How To Fix A Luxating Patella (Trick Knee) In A Dog Without Surgery

Surgical repair of a luxating patella is not possible for some dogs.
Surgical repair of a luxating patella is not possible for some dogs. | Source

What Is A Trick Knee?

A trick knee in your dog is caused by 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, mostly 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.

Your new puppy may have been diagnosed with a trick knee during his first exam. 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.

If a luxating patella is ignored, the dog will develop arthritis.
If a luxating patella is ignored, the dog will develop arthritis. | Source

How Can A Trick Knee Be Fixed?

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.

1. 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.

2. 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.

3. 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.

4. 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.

A luxating patella usually needs to be fixed surgically.
A luxating patella usually needs to be fixed surgically. | Source

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 move it back into place during his exam. For more permanent results, however, you need to consider all of the following alternatives:

1. Make sure your dog is not obese: Besides living a shorter life, obesity will cause extra stress on all of his joints. Obese dogs with trick knees will have more problems walking, and the arthritic changes to the knee will happen that much faster.

2. Walking: 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.

3. 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.

4. Glucosamine and chondroiton: 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.

5. 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. 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.

6. Acupuncture: Consult a veterinarian who specializes in treating conditions of the knee.

Dogs with bad knees usually need restricted activity.
Dogs with bad knees usually need restricted activity. | Source

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.

When the knee is okay, anything is possible.
When the knee is okay, anything is possible.

© 2012 DrMark1961

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Comments 11 comments

DrMark1961 profile image

DrMark1961 6 weeks ago from The Beach of Brazil Author

David, just take hold of your dogs foot and extend the leg all the way. The patella often pops back in when the leg is extended all of the way, if not just massage it and gently push it towards the center of the dog´s body. If she cries a lot she might need to be sedated, but this almost always works.

David 6 weeks ago

How do you massage the patella back in place, I have a chihuahua she owns the house we just live their.

Sally 7 weeks ago

My 14 year old Bichons was just diagnosed with this. We are doing acupunture along with total body massage with lavender oil from Young Living Essential Oils ...only therapeutic essential oil on the market. I've learned how to move her knee cap back into place and she lets me do it. Our vet is trained in Chinesse herbs and acupunture. She is also on an herb for inflammation along with a lot of rest and being carried up and down the steps and doing very well. Vet is AMAZED at how well she is responding!! GLORY!!

jm 2 months ago

my 5 years old pekingese with congenital patellar luxation worsen, from grade 2 became grade 4, we did the surgery, he is recovy right now, and rehab program after 2 weeks.

Yvone 4 months ago

All of this information was very helpful my puppy's leg literally just started acting up and I was so scared

Sherry Resnick 4 months ago

Devasted right now! Our almost 3 year old 80# pit was just dignosed with luxating patella in both knees!! We are beside ourselves he is our baby!! I will not do the surgery! Has anyone had any luck with holistic vets?

Cindy 6 months ago

Hi we have a boerbull. At 10 months he started limping. We took him to the vet and first opinion was an ACL. We took him to a second vet and exrays showed a luxating patella. We had the op done which was not completely successfull. They redid the op a few days later to tighten the knee as it was still popping out. A month and a half into recovery his second leg started showing signs of discomfort and this was now also putting weight on his leg that had been operated on. We then had the other leg operated on a couple of months later which was a huge success but because the first leg was not done correctly the first time and because of the added weight during healing he needed a third op on the 1st leg. We noted our concerns that something was not right when we took Rocky to have his stitches out. He has a follow up soon but I realized his leg was popping out again. The heart break. What now. The ops are exhausting not just to Rocky but us as well. He is confined to a cage most of the day and knight but as a very active strong willed dog he is throwing tantrums and he is totally oblivious to pain he really cares less about his sore legs. So the delema He wants to run and jump and as a huge dog he loves to throw his weight around. His had a bit of obedience training but the cage is taxing on him. Surgery on the leg does not seem as if its going to work on the leg that has had three ops already. I'm at my wits end what else can we do to stabilize the knee because i dont think Rocky would survive being confined all his life.

jacqueline 7 months ago

My 15 month old baby girl Sopie as just diagnosed with this she is a pom. I am trying a brace and glucosamine with chronditan and omega 369

Beth 7 months ago

Thank you for all this information. I just found out my dog has this.

DrMark1961 profile image

DrMark1961 3 years ago from The Beach of Brazil Author

Thanks Michelle this is not a popular subject, and not one people want to hear about. I hope your Westie never needs this information.

midget38 profile image

midget38 3 years ago from Singapore

This is awesome, Mark. I would think especially so as the dog grows older. Thanks for sharing!

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