# Sticky  LUXATING PATELLA INFORMATION



## ilovesadie

Can someone please Sticky this?

Information Directly from the OFA website:

What is Patellar Luxation?

The patella, or kneecap, is part of the stifle joint (knee). In patellar luxation, the kneecap luxates, or pops out of place, either in a medial or lateral position.

Bilateral involvement is most common, but unilateral is not uncommon. Animals can be affected by the time they are 8 weeks of age. The most notable finding is a knock-knee (genu valgum) stance. The patella is usually reducible, and laxity of the medial collateral ligament may be evident. The medial retinacular tissues of the stifle joint are often thickened, and the foot can be seen to twist laterally as weight is placed on the limb.
Patellar Luxation Categories
Patellar luxations fall into several categories:

1. Medial luxation; toy, miniature, and large breeds

2. Lateral luxation; toy and miniature breeds

3. Lateral luxation; large and giant breeds.

4. Luxation resulting from trauma; various breeds, of no importance to the certification process.

Numbers 1, 2 and 3 are either known to be heritable or strongly suspected.

Medial Luxation in Toy, Miniature, and Large Breeds
Although the luxation may not be present at birth, the anatomical deformities that cause these luxations are present at that time and are responsible for subsequent recurrent patellar luxation. Patellar luxation should be considered an inherited disease.

Clinical Signs
Three classes of patients are identifiable:

1. Neonates and older puppies often show clinical signs of abnormal hind-leg carriage and function from the time they start walking; these present grades 3 and 4 generally.

2. Young to mature animals with grade 2 to 3 luxations usually have exhibited abnormal or intermittently abnormal gaits all their lives but are presented when the problem symptomatically worsens.

3. Older animals with grade 1 and 2 luxations may exhibit sudden signs of lameness because of further breakdown of soft tissues as result of minor trauma or because of worsening of degenerative joint disease pain.

Signs vary dramatically with the degree of luxation. In grades 1 and 2, lameness is evident only when the patella is in the luxated position. The leg is carried with the stifle joint flexed but may be touched to the ground every third or fourth step at fast gaits. Grade 3 and 4 animals exhibit a crouching, bowlegged stance (genu varum) with the feet turned inward and with most of the weight transferred to the front legs.

Permanent luxation renders the quadriceps ineffective in extending the stifle. Extension of the stifle will allow reduction of the luxation in grades 1 and 2. Pain is present in some cases, especially when chondromalacia of the patella and femoral condyle is present. Most animals; however, seem to show little irritation upon palpation.
Lateral Luxation in Toy and Miniature Breeds

Lateral luxation in small breeds is most often seen late in the animal's life, from 5 to 8 years of age. The heritability is unknown. Skeletal abnormalities are relatively minor in this syndrome, which seems to represent a breakdown in soft tissue in response to, as yet, obscure skeletal derangement. Thus, most lateral luxations are grades 1 and 2, and the bony changes are similar, but opposite, to those described for medial luxation. The dog has more functional disability with lateral luxation than with medial luxation.

Clinical Signs
In mature animals, signs may develop rapidly and may be associated with minor trauma or strenuous activity. A knock-knee or genu valgum stance, sometimes described as seal-like, is characteristic.

Sudden bilateral luxation may render the animal unable to stand and so simulate neurological disease. Physical examination is as described for medial luxation.

Examination and Certification

The dog is examined awake (chemical restraint is not recommended) and classified by the attending veterinarian according to the application and general information instructions. The veterinarian then completes the application form indicating the the results of the dog's patella evaluation.

The application and fee can then be mailed to OFA. The attending veterinarian and owner is encouraged to submit all evaluations, whether normal or abnormal, for the purpose of completeness of data. There is no OFA fee for entering an abnormal evaluation of the patella in the data bank.

A breed database number will be issued to all dogs found to be normal at 12 months of age or older. The breed database number will contain the age at evaluation and it is recommended that dogs be periodically reexamined as some luxations will not be evident until later in life.
Preliminary Evaluations

Evaluation of dogs under 12 months of age is encouraged if the owner desires to breed at this age. The most opportune time to gather breeding data is at 6-8 weeks of age prior to the puppy's release to the new owner.

Grades of Patellar Luxation


The Patellar Luxation Database is for dogs 12 months and over. Examinations performed on dogs less than 12 months will be treated as Consultations and no OFA breed numbers will be assigned.

A method of classifying the degree of luxation and bony deformity is useful for diagnosis, and can be applied to either medial or lateral luxations by reversing the medial-lateral directional references. The position of the patella can easily be palpated starting at the tibial tubercle and working proximal along the patellar ligament to the patella.
Grade 1

Manually the patella easily luxates at full extension of the stifle joint, but returns to the trochlea when released. No crepitation is apparent. The medial, or very occasionally, lateral deviation of the tibial crest (with lateral luxation of the patella) is only minimal, and there is very slight rotation of the tibia. Flexion and extension of the stifle is in a straight line with no abduction of the hock.
Grade 2

There is frequent patellar luxation, which, in some cases, becomes more or less permanent. The limb is sometimes carried, although weight bearing routinely occurs with the stifle remaining slightly flexed. Especially under anesthesia it is often possible to reduce the luxation by manually turning the tibia laterally, but the patella reluxates with ease when manual tension of the joint is released. As much as 30 degrees of medial tibial torsion and a slight medial deviation of the tibial crest may exist. When the patella is resting medially the hock is slightly abducted. If the condition is bilateral, more weight is thrown onto the forelimbs.

Many dogs with this grade live with the condition reasonably well for many years, but the constant luxation of the patella over the medial trochlear ridge of the trochlea causes erosion of the articulating surface of the patella and also the proximal area of the medial lip. This results in crepitation becoming apparent when the patella is luxated manually.
Grade 3

The patella is permanently luxated with torsion of the tibia and deviation of the tibial crest of between 30 degrees and 50 degrees from the cranial/caudal plane. Although the luxation is not intermittent, many animals use the limb with the stifle held in a semi flexed position. The trochlea is very shallow or even flattened.
Grade 4

The tibia is medially twisted and the tibial crest may show further deviation medially with the result that it lies 50 degrees to 90 degrees from the cranial/caudal plane. The patella is permanently luxated. The patella lies just above the medial condyle and a space can be palpated between the patellar ligament and the distal end of the femur. The trochlea is absent or even convex. The limb is carried, or the animal moves in a crouched position, with the limb flexed.

Does a luxating patella cause any long-term problems for my dog?

Some dogs can tolerate this problem for many years, some for all of their lives. Since the joint surfaces are very slick and bathed in a slippery joint fluid, there is usually little or no discomfort early in the process. However, this abnormality predisposes the knee to other injuries, especially torn cruciate ligaments. Also, with advancing age, the joint may become arthritic and painful. The bones may actually curve in response to the abnormal location of the kneecap..

Can a luxating patella be corrected?

Surgery should be performed if your dog has a persistent lameness or if other knee injuries occur secondary to the luxation.

The methods used for surgical repair depend on how far the process has gone before intervention. Surgical repair may include any or all of the following:

* 1) The point of attachment of the patellar ligament is cut from the tibia and transplanted to its proper location to correct the in correct alignment.
* 2) The groove in the femur is deepened so the patella will stay in place.
* 3) The capsule around the joint is tightened. This last step is important because the joint capsule will have stretched during the period of luxation.

If the surgery is performed before arthritis occurs, the prognosis is excellent. Your dog should regain full use of its leg. However, if arthritis has already occurred, the joint will still be somewhat painful, especially in cold weather. Some veterinarians believe supplementing diet with glucosamine/chondroitin will slow the joint damage that may occur that causes arthritis.


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## OzzyAndLilysMom

Done  thanks nate :wave:


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## LuvMyChiwawas

Very informative. Thank you.


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## Teddy's Mummy!

thankyou.....very helpful


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## mjstett

thx
needed that info
mj


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## spud250

hiya all 
i have a chi that is about 1 and a half and she is gorgeous ! but the problem is i bought her for £450 because he said she has a dodgey back leg...i accepted that and still got her..and my neighbour also has a short haired chi and he said it could be pattella?but im not sure  ...she dosent seem to be in any pain with it just wen she walks she sretches her back legs rightttt back as high as possible and then puts it down and walks so?what do you think it is ? if it is patella is it heriditory or inhareditory?anfd if she had a operation how much do you think it would cost? :?: 

thanks 
katie


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## LocasMom

Loca has this and surgery was recommended......


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## danton

Very informative article the more we have the better.


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## sesar_galvez

i agree


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## Jennifer&Patrón

with the "bow legged" comment.. thats how my chi is, he kind of reminded me of how a pit bull looks when hes standing. i havnt noticed any kind of trouble with him walking on it & his feet arent turned inward or out.. im not sure if i should be worried about this?


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## amf

Brutus was diagnosed with grade 2 luxating patella. He was prescribed with Glucosamine with MSM. After 3 weeks, it was gone. No more limping!


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## Chigang

amf said:


> Brutus was diagnosed with grade 2 luxating patella. He was prescribed with Glucosamine with MSM. After 3 weeks, it was gone. No more limping!




OMG your little man was soooooo lucky, my poor Polly had grade 4 and had to have a horrible op.


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## Rosiesmum

My little lad Jago had a grade 4 patella luxation and he too needed surgery. He was only 6 months old, he is 5.5 now. Thank goodness we have skilled vets to correct this problem. You would never believe Jago had had a problem.

Barbara


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## LuvMyPrecious

Precious has a grade 2 luxating patella on her left leg. I just make sure to feed a really good food with glucosamine in it rather than giving her supplements. She's not a good pill taker so for 2 yrs now she's done really good hasn't gotten any worse in fact I think it is somewhat better than at first. About the only time she carries her leg or limps anymore is when she is coming back from a walk or when she is running or if it's raining out.


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## 17428

Very informative article!


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## TLI

If your pup is under 6 months of age and diagnosed with stage 1 LP's, that is no real cause for alarm. Almost all puppies have some degree of slipping at that age and under do to their growth plates being open.


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## EmmaandSpikesMommy

spike just had this surgery done on tuesday the 1st


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## Rosiesmum

EmmaandSpikesMommy said:


> spike just had this surgery done on tuesday the 1st


How is he doing, my Jago had it done several years ago, he's fine now. Hope your little one is okay 

It's a difficult time.

x


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## voodewlady

Does this condition happen to every chi? Is it preventable?


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## EmmaandSpikesMommy

Rosiesmum said:


> How is he doing, my Jago had it done several years ago, he's fine now. Hope your little one is okay
> 
> It's a difficult time.
> 
> x


hes doing pretty good i think it might be a bit harder on me then it is on him now that he has learned to walk with the bandages on it is getting harder and harder to keep him still it just makes me very sad to see him this way but i know it was the best thing he could have had done


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## Rosiesmum

voodewlady said:


> Does this condition happen to every chi? Is it preventable?


No it doesn't happen to all Chihuahuas but a lot, certainly here in the UK seem to be prone to it. Not allowing your Chihuahua to jump off furniture is a good idea, but some Chi's are born with the structural problem.

Not all Chihuahuas that develop a patella luxation will need surgery, depends on the severity.

x


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## 17428

I was told by my vet this week that 75% of all chis
have it to some degree and that it is hereditary.
It plagues this breed.


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## mrfiero

Hazel is now 18 weeks old. When she runs on the grass, she gallups. The rear legs push off together as do the front legs. She can run very fast!! At a slow or fast pace walk her legs are normall.

Is this "galluping" a sign of LP?


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## andrea11

thanks for this information..


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## Willowjune

My vet told me that my dog Vana, age 1 1/2, has "shallow knee sockets." She is already hopping quite a bit, much more on one foot than the other. The vet said she would need surgery within the next two years. Is a shallow knee socket the same as a luxating patella? I know that a kneecap and a knee socket aren't the same thing, but is it just a different description of the same problem? Thanks.


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## flippedstars

Willowjune said:


> My vet told me that my dog Vana, age 1 1/2, has "shallow knee sockets." She is already hopping quite a bit, much more on one foot than the other. The vet said she would need surgery within the next two years. Is a shallow knee socket the same as a luxating patella? I know that a kneecap and a knee socket aren't the same thing, but is it just a different description of the same problem? Thanks.


A shallow knee socket often can be the cause of the patella luxating, so it's not exactly the same thing, but essentially your vet is just putting it into words you can understand. 

Do you have her on a glucosamine supplement and high quality grain free diet?


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## Willowjune

flippedstars said:


> Do you have her on a glucosamine supplement and high quality grain free diet?


Thanks for the explanation. And yes to both the glucosamine and grain free diet. I appreciate the quick response!


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## sonam

I am new to the forum and have an 8, nearly 9 month old chihuahua (she is already spayed) that was recently diagnosed with this. 

I've started her on a joint supplement he recommended already and we are doing our best to keep her from making the damage worse (she is lame much of the time, on three legs, but it doesn't slow her down if we don't intervene.)

She is scheduled to have surgery on Nov. 11th, the vet says the success rate for this surgery is very high. Will let everyone know how it goes. He is saying the surgery will actually help preserve her cartilage, preventing what could be severe arthritis early in her life if we don't have the problem repaired now. 

Evidently the recovery period afterwards is crucial to the success of the repair. If anyone has been through this and has any advice on how to navigate it in a way the minimizes any suffering she may have to endure it would be much appreciated.

She is a playful, adventurous little girl and it's going to be hard to keep her confined for the 6 weeks he says will be necessary to ensure the surgery heals completely before she can bound around once again. 

I adore this little girl, and wouldn't trade her for the world. Seeking only advice on how to help her have a great life, despite having an early challenge. 

Thank you for any insights you all may have.


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## AnnHelen

What about getting those puppy purse harness like thing dogs can hang from?? It*s disgusting used if the doggi is healthy, but I thought maybe it would be great for post op dogs trying to walk..Just a thougt..so they can get some support while walking..on the ground..not hanging, if you understand.. Puppy Purses - PurseBlog


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## Zoomie

Very interesting. Thank you !


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## titiaamor

*Glucosamine supplement*

Can you share what Glucosamine you like? I was overwhelmed with all the options!



amf said:


> Brutus was diagnosed with grade 2 luxating patella. He was prescribed with Glucosamine with MSM. After 3 weeks, it was gone. No more limping!


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## boubou

I realize this is an old post bit suspect that Coco has a luxating patella on lesft knee. Not yet diagnosed but she sometimes streches it backward, holds it up, then walks again normally. There doesn't seem to be any pain. She is almost 10 months.
We give our sheltie glyco flex II 
What do you use for supplement?


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## famouschihuahua

*Patellar luxation: A knee problem in Chihuahuas*

This is a great article on luxating patellas in Chihuahuas. It offers you an abundance of information on the condition and you can even view bone images and watch a video of a Chihuahua with luxating patellas.

patellar luxation: what you should know about this knee problem in chihuahuas | famous chihuahua

It begins with:

The chihuahua breed is known to have the knee condition known as patellar luxation and is one of the most common health problems associated with chihuahuas. The knee is a complex structure consisting of muscles, ligaments, tendons, cartilage, and bones. these components must align properly and interact harmoniously in order to function properly. Three bones are included in the knee: the femur, the tibia, and the patella (kneecap).

The lower front portion of the femur (thigh bone) in a normal Chihuahua has two bony ridges that form a fairly deep groove in which the patella is supposed to slide up and down. These structures limit the patella’s movement to one restricted place, and in doing so, control the activity of the quadriceps muscle. The entire system is constantly lubricated by joint fluid. It works so that there is total freedom of motion between the structures....

Read the rest of this article here


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