Luxating patella is a condition where the kneecap (patella) moves out of its normal position, usually by imbalanced forces from the muscles down the hip and leg. Luxating patella is one of the most common knee joint abnormalities of small breed dogs, but it is only occasionally seen in cats. It may affect one or both of the knees. In most cases it moves (luxates) towards the inside of the knee, although it does rarely luxate towards the outside of the knee. Luxation to the inside of the knee is the most common form seen; it is most commonly seen in the small or miniature breeds of dogs such as Poodles, Maltese, Yorkies, and Chihuahuas. Luxations towards the outside of the knee are seen less frequently. It can be present in many breeds, but is seen especially in Newfoundlands in our canines. The lateral luxation is also the most common form seen in our equines.
There are four grades of patellar luxation:
• Grade I- the kneecap can be manually luxated but the kneecap returns to its normal position when the pressure is released. This is often non-problematic, but must be monitored as it can progress to higher levels.
• Grade II- the kneecap can spontaneously luxate out of position with just normal movement of the knee. This is often during a tightness of the quadriceps and can “pop” over the ridge of the patellar groove and be painful. This level may or may not need treatment but must be monitored.
• Grade III- the kneecap remains luxated most of the time but can be manually reduced into the normal position. This is commonly a continual level of discomfort to some degree but can develop into quite painful arthritic changes in the knee if left unattended.
• Grade IV- the patella is permanently luxated and cannot be manually repositioned. This is a condition that developed when the puppy was in utero and the abnormal muscular balance placed the patella laterally as the leg formed and then the quadriceps tightened down disallowing it to return to proper placement.
Dogs frequently start with a Grade I or Grade II and worsen over time to a Grade III or IV. Many people are not aware their pet is affected, but a luxating patella can cause pain. Owners may see the pet limp on a rear leg, or they may see them shake or stretch a rear leg to try to snap the kneecap back into place.
Evaluation by a practitioner for massage and “chiropractic” adjustments can ease the tightness along the leg and take the pressure off of the knee to let it function in a more natural manor. Correcting the nerve imbalance along the spine brings the reason the muscles are imbalanced back into a healing condition. Some pets can be reduced to a manageable condition with just adjustments and massage, while others may still benefit from surgery. Grade IV requires surgery.
The addition of nutritional supplements will also benefit these pets to help rebuild cartilage in the knee as well as to reduce inflammation and pain of the muscles as well as the surrounding joint tissues.