How to Fix a Luxating Patella (Bad Knee) in a Dog Without Surgery
What Is a Trick Knee?
A "trick knee" in your dog is caused by a dislocated kneecap: a luxating patella. Patellas (kneecaps) can luxate (move out of place) towards the dog's body (medially) or away (laterally). The kneecap normally rides in a groove in the femur and works so well that most owners do not even realize that it is there. A trick knee shows up occasionally, though, often inherited in small dogs or larger breeds that have hip dysplasia.
Some dog owners will also say that their dog has a “trick knee” after a cruciate ligament tear, but ruptured ligaments are actually a lot more serious and have to be treated quite differently. If not treated properly they may even require surgery.
Your new puppy may have been diagnosed with a trick knee during his first visit to the vet. You may have just noticed your puppy running on one back leg, or running with both back legs together (bunny hopping). This is more common is some breeds but can happen in any size dog, and at any age.
Will My Dog Need Surgery?
When this problem is first noticed and diagnosed the vet will probably recommend strict confinement. She might try NSAIDs like Rimadyl or aspirin, and may even want to put your dog on a course of steroids. Sometimes these things will work.
Trick knees might respond to confinement or might get worse if not surgically repaired. There are four grades of luxations, however, and not all even need surgery.
- Grade I: Dogs are not in pain. When the knee moves out of place, it can be massaged back to where it belongs. Since dogs carry most of their weight on their front legs, this dog will probably never need surgery if the problem is taken care of right away.
- Grade II: Dogs have a few more problems with the affected knee. It can still be massaged back but it usually moves out of place again as soon as the dog starts walking around. A dog with this grade is usually not in pain but may develop arthritis and pain in the knee, and will sometimes need surgery.
- Grade III: Dogs with this level of luxation are usually already arthritic and in pain by the time they are seen. The knee is out of the groove more than in it.
- Grade IV: Dogs no longer have a groove and the kneecap cannot be put back into place. If this has been going on for a long time the dog is arthritic and in pain. A dog like this always needs surgery.
Surgical repair of trick knees differs based on how the dog is built, how many changes have already occurred, and what the surgeon will think is going to work. Sometimes a dog can get by with having the kneecap ligaments strengthened with non-absorbable suture, some will need a deeper groove cut for the kneecap to move in, and some even need surgical changes to the bone where the kneecap attaches. When the bone has changed a specialist may need to do the surgery and the dog will have less of a chance of recovering.
There are several nutritional, non-surgical alternatives. A non-surgical method is never going to change the anatomy of your dog's leg. You can choose to accept alternative theories or not, but of course by delaying surgery the chances of recovery after surgery are lessened.
What a nutritional alternative can do is improve the dog's health and the quality of the joint so that secondary changes are reduced. This is an important issue with knee conditions and a reason that so many dogs develop arthritis in their knees as they become older.
How Can a Trick Knee Be Fixed Without Surgery?
If your dog's trick knee is very mild, your vet can show you how to pop the knee back into place during his exam. It is easy to do if your dog is calm and not in pain. All you have to do to put the knee back in place is to straighten out the leg, massage gently and move the knee as you are massaging. I find that it helps a lot to talk to the dog and distract him so that he will be even more calm as you are doing this.
For more permanent results, however, you need to consider all of the following alternatives:
- Put your dog on a severe diet so that he is not overweight, and definitely not obese: Besides living a shorter life, obesity will cause extra stress on all of his joints. Overweight dogs with trick knees will have more problems walking, and the arthritic changes to the knee will happen that much faster.
- Walk your dog for a short distance several times a day: Exercise is good to treat many behavioral problems, and in this instance will also keep your dog physically healthier. Besides keeping off his excess weight, the muscles that hold his knee in place will be healthier.
- Improved diet: A raw or homemade organic diet may improve overall cartilage condition and make all joints, including the knee, healthier. A raw diet can even be made with beef traches and chicken legs, which will add glucosamine and improve the condition of the joint.
- Give glucosamine and chondroiton dietary supplements: These supplements improve the quality of the joint. They improve the cartilage and may even improve the fluid available in the knee. Some diets advertise the presence of chondroiton, but adequate amounts are only available in balanced raw diets.
- Give added Vitamin C: This still needs a lot more evidence. Dogs produce vitamin C but the amounts are probably not enough to help with strengthening the ligament when your dog is affected by a trick knee. Doses have not been worked out but you should probably give your dog 1000mg a day (500 mg for a smaller dog), and preferably use natural sources like acerola.
- Acupuncture: Consult a veterinarian who specializes in treating conditions of the knee.
More About Your Dog
- 7 Ways To Help Your Dog Lose Weight
Need to know how to start? Great exercise routines and estimated calorie burn for each exercise are included to help you work with your obese dog. Easy steps you can follow to get your dog in shape and prevent the diseases associated with obesity.
- Natural Dog Health: Lameness
If your dog´s lameness does not respond to conventional therapy, you might want to search for alternatives. Alternative, natural therapies take a lot longer to start showing effects than conventional therapy so do not expect a quick cure.
If your dog has been diagnosed with a luxating patella it is not the end of the world. You can find alternative treatments, and if nothing works find a good surgeon to repair the knee so that your dog can live normally.
If your dog has a trick knee, however, she should not be bred! Bad knees are sometimes a sign of hip problems, which are inherited. Even if only the knee is affected, this condition is genetic—it will be passed on to her puppies.
There is still a lot of controversy in this subject so I cannot definitely state which method is best and which method will succeed or fail. In 2011 a report came out that stated the method used by most vets was not even successful. If you choose the surgical alternative for your dog please research this subject carefully. Find the best orthopedic surgeon you can afford, and take care of this problem as soon as you can.
This article is accurate and true to the best of the author’s knowledge. It is not meant to substitute for diagnosis, prognosis, treatment, prescription, or formal and individualized advice from a veterinary medical professional. Animals exhibiting signs and symptoms of distress should be seen by a veterinarian immediately.
Questions & Answers
Can a vet pop the knee back in place for my Toy Pomeranian (she has a luxating patella) or do I have to take her to a surgeon?
Your local vet can do this, but unless the knee is very bad, you can do it yourself. You might need someone to help you hold your dog on their lap, belly up, and then take the leg and extend it, holding on to the toes.
When the leg is straight, fully extended, just put your fingers on the kneecap and gently massage. Talk to your dog to get her to relax. Usually, it is easier to move it back into place at home where the dog is not so stressed out.
If this does not work, your vet may need to sedate your dog.Helpful 3
I have a ten year old papillon with Addisons. She cannot have surgery for her knees due to medical issues. Would leg braces be any good?
Some people claim they delay the onset of arthritis since they keep the patellas in place. Of course if the patellas are not in place when the brace is put on, they also keep the patellas from moving back into a normal position.
The most important thing you can do for your Papillon is carry her up and down stairs, put her up on the bed if she sleeps with you, etc. She may benefit from massage.Helpful 14
Our dog´s surgeon is board certified and we cannot change since they don’t charge for repeated surgeries. The first surgery put the kneecap back in the grove and things were tightened. The second time, he made the groove a little deeper and did something more with the sutures. I think the kneecap is all the way out again. Our regular vet believes so. The surgeon will see her in the morning. What happens when it’s not fixable?
If it is not possible for him to fix the kneecap, eventually the dog will develop arthritis in the joint and will either walk with three legs or may even have to drag her end. You might look into a wheeled cart that supports the hind end, similar to that which is used when Dachshunds undergo back surgery and are no longer able to walk.
I have seen some dogs that no one is able to repair. As long as they are small breeds, the owner just has to make adjustments. It is very difficult when the dog is large and not able to be carried around.
If you would like to look down at the comments section and there is a Facebook link with a video of a small dog that is so severely affected that surgery is not an option.Helpful 10
How much does it cost for a patella surgery on a Yorkie?
The cost of the surgery depends on the severity of the knee and how many degenerative changes have taken place, by the location, by the skill of the surgeon, etc. It does not depend on whether the dog is a Yorkie or Maltese.
If you are in NY it will cost several thousand, half of that in Kansas, and about $1500 for a small dog in Chicago.Helpful 9
What kind of brace is used while a luxating patella is healing?
There is a temporary brace that you can use. Instructions on how to make it are on YouTube, or you can read this article and look at it there. https://hubpages.com/dogs/dog-cruciate-ligament-re...
The article also discusses a more permanent brace that you can purchase through Amazon. It is not always needed, and if your dog is very small and you can control her movements, then it will probably not be needed at all.Helpful 7
© 2012 Dr Mark