Luxating Patella in Dogs
What Is a Luxating Patella in Dogs?
Are you noticing your dog skipping or hopping more often than usual? It’s likely not just a cute quirk. Your dog could be experiencing a luxating patella and needs prompt veterinary attention.
Also known as canine patellar luxation or kneecap dislocation, luxating patella is one of the most common orthopaedic conditions seen in dogs, affecting 1.3% of dogs, and is particularly common in small and toy breeds1.
It occurs when a dog’s kneecap dislocates or slips out of its groove, causing discomfort, altered gait, and if left untreated, progressive joint damage and arthritis.
Luxating patella in dogs can occur in one or both hind legs and may be intermittent or permanent, so it’s important to be observant about changes to your dog’s gait.
The patella sits within the trochlear groove at the end of the femur and protects the inner knee structures and aligns the ligaments and tendon as the knee flexes and extends. It stabilizes the patellar ligament and transmits force from the quadriceps to the tibia, allowing your dog to run, walk and jump.
Types of Patellar Luxation in Dogs
Luxation is classified by direction of kneecap displacement, and a careful diagnosis is important as it dictates the best type of treatment for your dog.
Medial Luxation
For dogs experiencing medial luxation, the kneecap dislocates towards the inside of the limb towards the body’s midline. This is the most common form of patellar luxation, accounting for approximately 75% of cases.
Medial patellar luxation (MPL) is strongly associated with small and toy dog breeds2 due to a unique skeletal configuration, where bowing of the femur causes the patellar ligament attachment to sit too far medially.
Lateral Luxation
The kneecap dislocates towards the outside of the limb for lateral patellar luxation. It is less commonly diagnosed than medial luxation and more frequently seen in medium and large breed dogs3, but can occur in small breeds too.
1Engdahl, K. Bergström A. Höglund, O. et al. The epidemiology of patellar luxation in an insured Swedish dog population. Prev Vet Med. 2023 Nov 220:106034.
2Di Dona, F. Della Valle, G. Fatone, G. Patellar Luxation in Dogs. Vet Med (Auckl). 2018 May 31;9:23–32
3Hayes AG, Boudrieau RJ, Hungerford LL. Frequency and distribution of medial and lateral patellar luxation in dogs: 124 cases (1982–1992) J Am Vet Med Assoc. 1994;205(5):716–720
Causes of Luxating Patella in Dogs
Here are some common causes of luxating patella in dogs:
The primary cause of luxating patella, a congenital skeletal abnormality involves the malformation of the femur, tibia, or trochlear groove depth. While the condition is typically not present at birth, the risk of patella luxation increases as the dog grows and the skeletal framework matures.
Predisposing structural factors include a shallow trochlear groove, lateral or medial displacement of the tibial tuberosity, femoral or tibial torsion, and weakness in the muscles stabilizing the patella.
While trauma can worsen a luxating patella, it is considered as a secondary rather than a primary cause.
Types of Dogs More Prone to Luxating Patella
Certain Breeds Are Genetically Predisposed, Including:
While any dog can develop a patellar luxation, certain breeds are more genetically predisposed to develop the condition due to certain inherent weaknesses in their skeletal configuration. In our clinic, we regularly work with Chihuahuas and Maltese dogs presenting with Grade 1–2 medial luxation managed conservatively through rehabilitation.
Overall, you’re more likely to find that smaller sized dog breeds are at higher risk of medical luxation, whereas larger sized dog breeds experience lateral luxation.
Symptoms and Diagnosis of Luxating Patella in Dogs
Some dogs show no obvious pain or discomfort, especially at the Grade 1 stage of the disease, while others with chronic luxation develop compensatory movement patterns.
The most recognizable luxating patella symptom you’ll notice is that your dog suddenly exhibits hind leg lifting or “skipping”, where it takes a step or two with a leg held up, then puts it back down once the kneecap resets.
What to watch out for
Here’s some other signs of kneecap issues in dogs:
- Intermittent lameness
- Yelping or vocalizing when the patella luxates
- A bunny-hop gait (using both hind legs simultaneously)
- Stiffness after rest
- Reluctance to jump or use stairs
- In severe cases a bowlegged stance or permanently stiff gait
How Is Luxating Patella Diagnosed?
A professional veterinary diagnosis combines physical examination with imaging and follows a standardized grading system.
Physical Examination and Grading
A luxating patella diagnosis involves a vet performing a manual assessment of the knee joint by palpating the patella to determine how easily it displaces, and whether it returns spontaneously. These movements are then graded via the following scale of disease severity to determine the most appropriate course of treatment:
- Grade 1: Patella is manually luxated but returns to the normal position immediately when released.
- Grade 2: Patella luxates spontaneously during flexion and may remain displaced until manually reduced or until the dog kicks the leg straight, moves with intermittent lameness.
- Grade 3: Patella remains luxated most of the time but can be manually repositioned. It luxates again spontaneously when pressure is released and moves with frequent lameness.
- Grade 4: Patella permanently luxated and cannot be manually repositioned, resulting in severe, often chronic lameness accompanied by a visible skeletal deformity in affected limb. This requires urgent veterinary care.
Diagnostic Imaging (X-rays, CT)
Modern scans are helpful in grading the severity of the condition, including:
Radiographs (X-rays) which are used to assess skeletal alignment, the degree of trochlear groove shallowness, tibial tuberosity position, and any signs of secondary osteoarthritis.
CT (computed tomography) may be used for complex cases, particularly where corrective osteotomy is being considered, to plan a surgical approach with greater precision.
Treatment of Luxating Patella in Dogs
Treatment is guided by the severity grading, clinical signs, the dog’s age and overall health, and whether secondary changes (arthritis, cruciate damage) are present. Grades 1 and 2 are often managed conservatively while Grades 3 and 4 typically require surgical intervention.
Non-Surgical Management
Grade 1, many Grade 2, and some Grade 3 dogs with low clinical impact often do not require surgical intervention. Instead, they undergo a luxating patella care program which includes:
- Canine physical therapy/rehabilitation: targeted strengthening of the quadriceps and hip abductors to stabilize the patella in the groove, gait retraining and range-of-motion exercises.
- Weight management: reducing the load on an already compromised joint.
- Joint supplements: omega-3 fatty acids, glucosamine/chondroitin — note that these supplements support joint health but are not a cure.
- Activity modification: avoiding high-impact activities that trigger luxation events.
- Pain management: NSAIDs (prescribed by a vet) during flare-ups.
At Canine PT and Me, our rehabilitation programs for conservative luxating patella management focus on building the muscular support structures that hold the kneecap in alignment — reducing the frequency of luxation events and slowing joint degeneration.
Surgical Treatments
When non-surgical management is no longer useful, surgery is generally recommended for Grade 3–4 luxation and for Grade 2 dogs with persistent lameness, rapid progression, or concurrent cruciate ligament damage. Several surgical techniques exist and may be combined.
Tibial Tuberosity Transposition (TTT)
The most common surgical procedure for patellar luxation, a TTT involves cutting and repositioning the tibial tuberosity (the bony prominence where the patellar tendon attaches on the shin), so the pull of the quadriceps muscle is re-aligned with the trochlear groove, keeping the patella centralized. A pin and/or wire secures the muscle while bone healing occurs.
Trochleoplasty and Sulcoplasty
These procedures aim to deepen the trochlear groove to prevent dislocation by keeping the patella physically constrained within it.
- Trochlear wedge recession: a wedge of cartilage and bone is removed to deepen the trochlea.
- Block recession: a rectangular block of bone and cartilage is removed to deepen the groove.
- Sulcoplasty (trochlear chondroplasty): may be used in very young dogs whose growth plates are still open.
Corrective Osteotomies
These more complex surgical luxating patella treatments in dogs are effective when angular or rotational deformity of the femur or tibia is contributing to luxation. They are typically reserved for severe skeletal deformity or cases where softer-tissue procedures alone would be insufficient. An osteotomy can be combined with other types of luxating patella surgery in the same procedure where required, including TTT and sulcoplasty.
It’s well established that muscles weaken through disuse, regardless of surgical treatment status, resulting in the development of compensatory movement patterns. Without a targeted rehabilitation program, this abnormal movement can begin as soon as the structural abnormalities begin to manifest and persist long after the skeletal issue is corrected.
The Role of Physical Therapy in Patellar Luxation Recovery
For conservatively managed dogs
Targeted physical therapy can slow progression and reduce the frequency and impact of luxation events by strengthening the hip abductors and quadriceps to compensate for groove shallowness or ligament laxity.
For post-surgical dogs
In our clinic, we commonly see dogs referred post-patella surgery who have developed a significant hip-drop or toe-touching gait pattern from months of pain avoidance. Rehabilitation has been shown to be highly effective in improving movement patterns along the whole kinetic chain, not just the knee4.
We follow a personalized rehabilitation timeline to optimize luxating patella care, starting with gentle range-of-motion work in the first 2–4 weeks, progressing to strengthening, proprioception (balance and body-awareness work), and functional movement as healing progresses.
Rehabilitation exercises used
For luxating patella recovery, we use a combination of tailored therapeutic exercises, including, laser therapy, massage, and NMES (neuromuscular electrical stimulation).
4Akaraphutiporn, E. Kwananocha, I. Meechai, et al. Comparative analysis of post-operative rehabilitation approaches for medial patellar luxation in small-breed dogs. Vet World. 2024 Mar 7;17(3):550–557.
Recovery of Dogs from Luxating Patella
Even though the diagnosis can be serious, most dogs with luxating patella, including those with Grade 3–4 luxation treated surgically, return to comfortable, active lives, particularly with the help of active rehabilitation. It’s important to remember that early intervention improves long-term outcomes, so watching out for early signs is key.
Surgically treated dogs
The typical return-to-function timeline for luxating patella surgery recovery is 8–12 weeks for soft-tissue procedures (TTT) and longer for osteotomies. Activity restriction in the first 4–6 weeks is standard, including lead walking only. The recurrence of luxation post-surgery can occur in a minority of cases and secondary cruciate ligament injury is a known complication, particularly in higher-grade cases.
Conservatively managed dogs
For untreated dogs with luxating patella, there is no fixed recovery period. Therefore, we emphasize the importance of adhering to an ongoing management program with the goal of maintaining quality of life and slowing progression as much as possible.
Written & reviewed by Kelsey Jonas, PT, DPT, CCRT
8 years experience in canine physical therapy
Last reviewed: May 2026
The information on this page is intended as a general guide only and does not constitute veterinary advice. Always consult a registered veterinarian for diagnosis and treatment of your dog’s condition
Prevention of Luxating Patella in Dogs
As the condition is largely genetic in origin, it cannot be prevented. Therefore, no supplement or proven exercise program exists to prevent the condition from developing in a genetically predisposed dog. However, we offer interventions to reduce the risk or delay the progression in at-risk dogs, including:
- Maintaining healthy body weight throughout the dog’s life to reduce joint load.
- Avoiding high-impact activities in young dogs of predisposed breeds while their skeleton is still developing.
- Regular veterinary check-ups for at-risk breeds, enabling early detection before symptomatic progression.
- Implementing dog breeding programs that screen for patellar luxation where responsible breeders in predisposed breeds should have breeding stock graded.
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FAQs About Luxating Patella in Dogs
How Long Can a Dog Live with Luxating Patella?
Many dogs with Grade 1–2 luxation live normal, full lifespans with no significant impact on quality of life, particularly with appropriate weight management and rehabilitation.
Dogs with a luxating patella at Grade 3–4 will progress if left untreated, resulting in the acceleration of arthritis development, leading to chronic pain and a decline in mobility. However, with timely surgical and rehabilitation intervention, prognosis is very good.
Although it can seem daunting, patellar luxation in dogs is best regarded as a manageable condition, with an excellent quality of life being possible for your furry friend if the correct steps are taken at the right time.
When to Contact Your Veterinarian
We recommend contacting your vet if your dog shows any of the following signs: sudden hind leg lameness, skipping gait, reluctance to bear weight, yelping when the leg moves, or noticeable changes in how they walk or climb stairs. We do not recommend waiting for symptoms to worsen as early diagnosis and intervention gives the best outcomes.
Disclaimer: The information on this page is intended as a general guide only and does not constitute veterinary advice. Always consult a registered veterinarian for diagnosis and treatment of your dog’s condition.
Can Luxating Patella Lead to Other Joint Problems?
Yes. Chronic patellar luxation accelerates the development of osteoarthritis (degenerative joint disease) in the affected knee. There is a well-documented association between patellar luxation and cranial cruciate ligament (CCL) rupture. This occurs due to the abnormal mechanics of a luxating patella placing increased strain on the cruciate ligaments over time. These joint problems can be avoided with early intervention, either conservative or surgical, rather than adopting a “wait and see” approach.
Can Both Knees Be Affected at the Same Time?
Yes, luxating patella is a bilateral condition affecting both hind legs in a significant proportion of cases, particularly in small breeds with congenital skeletal predisposition. Both knees may not be symptomatic simultaneously and one knee may progress faster than the other. Your vet should examine both stifle joints at the time of diagnosis.
Does Pet Insurance Cover Luxating Patella Treatment?
Many insurers classify patellar luxation as a hereditary/congenital condition, so some policies exclude treatment cover. Other providers will cover luxating patella treatment, provided that the condition was not pre-existing at the time the policy was taken out. It really depends on the fine print of the individual policy, so it’s best to check with the individual provider for more information about rebates.
- Include a CTA here: “Contact us to discuss payment options and availability for rehabilitation services.”
“Very happy to have Kelsey help our 15 y.o pug be more comfortable in his old age. We’ve learned a lot more about his back condition, and what we can do to improve his mobility. He loves it when she visits for his PT sessions!”
–Anna W., Napoleon’s mom
–Lisette H., Sunny’s mom
“We called many PT in the area and none of them had any appointments. I called Kelsey and she made room for us in her busy schedule due to the severity of our puppy’s condition and timing after her surgery. It was amazing! My recommendation would be to see Kelsey right away to get your puppy on the road to recovery!”
–Robert B., Beep’s dad
