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{{SI}}
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{{CMG}}
{{Dislocated patella}}
'''For patient information, click [[Dislocated patella (patient information)|here]]'''


{{SK}} dislocated kneecap; patellar subluxation; subluxation of the patella
{{CMG}}; {{AE}} [[Grace M. Gibson]]


==Overview==
{{SK}} Dislocated kneecap; patellar dislocation; patellar subluxation; subluxation of the patella; subluxation of patella; luxating patella; trick knee
'''Luxating patella''', or trick knee, is a condition in which the [[patella]], or kneecap, dislocates or moves out of its normal location.  The luxation is usually medial, but can be lateral.  It can be caused by some form of [[blunt force trauma|blunt trauma]], or may be a [[congenital]] defect.  In congenital cases, it is usually bilateral.  Patellar luxation is a common condition in [[dog]]s, particularly small and miniature breeds.  The condition usually becomes evident between the ages of 4 to 6 months.  It also occurs in [[cat]]s, especially the [[Domestic shorthaired cat|Domestic Shorthair]].<ref name=Ettinger_1995>{{cite book|author=Ettinger, Stephen J.;Feldman, Edward C.|title=Textbook of Veterinary Internal Medicine|edition=4th ed.|publisher=W.B. Saunders Company|year=1995|id=ISBN 0-7216-6795-3}}</ref>


Diagnosis is made through palpation of the knee.  [[X-ray]]s are necessary in some cases.  The luxating patella often causes no or very slight symptoms.  There may be intermittent limping in the rear leg.  [[Osteoarthritis]] can develop secondarily.
==[[Dislocated patella overview|Overview]]==
==[[Dislocated patella historical perspective|Historical Perspective]]==


There are four diagnostic grades of patellar luxation<ref>{{cite web
==[[Dislocated patella classification|Classification]]==
  | author = OFA
 
  | title = Patellar Luxation
==[[Dislocated patella pathophysiology|Pathophysiology]]==
  | publisher = [[Orthopedic Foundation for Animals]]
 
  | url = http://www.offa.org/patluxinfo.html
==[[Dislocated patella causes|Causes]]==
  | format = text/html
 
  | accessdate = 2007-09-04}}</ref>, each more severe than the previous:
==[[Dislocated patella differential diagnosis|Differentiating Dislocated Patella from other Diseases]]==
* Grade I - the patella can be manually luxated but is reduced (returns to the normal position) when released;
 
* Grade II - the patella can be manually luxated or it can spontaneously luxate with [[flexion]] of the stifle joint. The patella remains luxated until it is manually reduced or when the animal extends the joint and derotates the [[tibia]] in the opposite direction of luxation;
==[[Dislocated patella epidemiology and demographics|Epidemiology and Demographics]]==
* Grade III - the patella remains luxated most of the time but can be manually reduced with the stifle joint in extension. Flexion and extension of the stifle results in reluxation of the patella;
 
* Grade IV - the patella is permanently luxated and cannot be manually repositioned. There may be up to 90¼ of rotation of the proximal tibial plateau. The [[femur|femoral]] [[trochlea]]r groove is shallow or absent, and there is displacement of the [[quadriceps]] muscle group in the direction of luxation.
==[[Dislocated patella risk factors|Risk Factors]]==
 
==[[Dislocated patella natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
 
==Diagnosis==
[[Dislocated patella history and symptoms|History and Symptoms]] | [[Dislocated patella physical examination|Physical Examination]] | [[Dislocated patella laboratory findings|Laboratory Findings]] | [[Dislocated patella x ray|X Ray]] | [[Dislocated patella CT|CT]] | [[Dislocated patella MRI|MRI]] | [[Dislocated patella other imaging findings|Other Imaging Findings]] | [[Dislocated patella other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
==Treatment==
Grades III and IV, as well as most grade II cases, require [[surgery]] to correct, if the animal has difficulty walking. The surgery involves a [[sulcoplasty]], a deepening of the [[trochlea]]r sulcus that the patella sits in.
[[Dislocated patella medical therapy|Medical Therapy]] | [[Dislocated patella surgery|Surgery]] | [[Dislocated patella primary prevention|Primary Prevention]] | [[Dislocated patella secondary prevention|Secondary Prevention]] | [[Dislocated patella cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Dislocated patella future or investigational therapies|Future or Investigational Therapies]]
 
Additional help can be given with the use of pet ramps, stairs, or steps.  These can help the animal travel from one place to another, especially up and down, without adding any pain or damage to the patella.


==References==
== Case Studies ==
{{Reflist|2}}
[[Dislocated patella case study one|Case #1]]


[[Category:Orthopedics]]
[[Category:Orthopedics]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Disease]]


[[de:Patellaluxation]]
[[de:Patellaluxation]]
[[pl:Zwichnięcie rzepki]]
[[pl:Zwichnięcie rzepki]]

Latest revision as of 02:03, 24 July 2013

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Grace M. Gibson

Synonyms and keywords: Dislocated kneecap; patellar dislocation; patellar subluxation; subluxation of the patella; subluxation of patella; luxating patella; trick knee

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Dislocated Patella from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | X Ray | CT | MRI | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

de:Patellaluxation

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