Patellar Luxation in Dogs: Symptoms and Stage-Specific Management

JointQ&AMeongsiljang Veterinary Advisory Board

Patellar luxation is the most common orthopedic condition in small-breed dogs. We’ve summarized the signs associated with each of the four stages, along with stage-specific management recommendations, based on veterinary textbooks.

What Are the Symptoms of Patellar Luxation in Dogs?

Illustration of a small dog holding up its hind leg

Patellar luxation in dogs is an orthopedic condition in which the kneecap (patella) slips out of its normal position, either inward or outward. It is one of the most common orthopedic issues in small-breed dogs, particularly affecting breeds such as Maltese, Pomeranians, and Toy Poodles.

Suspect Patellar Luxation If You Notice These Signs

According to veterinary orthopedic textbooks, these are the hallmark signs of patellar luxation. Intermittent limping: Your dog may suddenly lift one hind leg while walking, then resume normal gait after a few steps. Hind leg flexion and extension: Your dog may repeatedly bend and straighten the affected hind leg, an attempt to manually reposition the dislocated kneecap. Difficulty rising from a seated position: As the frequency of luxation increases, knee joint movement becomes less natural, making it appear awkward when your dog stands up from a sitting position. Palpable luxation: You may feel the kneecap slipping out of or back into place at the knee. During a physical exam, a veterinarian will palpate the area to determine the direction and severity of the luxation. Decreased activity level: In more severe cases, your dog may avoid walks or tire quickly and seek to sit down.

How to Distinguish Stages 1–4

In veterinary medicine, patellar luxation is classified into four stages based on severity, according to standard veterinary internal medicine textbooks.

Stage	Patellar Condition	Key Symptoms	Management Approach
Stage 1	Dislocates when manually pushed but returns to place immediately	Mostly asymptomatic	Weight management + joint supplements
Stage 2	Spontaneously dislocates but can be manually reduced	Intermittent limping	Veterinary consultation + lifestyle management
Stage 3	Mostly dislocated; returns to place only briefly before dislocating again	Persistent lameness	Surgery recommended
Stage 4	Permanently dislocated and cannot be manually reduced	Severe lamening + leg deformity	Surgery essential

A Closer Look at Each Stage

Stage 1 is often discovered incidentally during a physical exam, as it’s difficult for pet owners to notice. The patella can be manually displaced but returns to its normal position on its own when released. Stage 2 is when owners typically begin to notice symptoms. The patella dislocates naturally as the knee bends or extends, causing the dog to suddenly lift its leg while walking and then resume normal gait after a few steps. Stages 3–4 involve persistent limping or, in severe cases, walking with the knee permanently bent. At this point, damage to the articular cartilage and laxity of the ligaments have already progressed.

Illustration of a puppy having its knee examined by a veterinarian

Visit the Vet Immediately If You See These Symptoms

If your dog suddenly refuses to put any weight on its hind legs, shows severe pain when touched, or has noticeable swelling around the knee, please visit a veterinary clinic immediately. This may not be a simple patellar luxation but could involve a torn cruciate ligament or a fracture. In fact, 15–20% of dogs with patellar luxation also have a concurrent cruciate ligament tear.

Home Management for Stages 1–2

In stages 1 and 2, management without surgery is often possible. The key is to adopt lifestyle habits that prevent the condition from worsening.

Weight Management: Excess weight can increase the burden on the joints. Maintaining an ideal weight is fundamental to joint health.

Slip Prevention: Slippery floors can increase the frequency of patellar luxation. Please use rugs or non-slip mats.

Joint Health Supplements: Supplements such as glucosamine and chondroitin may be used to support joint health. Since effectiveness and suitability vary by individual, always consult your veterinarian before deciding whether to administer them.

Appropriate Exercise: Avoid strenuous jumping or climbing stairs, and focus on walks on flat ground.

Illustration of a puppy walking on a non-slip mat

Surgery Is Recommended for Stages 3–4

For grade 3 or higher, most veterinarians recommend surgery. According to veterinary orthopedic textbooks, even small-breed dogs show good outcomes after surgery. Delaying surgery can lead to wear of the articular cartilage and laxity of the ligaments, progressing to degenerative joint disease. After surgery, it is important to restrict activity for 6 to 8 weeks. If you are curious about the surgical procedure, check out the Patellar Surgery Guide. If you have questions about braces, see the Brace Selection Guide.

Illustration of a puppy recovering healthily after surgery

Certain Breeds Are More Prone

Patellar luxation is largely influenced by genetic and developmental factors, making it more common in certain breeds.

Small breeds: Maltese, Pomeranian, Toy Poodle, Chihuahua, and Yorkshire Terrier are particularly prone. In small dogs, the patella typically dislocates medially (toward the inside of the knee).

Large breeds: Large breeds such as Labrador Retrievers and Golden Retrievers can also be affected. In these dogs, lateral (outward) luxation has also been reported.

If you own a dog from one of these breeds, we recommend having your veterinarian check the patellar status during regular health screenings, even if no symptoms are present.

Reviewed by a veterinarian

Dr. Tony — Punnawat Phongkittirak

Veterinarian

A veterinarian who majored in veterinary medicine at Khon Kaen University, Thailand, and completed the IVSA program at North Carolina State University in the United States. Drawing on clinical experience at animal hospitals, he works in the pet healthcare field and is dedicated to building a digital care environment that connects pet parents with veterinarians.

Frequently Asked Questions

My dog has grade 1 patellar luxation. Does it need surgery?

Stage 1 can usually be managed without surgery. The key is to prevent progression through weight management, non-slip flooring, and appropriate exercise. Regular veterinary check-ups are essential to monitor the condition.

Can patellar luxation occur in both legs?

Yes, it can affect both legs. Even when both sides are involved, one side is often more severely affected than the other. Therefore, if patellar luxation is diagnosed in one leg, it’s a good idea to have the opposite leg checked regularly as well.

Can patellar luxation heal on its own?

Patellar luxation is a structural issue, so it won’t resolve on its own. However, in stages 1 and 2, you can help prevent the condition from worsening through weight management and muscle strengthening.

How is a patellar luxation diagnosed?

Veterinarians diagnose this condition through palpation, which involves manually examining the patella. They assess whether dislocation is present and determine its severity, and if necessary, use X-rays to further evaluate bone structure and joint condition.

Does dog insurance cover patellar surgery?

While coverage varies by pet insurance plan, many policies do cover patellar surgery. However, conditions diagnosed before enrollment may be excluded, so be sure to carefully review your policy’s terms and conditions.