouvier Des Flandres0.3%344
Mastiff0.3%2,693
Miniature Schnauzer0.0%164
Briard0.0%66
Pembroke Welsh Corgi0.0%150
Staffordshire Bull Terrier0.0%103
Welsh Terrier0.0%75
Belgian Shepherd Tervuren0.0%58
Belgian Shepherd Malinois0.0%115
Chesapeake Bay Retriever0.0%81
Doberman Pinscher0.0%63
 

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