luxting patella

What is luxating patella?

Luxating Patella in dogs, also known as slipping kneecap or floating kneecap, occurs when the patella dislocates outside of its normal stabilising trochlea groove – a depression on the front of the femur which is meant to provide a ridge in which the patella sits. This can happen in one, or in both of the hind limbs. In most occurrences, in small breeds, the movement occurs medially (toward the inside of the limb). The movement can be laterally, however this is less common and occurs mainly in larger breeds. There are 4 grades of this orthopaedic condition:

1 - Patella luxates and returns to normal position
2 - Patella luxates when stifle is flexed and remains in this position until the stifle is extended.
3 - Patella is luxated for a majority of the time, can be manually replaced but will luxate again after a short period of time.
4 - Permanent luxation. Patella stays misaligned and will not sit in its groove even for  short periods of time.

how does it progress?

From the first occurrence of the condition, which may result in a dog skipping for a few steps while walking, the progression, as the condition gets more severe, will include shaking and or extending the leg prior to relocation of the patella. As the condition progresses further in severity or duration the lameness will become more severe and can become continuous. The appearance of the limb will also take on a bow legged appearance, in small breeds, and a “knocked out” knee appearance in the larger breeds. 

There are several treatments available for this condition, depending on the severity. These include, massage therapy and physiotherapy for grade 1 and grade 2 conditions. In grade 3, occasionally, and grade 4 luxations surgical intervention is required to reposition the patella and likely alteration of the surrounding bone and tissue to help the patella stay in position.

Image from Rehab Vet. Please note that BelMar Canine Massage Therapy is not affiliated with Rehab Vet.

what causes luxating patella?

There are various causes for luxating patella however the primary cause of it would be selective breeding, where this is a consequence of requiring a bow legged appearance to a breed, meaning it is primarily genetic. Other causes are:

  • Laminate flooring - where the legs cannot maintain grip and slide around this can increase the frequency of dislocations

  • Persistent standing on the back legs can also cause more instances of this condition

  • A trauma to this area of the hind limb can also cause the patella to dislocate

  • Certain dog breeds have a predisposition to this condition, such as Maltese, Chihuahua, French Poodle and Bichon Frisé

what are the symptoms and signs?

The onset of this condition will be skipping when walking, shaking of the limb as well as extended extension of the limb to reposition the patella. Other symptoms include:

  • Pain in and around the area

  • Lameness

  • A distinct ‘clicking’ around the knee

  • Stiffness around the joint

  • Altered gait, for instance walking in a crouched position and being unable to fully extend the affected leg

  • Altered posture when standing, fir instance ‘bowed legs’ and ‘knocked out’ knees

If there is a problem with the patella and the stifle joint it can have an affect on the group of quadriceps muscles (rectus femoris, vastus madialis, vastus lateralis and the vastus intermedius) as it creates an abnormal pull on the quadriceps. This can then also lead to other structures in the stifle joint being affected by the altered movement. Other muscle groups that can affected are the medial muscles of the thigh (sartorius) and the caudal muscles of the crus (gastrocnemius and the flexor digitorum superficialis)

how can massage help with luxating patella?

Canine Massage can seriously help dogs with Grade 1 luxating patella and may even help reduce the possibility of your dog needing surgery to rectify. Your dogs verterinarian would be required to reassess the patella and i will provide a full report after the massage sessions so that they can comprehensive notes on the treatment i have provided. Being part of the Canine Massage Guild, and with the training i have been given, i have the ability to specifically deal with this issue by using a range of soft tissue techniques in and around the area, on the soft tissue related to the patella. Please note that I DO NOT manually manipulate bone, only muscle. If your dog has grade 3 or 4 luxating patella then massage therapy will not aid in realigning the patella however massage therapy can help with pain management and also with overcompensation issues as a result of the condition.

Massage can also help with:

  • Improving comfort and reducing pain associated with the condition

  • Improving mobility of the hind limbs

  • Addressing areas of protective muscle splinting

  • Improving gait and activity levels

  • returning your dog to normal exercise and movement patterns, albeit this should be taken slowly and built up to

Contraindications (reasons to not massage or to alter the massage) to be aware of - if your dog is showing any signs of the following then please let me know and then we can discuss a treatment schedule to work around or outside of the particular issue.

Specifically for luxating patella:

  • Muscle ruptures

  • Sprains and strains

  • Broken bones

  • Arthritis

  • Infections in the area

  • Inflammation

  • Tendon rupture - either suspected or actual

  • Bursitis

  • A recent contusion to the area

  • Open wounds

Generally:

  • High blood pressure

  • Diabetes

  • Cardio-vascular conditions

  • Bruises

  • Pregnancy

  • Epilepsy

  • The severity of the condition

  • The level of inflammation in the area

    (heat therapy should be avoided if inflammation present)

  • Skin irritations such as eczema