Patellar Luxation = "Dislocating Kneecaps"

Degree of luxation is graded on a scale of 1-4.  Notice the kneecap on the middle x-ray on the left side is not sitting in the center groove but riding on the inner side of the femur (thighbone)

Dogs under 30 lbs.  Case Study "Lucy"

This is a fairly common condition in little dogs.  We grade the degree of luxation on a scale of 1-4.  Grade 1-2 usually are asymptomatic, Grade 3-4 may or may not require surgery to achieve acceptable function and prevent arthritis. Surgery involves moving the crest of bone where the tendon attaches back to center alignment, deepening the groove, and tightening the tissue on the outer part of the knee to keep the patella riding in the center.  Typical recovery is rest and range of motion exercises for 2 weeks, then a slow to return to normal over 4 more weeks.  Over 90% of dogs achieve near normal function for life. 

Lucy had been lame for nearly 2 years when she finally was brought in.  Although it took more rehab than expected due to not using her leg correctly, she has recovered completely and now enjoys activities she was not able to do 6 months ago!

Dogs over 30 Lbs.  Case Study "Huck"

Dr. Katie is pioneering new research in this area due to up to 25% of dogs this size rupturing the ACL ligament in the repaired leg several years down the line. Many larger dogs are lame even with a grade 1-2 luxation patella and usually will need it repaired to be able to use the leg comfortably.   Dr. Katie is certified for TTA and uses that theory and hardware to realign the quadriceps mechanism and prevent strain on the ACL by advancing the crest slightly.  Results so far have been excellent.  Although there is a slight increase in initial cost, it should prevent a second very costly surgery later by preserving the ACL.  Recovery is similar to what we see in smaller breeds as in 4-6 weeks of slow increase in activity and return to normal function in over 90% of dogs for life.

Huck had an injury as a young puppy causing a severe luxation and formation of a false knee joint.  Even though he is approaching 2 years old he was a good candidate for the new modified procedure.  Huck spent one night in the hospital and walked out nearly 80% on his leg already the next day even though you can see extensive remodeling to re-align his knee and repair the joint.  We expect this surgery to limit the amount of arthritis and give him full use of his leg to chase lots of squirrels!

Links to excellent write-ups regarding Patellar Luxation and repair.

http://www.acvs.org/AnimalOwners/HealthConditions/SmallAnimalTopics/MedialPatellarLuxations/

http://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=2448&EVetID=3001459