Muss eine Patellaluxation beim Hund immer operiert werden?

Nein — Grad I und manchmal Grad II ohne starke Symptome sind konservativ führbar. Grad III und IV sollten operiert werden, da ohne Korrektur progressive Arthrose entsteht.

Bei welchen Rassen tritt Patellaluxation häufig auf?

Kleine Rassen: Yorkshire, Chihuahua, Spitz, Malteser, Pudel. Mittelgroß: Bulldogge, Boston Terrier. Großrassen: Labrador, Rottweiler (dann häufiger lateral). Genetische Prädisposition ist belegt.

Wie hoch sind die Operationskosten bei Patellaluxation?

Typisch 800–2.000 Euro pro Bein je nach Schweregrad und Technik. Bei bilateralem Befall (häufig) entsprechend höher. Hundekrankenversicherung deckt orthopädische Operationen häufig ab — Abschluss vor Diagnose notwendig.

Health & Diseases

Patellar Luxation in Dogs: Severity, Symptoms, and Treatment

Patellar luxation is the lateral displacement of the kneecap (patella) from its physiological position in the trochlear groove of the femur. The condition is often congenital or developmental—rarely traumatic. It primarily affects small and medium-sized breeds, but also occurs in large breeds. Depending on the severity, the patella may spontaneously return to its normal position, remain permanently displaced, or be manually repositioned.

Auf einen Blick

Patellar luxation is the lateral displacement of the kneecap (patella) from its physiological position in the trochlear groove of the femur. The condition is often congenital or developmental—rarely traumatic. It primarily affects small and medium-sized breeds, but also occurs in large breeds. Depending on the severity, the patella may spontaneously return to its normal position, remain permanently displaced, or be manually repositioned.
Risiko-Hinweis: low-moderate: Consider context and individual differences
Wissenschaftliche Einordnung: Roush (1993, VCNA, PubMed 8337660) describes the clinical classification of patellar luxation into four grades: Grade I – patella manually luxatable, spontaneously reduces; Grade II – spontaneous luxation, dog occasionally limps, spontaneous reduction possible; Grade III – patella permanently luxated, can be manually reduced but does not spontaneously reduce; Grade IV – permanently luxated, not or hardly reducible, severe limb deformity. Medial patellar luxation (MPL) predominates in small breeds; lateral luxation in large breeds.Piermattei and Flo (1997, Handbook of Small Animal Orthopedics) describe surgical correction options: trochleoplasty (deepening of the trochlear groove), tibial tuberosity transposition (relocation of the patellar ligament insertion), and soft tissue reconstruction are the standard procedures. Two to three techniques are usually combined; Grade III–IV without surgery leads to progressive deformity and osteoarthritis.Gibbons et al. (2006, JSAP, PubMed 16553638) analyzed patellar luxation in 70 large breed dogs: large breed patellar luxation differs from small breeds — more frequent lateral luxation, more frequent cruciate ligament comorbidity, higher postoperative complication rates. In large breed patellar luxation, simultaneous cruciate ligament pathology should be excluded preoperatively, as cranial cruciate ligament rupture determines the surgical prognosis.

Patellar Luxation in Dogs: Severity, Symptoms, and Treatment

What is patellar luxation in dogs?

Patellar luxation is the lateral displacement of the kneecap (patella) from its normal position in the trochlear groove of the femur. The condition is often congenital or developmental in nature—rarely traumatic. It primarily affects small and medium-sized breeds, but also occurs in large breeds. Depending on the severity, the patella may spontaneously return to its normal position, remain permanently displaced, or be manually repositioned.

Patellar luxation is the most common knee condition in dogs. Its clinical significance varies widely: Grade I is often asymptomatic throughout the dog’s life; Grade III–IV causes progressive lameness and, if left untreated, leads to secondary osteoarthritis.

Background + Scientific Context

Roush (1993, VCNA, PubMed 8337660) describes the clinical classification of patellar luxation into four grades: Grade I — Patella can be manually luxated, pops back into place spontaneously; Grade II — Spontaneous luxation, dog occasionally walks on three legs, spontaneous reduction possible; Grade III — Patella permanently dislocated, can be manually reduced but does not reduce spontaneously; Grade IV — Permanently dislocated, cannot be reduced or is very difficult to reduce, severe limb deformity. Medial patellar luxation (MPL) is more common in small breeds; lateral patellar luxation in large breeds.

Piermattei and Flo (1997, Handbook of Small Animal Orthopedics) describe the surgical correction options: trochleoplasty (deepening of the trochlear groove), tibial tubercle transposition (relocation of the attachment point of the patellar ligament), and soft tissue reconstruction are the standard procedures. In most cases, two to three techniques are combined; Grade III–IV without surgery leads to progressive deformity and osteoarthritis.

Gibbons et al. (2006, JSAP, PubMed 16553638) analyzed patellar luxation in 70 large-breed dogs: Patellar luxation in large breeds differs from that in small breeds—more frequent lateral luxation, more frequent cruciate ligament comorbidity, and higher rates of postoperative complications. In cases of patellar luxation in large breeds, concomitant cruciate ligament pathology should be ruled out preoperatively, as a cruciate ligament rupture determines the surgical prognosis.

Vitomalia-Position

Grade I–II patellar luxation in asymptomatic dogs does not require surgery—but regular veterinary checkups, weight management, and joint protection are recommended. Grade III–IV causes progressive joint damage and should be corrected surgically before secondary osteoarthritis sets in.

When does patellar dislocation become a concern?

Occasional hopping on three legs (typical of Grade II)
The dog suddenly extends its leg and then walks normally again
Small breeds with a genetic predisposition: Yorkshire Terrier, Chihuahua, Spitz, Maltese
Lameness after physical exertion
Diagnostic: X-rays of both knees to obtain a complete picture

Practical application

Grading and clinical significance:

Degree	Findings	Symptoms	Therapy
In	Can be adjusted manually; returns automatically	Often none	Conservative + Control
Second	Spontaneous dislocation, spontaneous reduction	Occasionally hop	Conservative to open, depending on progression
Three	Permanently dislocated, can be manually reduced	Lameness, pain	Surgery is recommended
Fourth	Permanent, non-repositionable	Persistent lameness, deformity	Surgery is urgent

Conservative measures (Grade I–II): - Weight management: Being overweight increases mechanical stress on the knee joint - Joint health supplements: Omega-3, glucosamine/chondroitin for support - Movement restrictions: no jumping on furniture, no sudden changes in direction - Regular checkups (every 6 months)

Common Mistakes & Myths

"Grade I always requires surgery." Grade I without clinical symptoms and without progression can often be managed conservatively for life. Surgery is not automatically indicated for every diagnosis.
“After surgery, the dog is cured.” Surgical correction halts the progression of the condition but does not reverse existing osteoarthritis. Postoperative physical therapy and long-term joint management are essential.
“Hopping is just a habit.” Occasional hopping on three legs followed by a normal gait is a classic Grade II sign—not a quirk, but an orthopedic finding.

Current State of Research (2026)

Patellar luxation is one of the most common reasons for referral in veterinary orthopedics. Surgical success rates for Grade III–IV cases exceed 85%, with good long-term outcomes. Minimally invasive correction techniques (arthroscopically assisted trochleoplasty) are gaining prominence. For small breeds with a known genetic predisposition, breeders’ associations are discussing X-ray screening for breeding selection—similar to HD screening.

Frequently Asked Questions

Does a dog with patellar luxation always need surgery?

No — Grade I and, in some cases, Grade II cases without severe symptoms can be managed conservatively. Grade III and IV cases should be treated surgically, as progressive osteoarthritis and deformity will develop without correction. The decision is made by the veterinarian based on clinical and radiographic evaluation.

In which breeds does patellar luxation occur frequently?

Small breeds: Yorkshire Terrier, Chihuahua, Miniature Poodle, Maltese, Bichon Frisé, Poodle. Medium breeds: Bulldog, Boston Terrier. Large breeds: Labrador, Rottweiler, Boxer (more commonly lateral). A genetic component has been established; predisposition is becoming increasingly relevant in breeding.

How much does surgery for patellar dislocation cost?

Costs vary depending on the severity, surgical technique, and veterinary practice—typically ranging from 800 to 2,000 euros per leg. Since patellar luxation often occurs in both legs, the total cost may be higher. Dog health insurance often covers orthopedic surgeries; however, the policy must be in effect prior to diagnosis.

Related terms

Sources & Further Reading

Piermattei, D. L., & Flo, G. L. (1997). Handbook of Small Animal Orthopedics and Fracture Repair (3rd ed.). Saunders. ISBN 9780721657257.
Roush, J. K. (1993). Canine patellar luxation. Veterinary Clinics of North America: Small Animal Practice, 23(4), 855–868. https://pubmed.ncbi.nlm.nih.gov/8337660/
Gibbons, S. E., Macias, C., Pablo Martinez, T., Pinchbeck, G. L., & McKee, W. M. (2006). Patellar luxation in 70 large breed dogs. Journal of Small Animal Practice, 47(1), 3–9. https://pubmed.ncbi.nlm.nih.gov/16553638/

Wissenschaftliche Einordnung

Roush (1993, VCNA, PubMed 8337660) describes the clinical classification of patellar luxation into four grades: Grade I – patella manually luxatable, spontaneously reduces; Grade II – spontaneous luxation, dog occasionally limps, spontaneous reduction possible; Grade III – patella permanently luxated, can be manually reduced but does not spontaneously reduce; Grade IV – permanently luxated, not or hardly reducible, severe limb deformity. Medial patellar luxation (MPL) predominates in small breeds; lateral luxation in large breeds.

Piermattei and Flo (1997, Handbook of Small Animal Orthopedics) describe surgical correction options: trochleoplasty (deepening of the trochlear groove), tibial tuberosity transposition (relocation of the patellar ligament insertion), and soft tissue reconstruction are the standard procedures. Two to three techniques are usually combined; Grade III–IV without surgery leads to progressive deformity and osteoarthritis.

Gibbons et al. (2006, JSAP, PubMed 16553638) analyzed patellar luxation in 70 large breed dogs: large breed patellar luxation differs from small breeds — more frequent lateral luxation, more frequent cruciate ligament comorbidity, higher postoperative complication rates. In large breed patellar luxation, simultaneous cruciate ligament pathology should be excluded preoperatively, as cranial cruciate ligament rupture determines the surgical prognosis.