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Luxating
patella (or Patellar luxation)
Luxating patella, or trick knee, is a condition
in which the patella, or kneecap, dislocates or
moves out of its normal location. The luxation is
usually medial, but can be lateral. It can be caused
by some form of blunt trauma, or may be a congenital
defect. In congenital cases, it is usually bilateral.
Patellar luxation is a common condition in dogs,
particularly small and miniature breeds. The condition
usually becomes evident between the ages of 4 to
6 months. It also occurs in cats, especially the
Domestic Shorthair. Diagnosis is made through
palpation of the knee. X-rays are necessary in some
cases. The luxating patella often causes no or very
slight symptoms. There may be intermittent limping
in the rear leg. Osteoarthritis can develop secondarily.
There are four diagnostic grades
of patellar luxation, each more severe than the
previous:
Grade I - the patella can be manually luxated
but is reduced (returns to the normal position)
when released;
Grade II - the patella can be manually luxated
or it can spontaneously luxate with flexion of the
stifle joint. The patella remains luxated until
it is manually reduced or when the animal extends
the joint and de rotates the tibia in the opposite
direction of luxation;
Grade III - the patella remains luxated most
of the time but can be manually reduced with the
stifle joint in extension. Flexion and extension
of the stifle results in reluxation of the patella;
Grade IV - the patella is permanently luxated
and cannot be manually repositioned. There may be
up to 90¼ of rotation of the proximal tibial
plateau. The femoral trochlear groove is shallow
or absent, and there is displacement of the quadriceps
muscle group in the direction of luxation.
Grades III and IV, as well as most grade
II cases, require surgery to correct, if the animal
has difficulty walking. The surgery involves a sulcoplasty,
a deepening of the trochlear sulcus that the patella
sits in.
Additional help can be given
with the use of pet ramps, stairs, or steps. These
can help the animal travel from one place to another,
especially up and down, without adding any pain
or damage to the patella.
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