Luxating Patella in Dogs: Symptoms, Grades and Care

The bottom line first: a repeated "skip" — your dog lifting a back leg for a few steps and then walking normally again — is the classic sign of a luxating patella, and only a hands-on vet exam with X-rays can tell you the grade.

What a luxating patella actually is

The patella is the small round bone at the front of the knee — the kneecap. Normally it glides up and down inside a groove at the end of the thigh bone, transmitting the force that straightens the knee. If that groove is too shallow, if the leg bones are slightly bowed, or if the ligaments and tendons that hold the knee are pulling off-line, the kneecap slides out of the groove. That is a luxating patella.

It is especially common in small and toy breeds such as Maltese, Poodles, Pomeranians, Chihuahuas and Bichons, and it usually comes from the shape of the bones the dog was born with. Owners often search for an accident to explain it, but far more often there was no injury at all — it simply becomes visible over time. In small dogs the kneecap usually slips toward the inside of the leg; in large breeds it can slip outward instead.

Signs worth paying attention to

The skipping gait — your dog is walking fine, suddenly holds up one back leg and hops a few steps, then carries on as if nothing happened. This is the most recognizable sign.
Stretching the leg back or shaking it out — often the dog's own way of getting the kneecap to slide back into place.
Sitting oddly — sitting with a back leg splayed out to the side, or always leaving one leg at an angle.
Avoiding stairs and the sofa — hesitating at jumps they used to make easily, or asking to be picked up.
Less enthusiasm for walks, tiring quickly, dislike of being touched near the knee, or an audible click at the joint.
Bow-legged stance — in dogs affected from a young age, the posture and shape of the back legs can look different.

Symptoms are usually intermittent rather than constant — showing up once every few days, or only with certain movements. That is exactly why so many owners write it off as "it happens now and then" and lose time. If you can, record a video of the skipping and bring it to the appointment. Most dogs walk perfectly in the exam room, so that clip is genuinely useful for the diagnosis.

What grades 1 to 4 mean

Veterinarians grade the condition by how easily the kneecap comes out and how readily it goes back.

Grade 1 — the kneecap sits normally and only luxates when the vet pushes it; it returns as soon as the pressure is released.
Grade 2 — it slips out on its own during normal activity but goes back when the leg is extended or moved. This is where the skipping gait typically becomes noticeable.
Grade 3 — the kneecap is out of place most of the time. It can be pushed back manually, but it slips out again quickly.
Grade 4 — the kneecap is permanently displaced and cannot be repositioned by hand. Changes in gait and leg shape are obvious.

The grade is determined by a vet palpating the knee, usually alongside X-rays to check bone alignment and the state of the joint. How severe the visible symptoms are does not always match the grade, so you cannot settle on "my dog is a grade 2" just from watching them walk at home.

When surgery comes into the conversation

Not every luxating patella goes straight to surgery. Mild, symptom-free cases are often monitored and managed, while surgery is generally considered more seriously from grade 2 upward when lameness or pain comes with it. The reasoning is that a knee slipping out repeatedly over a long period wears the cartilage and leads to arthritis, and an unstable knee puts extra strain on the cruciate ligament as well.

Owner satisfaction after surgery is reported as high, but the outcome and the recovery depend on age, body weight, how much the leg bones are deformed, and any other conditions present. Surgery also means a defined period of restricted activity and rehabilitation afterward. Talk it through with your veterinarian based on the actual exam findings. The more useful question is not "what grade is it" but is my dog in pain, and is it progressing.

Protecting the knees at home

Whether or not surgery happens, day-to-day management is the most reliable way to reduce load on the knee.

Weight comes first — a single kilogram feels much heavier to a small dog's knee than it does to you. Check whether the current portion size is right with our dog food portion calculator, and keep treats under 10% of daily calories.
Get rid of slippery floors — a slip on hardwood or tile twists the knee in an instant. Lay non-slip mats along the routes your dog uses most.
Trim paw hair and nails — long hair between the pads and overgrown nails are slip hazards by themselves.
Cut down on jumping — leaping down from the sofa or bed is the hardest thing on the knee. Add pet steps or lift your dog down. It also helps to discourage standing up on the hind legs to beg.
Keep the muscle — stopping walks entirely because the leg hurts causes thigh muscle to waste away, which makes the knee less stable. Short, regular walks on flat ground beat occasional bursts of rough play. In hot weather, walk early in the morning or late in the evening.

Joint supplements come up a lot. They are a supportive option at best and will not put a displaced kneecap back where it belongs. Before starting one, check with your vet that it suits your dog and does not overlap with the current food and treats. Never share human anti-inflammatory painkillers with your dog, and if you are unsure what else is unsafe, see our guide to foods dogs and cats can't eat.

Does a luxating patella always need surgery?

No. Mild cases without symptoms are often monitored and managed rather than operated on, and surgery is generally considered more seriously from grade 2 upward when there is pain or lameness along with it. Age, body weight, how much the leg bones are deformed, and the state of the cruciate ligament all change the picture, so the grade alone does not decide it. Have your dog examined, including X-rays, and discuss the options with your veterinarian.

Should I push the kneecap back into place myself?

Manipulating the knee or pulling on the leg to reset it at home is not recommended. It can hurt your dog, and repeating it puts strain on the tissue around the joint. In most cases the dog stretches or shakes the leg and the kneecap slides back on its own. If it slips out often or does not go back by itself, that is a situation for a veterinary exam, not a home fix.

🛒 Coupang Pet Best Sellers

As a Coupang Partners affiliate, we may earn a commission from qualifying purchases.

🔗 Related articles

🧮 All calculators 💡 Pet Guide

This content is general information and does not replace veterinary diagnosis. An accurate diagnosis and grading require a veterinary exam — and if your dog keeps holding the leg up or seems to be in real pain, have them seen right away.