Patella Luxation Repair

Patellar luxation is graded on a scale of I–IV based on how easily the kneecap is displaced and whether it reduces (slips back) on its own. Grade I cases are often managed conservatively, but grades II–IV generally benefit from surgery because the abnormal mechanics accelerate cartilage wear and muscle contracture and frequently lead to cruciate ligament damage if left untreated. Surgery is also recommended when a lower-grade luxation is causing persistent pain or worsening over time. Early intervention preserves more cartilage and gives younger patients the best long-term joint health.

Surgery is performed under general anesthesia. The corrective steps are tailored to the grade and direction of the luxation but typically include:

• Trochleoplasty — the groove in the thigh bone is deepened (by wedge recession or chondroplasty) so the kneecap has a proper track to ride in
• Tibial tuberosity transposition (TTT) — the bony attachment of the patellar tendon on the shin is cut and repositioned, realigning the pull of the quadriceps muscle
• Soft-tissue tightening or release — the joint capsule is tightened on the side the patella was luxating toward, and released on the other, to balance forces around the knee

The implants used for TTT (small pin and wire) are well-tolerated and rarely need removal. The goal is a kneecap that tracks centrally throughout the full range of motion.

A thorough orthopedic exam confirms the grade of luxation and whether one or both knees are affected — bilateral luxation is common in small breeds. X-rays assess the degree of bony malalignment and help plan the procedure. Pre-anesthetic bloodwork clears your pet for anesthesia. You will be asked to fast your pet the evening before surgery, and the team will confirm which supplements or medications to pause. Planning your home recovery setup — a small, non-slip pen or room — before the appointment makes the transition from hospital much smoother.

Most dogs and cats are weight-bearing on the repaired leg within a few days. A structured recovery plan is essential to protect the repair while bone and soft tissue heal:

• Weeks 1–2: strict rest in a confined space; short leashed trips outside; pain medication and cold-pack application to the knee; incision monitoring
• Weeks 3–6: progressive leash walks with no off-leash time; gentle range-of-motion exercises at home if recommended; follow-up exam
• Weeks 6–10: recheck evaluates stability and function; gradual return to normal activity once the surgeon clears the pet

Maintaining a healthy body weight is especially important in small-breed dogs, as extra pounds significantly increase patella stress. Both knees should be monitored even if only one was repaired initially.

Patella luxation repair has a high success rate and dramatically improves quality of life for most patients. Possible complications include re-luxation (especially if activity restrictions are not followed), implant migration, infection, and the development or progression of arthritis in the joint. Higher-grade luxations (III–IV) carry a slightly higher risk of re-luxation due to the degree of bony malalignment that must be corrected. Most pets return to comfortable, active lives after surgery and appropriate recovery. Pre-existing arthritis will not be reversed but often progresses more slowly once normal mechanics are restored.