Medial luxating patellas is a common issue in toy breed dogs. Often an owner will report that the dog holds a hind leg up for a few steps and then will place it back down as if there was never a problem - in a toy dog this is a tell tale sign of medial patella luxation
So what actually happens in a dog with a luxating patella. In short the kneecap (patella) has temporarily slipped out of the normal groove it sits in. This means the hind leg can't straighten and the dog cannot bear weight on it. In most dogs with this condition this is only fleeting and the knee cap will then flick back to it's usual position and the dog will bear weight and gait normally. There are some dogs where the knee cap is out of the groove more than it is in or may even remain out of it's normal position permanently.
This can occur in one or both knees.
Grading of patella luxation
The severity of this condition is graded 1 - 4. This gives the clinician an idea of which patient may benefit from surgery
Grade 1 - the kneecap can be moved out manually but will return immediately to it's normal position in the groove
Grade 2 - The knee cap will slide out of the groove spontaneously at times but will return to the groove on it's own
Grade 3 - The knee cap is permanently out of position but can be moved manually to sit within the groove
Grade 4 - The knee cap is permanently out of position and cannot be removed to it's normal position.
The malpositioning of the patella not only leads to local arthritis but also a change in load bearing leading to biomechanical changes that can affect the whole body.
When is rehabilitation appropriate?
Rehabilitation should be performed in all post surgical patients.
Rehabilitation is often worthwhile as a conservative approach before attempting surgery. Biomechanical changes may be achieved with manual therapies and home exercise programs which may lead to an improvement in the condition.
When is surgery appropriate?
This question is not really easy to answer. Many patients cope quite well with this condition without surgical intervention. There is however certainly a number of patients that would benefit from surgery. Your vet, specialist surgeon or rehab practitioner can help you decide when surgery is the right path.
Treatments offered by Balance Vet Rehab that may be beneficial for these pets include:
BalanceVet can advise you if surgery is an appropriate option for your pet. Referral to the best qualified surgeon is available when needed.
This is a worthwhile consideration in conservative management of these dogs. We may achieve biomechanical changes that may result in benefits. More studies are needed to support use of this treatment in medial patella luxation
This is a worthwhile consideration in conservative management of these dogs. We may achieve biomechanical changes that may result in benefits. More studies are needed to support use of this treatment in conservative medial patella luxation.
For pets with luxating patella who have had surgery rehabilitation should be part of the overall treatment plan.