If you’re the owner of a toy or miniature breed dog, luxating patella is something you’re likely to encounter at some point. This condition, where the kneecap dislocates from its normal groove, is particularly common in smaller breeds like Chihuahuas, Yorkies, and Maltese.

When it happens, many veterinarians suggest surgery as the only viable solution. While surgery can be necessary in severe cases, it’s not always the best or only option.

The good news is that many dogs with luxating patella can live happy, pain-free lives without undergoing surgery. By focusing on a combination of proper nutrition, controlled exercise, weight management, and natural therapies, pet parents can often manage the condition effectively.

Today, I'll explore what luxating patella is, what causes it, and how you can help your dog thrive without going under the knife.

What Is Luxating Patella?

The patella, or kneecap, is a small almond-shaped bone located within the knee joint. It serves as part of the “extensor mechanism,” which allows your dog to flex and extend their leg smoothly. When functioning properly, the kneecap glides up and down a groove in the thigh bone called the femoral groove.

Luxating patella occurs when the kneecap slips out of this groove, becoming temporarily or permanently dislocated. Think of it like a “trick knee” in humans—it can cause awkward movement and discomfort when it happens. In dogs, this misalignment can interfere with the knee’s ability to extend, leading to limping, hopping, or an abnormal gait.

Repeated dislocation of the kneecap can do more than just cause limping. Over time, it wears down the cartilage within the joint and can cause chronic inflammation. Left untreated, luxating patella may lead to arthritis and damage to the cranial cruciate ligament (CCL), a key stabilizer in the knee. Once the CCL is compromised, your dog is at higher risk for reduced mobility and significant joint pain.

Causes And Types Of Luxating Patella

Luxating patella is often genetic, meaning certain dogs are born with physical traits that predispose them to the condition. A shallow femoral groove, malformations in the tibia or femur, or imbalances in muscle strength can all contribute to the kneecap slipping out of place. In some cases, tight or weakened quadriceps muscles may pull the patella out of alignment.

While genetics are the leading cause, trauma can also result in a luxating patella. A sudden injury, such as a fall or overexertion during exercise, can dislocate the kneecap and cause lasting issues.

There are also a few different types of luxation to be aware of...

1. Medial Luxation: The most common type of patellar luxation, medial luxation, occurs when the kneecap slips toward the inside of the knee. This form is almost always congenital and seen in smaller breeds, often as early as puppyhood. Over half of dogs with medial luxation experience it in both knees.
2. Lateral Luxation: Lateral patellar luxation is more typical in larger or giant breeds. This occurs when the kneecap slips toward the outside of the knee. In small breeds, lateral luxation is often caused by tissue degeneration and occurs later in life, between 5 to 8 years of age. For large breeds, it’s frequently linked to structural problems like hip dysplasia.
3. Trauma-Induced Luxation: Although less common, traumatic luxation can occur in any dog, regardless of breed or size. A hard blow or injury to the knee joint may force the kneecap out of its groove, leading to sudden and severe lameness when the patella luxates.

By understanding the causes and types of luxating patella, you can better assess your dog’s risk factors and take proactive steps to support his joint health.

Recognizing Signs And Symptoms

Wondering if your dog has luxating patella?

One of the earliest signs of a luxating patella is an abnormal gait. You might notice your dog "skipping" steps, hopping on one leg, or occasionally limping, especially after activity. Some dogs develop a bow-legged stance, and in severe cases, their knees may fail to extend fully. As the kneecap dislocates, you might even hear a faint clicking sound as it slips out of alignment.

Keep an eye on how your dog sits—dogs with luxating patella often sit with their knees pointing outward at an unusual angle. These visible indicators, while subtle at first, can become more pronounced over time, especially if the condition progresses.

Luxating patella symptoms vary depending on the grade of the condition:

• Grade I: Mild cases where the kneecap can be manually shifted out of its groove but returns to its normal position on its own. Dogs in this category may show no visible symptoms or only occasional limping.
• Grade II: Moderate cases where the kneecap dislocates more frequently but can still be manually manipulated back into place. You might notice your dog limping more often or hesitating during physical activity.
• Grade III and IV: Severe cases where the kneecap is permanently dislocated, with Grade IV being the most extreme. Dogs in these categories often experience chronic pain, limited mobility, and noticeable joint deformities.

As dogs age, even a mild luxation can progress into a more severe stage due to increased wear on the joint. Pay close attention to any changes in your dog’s movement or posture, particularly if they belong to a breed prone to this condition.

Is Surgery Necessary For Luxating Patella In Dogs?

When a luxating patella progresses to Grade II or higher, many veterinarians recommend surgery.

Common surgical procedures include:

• Tibial Tuberosity Transposition: This procedure repositions the bone where the kneecap’s tendon attaches to improve alignment and reduce stress on the joint.
• Femoral Varus Osteotomy: Used in cases where the thigh bone is bowed, this surgery reshapes the femur to improve patellar stability. It’s more common in larger breeds.
• Recession Sulcoplasty: This involves deepening the femoral groove so the kneecap can glide properly. It’s often paired with soft tissue reconstruction to tighten or loosen specific ligaments.

These surgeries aim to realign the quadriceps mechanism, ensuring the patella remains stable within its groove.

While surgery can be effective, it’s not without risks. Complications may include patellar reluxation, implant failure, infection, or fractures in the repaired bones. Research suggests that 18% to 51% of dogs experience post-surgical complications, and bilateral procedures (operating on both knees simultaneously) carry an even higher risk.

Recovery is also lengthy and demanding, typically lasting 8 to 12 weeks. During this time, dogs require restricted activity, including crate confinement and on-leash potty breaks. Follow-up visits, potential rechecks with x-rays, and physical therapy are often necessary to ensure proper healing. Surgery may restore function for many dogs, but it’s a commitment that requires careful consideration.

Managing Luxating Patella Without Surgery

If you choose not to go the surgical correction route, there are still other ways to give your dog relief.

Here are a few options to consider.

Nutritional Strategies

Diet plays a crucial role in supporting joint health and managing luxating patella. A raw, whole-food diet rich in anti-inflammatory nutrients can help strengthen connective tissues. Key vitamins like C (for collagen synthesis), E (as an antioxidant), and B-complex (to support ligament health) are essential. Minerals like manganese, selenium, and calcium also contribute to maintaining strong bones and cartilage.

Adding supplements can provide additional joint support. Omega-3 fatty acids help manage inflammation, while chondroitin sulfate and MSM (methylsulfonylmethane) promote cartilage repair and reduce pain. Incorporating these into your dog’s diet can help slow the progression of the condition and reduce discomfort.

Weight Management

Excess weight puts unnecessary strain on your dog’s joints, making luxating patella symptoms worse. Maintaining a lean body condition is one of the most effective ways to minimize stress on the knees.

A fresh, raw diet is an excellent choice for weight management, as it avoids the high starch content found in kibble. Regular weigh-ins and portion control are critical to ensuring your dog stays fit and mobile.

Exercise and Physical Therapy

Controlled exercise can help strengthen the muscles surrounding the knee, providing better support for the joint. Activities like sit-to-stand drills and stair climbing improve quadriceps strength, while underwater treadmill sessions or swimming offer low-impact ways to build muscle.

It’s important to find the right balance—while regular movement is beneficial, overexertion can worsen symptoms. Working with a canine physical therapist can provide your dog with a tailored exercise program to enhance joint stability and prevent further complications.

Preventative Measures And Lifestyle Changes

There are also a few things you can do to help your dog age healthily and avoid problems like luxating patella in dogs. It all starts with a few strategies for supporting joint health over time.

Minimizing Risk Factors

Protecting your dog from luxating patella starts with reducing factors that contribute to joint degradation. Over-vaccination can create antibodies that harm connective tissue, which is essential for stabilizing your dog’s joints. By sticking to only necessary vaccines, like rabies every three years, you can limit potential damage to collagen and other joint-supporting structures.

Reducing exposure to environmental toxins also plays a crucial role. Use natural cleaning products, avoid chemical-laden lawn treatments, and opt for toxin-free shampoos and grooming supplies. A more natural lifestyle helps support overall health, keeping your dog’s joints strong and inflammation at bay.

Hands-On Care

Complementary therapies like chiropractic adjustments, acupuncture, and massage therapy can make a big difference for dogs with luxating patella. These treatments improve structural alignment, reduce pain, and enhance mobility. Regular chiropractic care can help maintain proper joint alignment, preventing further stress on the knees.

Acupuncture and massage work together to relieve muscle tension, reduce inflammation, and promote blood flow to affected areas. For dogs already showing symptoms of luxating patella, these therapies can be a gentle and effective way to manage discomfort and improve quality of life.

Screening Breeders

If you’re considering bringing a new puppy into your family, researching breeders is key to avoiding hereditary joint issues. Ask breeders whether the parents are certified by the Orthopedic Foundation for Animals (OFA). Dogs with a history of luxating patella should never be bred, and breeders with OFA certification ensure their breeding stock has been evaluated for joint health.

You can also search the OFA’s online database to confirm the health records of your puppy’s lineage. While OFA certification doesn’t guarantee a dog will never develop luxating patella, it significantly reduces the risk. A little extra research upfront can save you and your dog from future joint problems.

Long-Term Conditions Related To Luxating Patella

Though primarily affecting the esophagus, megaesophagus (ME) can sometimes co-occur with joint issues like luxating patella in certain breeds. ME weakens the esophagus muscles, making it difficult for dogs to swallow food and water. Breeds like Yorkies and Miniature Pinschers are particularly prone to both conditions, highlighting a possible link between hereditary musculoskeletal weaknesses.

If your dog struggles with both conditions, feeding adjustments like raised feeding platforms or soft, easily digestible foods can help. ME may not directly impact the knees, but its presence underscores the importance of managing overall health comprehensively.

Addison’s disease, a condition where the adrenal glands fail to produce sufficient cortisol, can indirectly influence joint health. Cortisol plays a role in regulating inflammation, and without proper levels, chronic inflammation can weaken joints over time.

Dogs with Addison’s may be more prone to connective tissue breakdown, exacerbating conditions like luxating patella. Monitoring your dog’s hormonal health and addressing underlying inflammation through diet and supplements can mitigate these risks.

Practical Steps For Supporting Joint Health

Supporting your dog’s joint health starts with simple, everyday practices. Invest in joint-supportive tools like harnesses to reduce strain during walks and orthopedic bedding to cushion their joints while they rest. These small changes make a significant difference, especially for older dogs or those prone to luxating patella.

Consistency is key—establish routines that include short, gentle walks and controlled exercise to keep muscles strong without overexertion. Pay attention to your dog’s comfort during activities, avoiding anything that causes visible pain or limping.

A holistic veterinarian can be an invaluable partner in managing luxating patella. They can help customize a care plan that includes non-surgical interventions like dietary adjustments, supplements, and alternative therapies. From acupuncture to physical therapy, holistic vets often provide options that traditional approaches may overlook.

FAQ

How long can a dog live with luxating patella? Dogs with grade I patellar luxation or grade II patellar luxation can often live full, happy lives with proper management, including diet, exercise, and weight control. However, severe patellar luxation, especially when affecting one or both knees, may lead to degenerative joint disease, impacting a dog's mobility and quality of life over time.

How do you treat patella luxation in dogs? To correct patellar luxation, treatments range from non-surgical options like weight management, supplements, and targeted exercises for the quadriceps muscle, to surgical correction for more severe cases. Therapy for patellar tendon and joint capsule alignment can help stabilize the knee, especially in small breed dogs prone to this condition.

Can a dog recover from a luxating patella without surgery? Yes, many dogs with grade I patellar luxation or medial patellar luxation manage well without surgery by focusing on joint-supportive diets, controlled activity, and supplements for cartilage health. Avoiding aggravating activities and keeping the shin bone aligned with proper exercise can help prevent progression of the condition.

Should you walk a dog with luxating patella? Walking a dog with dogs luxating patella is beneficial for strengthening the quadriceps muscle, which helps stabilize the kneecap. Avoid high-impact activities for large breed dogs or situations where lateral luxation occurs due to a traumatic injury, as this may worsen the condition.