Treatment Plan

Ideally a Grade 2 patella luxation should be surgically corrected.  Prompt surgical 
correction is recommended regardless of minimal or intermittent clinical signs.  If 
problem persists without surgical correction, degenerative joint disease is inevitable.  
Analgesic therapy may be temporarily useful; however, it is not recommended as a 
permanent solution.  It rarely alleviates the clinical signs permanently, and continued 
luxation and malalignment of the joint will cause increased degenerative change and 
progress to osteoarthritis.  

We would inform the client that the prognosis for normal use of the limb is good with 
surgical correction.   Considering the radiographic interpretation showed no evidence of 
osteoarthritis and the animal is still relatively young, degenerative changes in the joint 
can be greatly minimized at this point.  If we wait until lameness becomes worse, the 
degenerative changes could be much more severe and the prognosis more guarded.  
While non-steroidal anti-inflammatory administration may be temporarily palliative,  the 
intermittent patellar luxation may prematurely wear the articular cartilage of the patella, 
causing worse problems later.

There are a variety of surgical options for medial patella luxation.  We would have to do 
a more thorough radiographic evaluation of the joint to determine the best method.  In 
some mild cases, reinforcement of the lateral retinaculum may be sufficient but usually is 
used in combination with other techniques.  Ideally we need to neutralize the mechanical 
force pulling the patella out of the trochlear groove.  This can be done by deepening the 
trochlear groove with a trochlear wedge recession or a trochlear resection.  With a severe 
deformation of the bone, a rotational femoral osteotomy may be required.  Evaluation of 
the joint during surgery will also help determine the best option for correction.  


Regardless of which treatment the client chooses, we suggest that Titan be placed on a weight loss plan to reduce the amount of strain put on the patellar ligament and on its joints in general.