Preoperative and postoperative stance analysis in dogs

with patellar luxation confirms lameness improvement

after surgery
Lisa C. DiGiovanni, MS, DVM*; James K. Roush, DVM, MS, DACVS*; Kara Berke, DVM, DACVS*

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS
*Corresponding authors: Dr. DiGiovanni (lcdigiov1822@gmail.com); Dr. Roush (roushjk@vet.k-state.edu);
Dr. Berke (kberke@et.k-state.edu)
Received October 31, 2022.
Accepted January 3, 2023.
doi.org/10.2460/ajvr.22.10.0186

OBJECTIVE
To document and compare preoperative and postoperative stance analysis measurements in animals with naturally
occurring patellar luxation.
ANIMALS
131 client-owned dogs surgically treated for naturally occurring unilateral or bilateral patella luxation between
March 30, 2015, and February 12, 2020.
PROCEDURES
Weight bearing as a percent body weight on each limb was recorded with the use of a platform device for analyzing
stance (PetSafe Stance Analyzer; LiteCure LLC, Companion Animal Health) preoperatively and postoperatively for
all dogs. Signalment, limb affected, lameness grade, luxation direction, luxation grade, and surgical procedure were
collected from patient records and assessed for the effects of these variables on weight bearing preoperatively or at
the first or second postoperative recheck examination.
RESULTS
There were 61 males and 70 females, with a mean age and body weight of 4.62 years and 13.01 kg, included in
the study. As age increased, body weight decreased in these dogs (P = .025). There was a statistically significant
improvement in lameness after surgery (P = .008) at the second postoperative recheck examination. Lameness sig-
nificantly decreased as postoperative time increased (P < .001, r = 0.503). As age increased, lameness at the initial
visit decreased compared to younger dogs but not significantly (P = .062). There was no significant effect of preop-
erative luxation grade, luxation direction, surgical procedure, or sex when comparing initial lameness or lameness
at recheck examination.
CLINICAL RELEVANCE
Surgical correction of patella luxation improves lameness as measured by postoperative stance analysis. Preoperative
luxation grade or direction, surgical procedure performed, and sex of the animal did not significantly affect outcome
in this group of dogs.

M edial patella luxation (MPL) is common in young,

small-breed dogs. A luxating patella can occur
due to congenital, developmental, or traumatic
causes. It is most commonly a developmental dis-
ease that occurs when dogs are born with an ana-
tomic conformation that predisposes the limb to
patellar luxation over time.1
Clinical signs of patellar luxation vary based on the
severity of luxation but include gait abnormalities and
intermittent progressive lameness.1 Not all affected
dogs show clinical signs that are noticed by owners, and
MPL is often an incidental finding later in life. Surgery is
controversial when patients do not have a consistent or
obvious lameness at the time of consultation. The deci-
sion to pursue surgery in an attempt to prevent clinical
progression and to improve lameness is straightfor-
ward for animals that have obvious lameness. The
decision is not clear cut for dogs that are intermittently
lame, do not appear to be affected by their lameness,
or whose lameness is not progressing. With increased
age and luxation grade, joint pathology will continue to
progress despite surgical intervention.2–4
The prevalence of luxating patellas in dogs has
been reported in the United States to be approximately

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5.4%.5 Surgical correction commonly involves a com-
bination of procedures that deepen the trochlear
groove via a wedge or block recession, transpose the
tibial tuberosity, and imbricate or release periarticular
soft tissues.
It has been reported that for every occult grade
2 medially luxating patella that was presented to a
clinic and surgically corrected, 1 dog would have
had an unnecessary surgery to prevent lameness
within 4 years.6
Reported postoperative complication rates vary
between 13% and 48%.7 A common complication is
reluxation, which has been reported in 8% and 48%
of operated dogs and is more likely to occur in large
breed dogs.1 Not all reluxations required a second
surgery with 68% of reluxation cases resulting in a
grade 1 MPL. Overall, 92% of dogs were considered
sound at follow-up.1 In a paper by Cashmore et al,7
11.6% of cases had a luxation after initial patellar sta-
bilization and only 6.4% required a surgical revision.
Historically, patellar luxation correction has been
recommended for animals that are showing obvious
lameness. To our knowledge, there are no reports
of reliable, objective measurement of lameness in
dogs with patellar luxation following surgery. Data
obtained via stance analysis can provide an objective
measurement of lameness before or after surgery on
clinically sound animals with a luxating patella. An
objective measurement of lameness could help the
clinician advise owners in making the decision if sur-
gical correction is the best option.
Both subjective and objective measures of lame-
ness in dogs have been evaluated, but there are no
reports of objective measures of lameness due to
patellar luxation. Subjective lameness analysis meth-
ods such as the visual analog scale (VAS) and the
numeric rating scale (NRS) have been validated in
lame animals.8,9 These subjective assessments are
most useful for animals on either extreme of the
scale (very lame or sound dogs) but neither is reli-
able for the dogs that are subtly lame.8,9
Force plate analysis has been used as an objective
measure to evaluate lameness not easily observed
subjectively. Force plate measurements have been
compared and validated compared to the VAS or
NRS showing that the force plate was a more sen-
sitive objective measurement.10 Stance analysis was
first reported when Seibbert and colleagues11 found
that measuring the percentage of body weight (BW)
by placing a bathroom scale under each limb was a
valid measurement for differentiating which limb is
most affected due to signs of coxofemoral joint pain.
The percentage of BW is a measure of the percentage
of weight an animal is placing on each limb during
weight bearing. It has been used to obtain objective
measurements after various surgical procedures such
as cranial cruciate ligament repair, total hip replace-
ment, and osteoarthritis models as well as a method
to evaluate a patient’s response to analgesia.12–15
The PetSafe Stance Analyzer13 (LiteCure,
Companion Animal Health) is an objective tool to
diagnose lameness in dogs by measuring the per-
centage of BW. The dog is required to stand with
2
a single foot in 4 different quadrants to assess the
weight distribution in each limb at a given time point.
This device is less expensive than more advanced
gait analysis techniques such as pressure platform
force collection or joint kinematics, is a quick and
easy tool for most hospital staff to learn and under-
stand, and provides an objective measure to evalu-
ate lameness.16 The objective of the study reported
here was to document and compare preoperative
and postoperative stance analysis measurements in
animals with naturally occurring patellar luxation.
Materials and Methods
One hundred forty-seven dogs were evaluated
at the Kansas State University Veterinary Health
Center Orthopedic Surgery Service from March 2015
to February 2020 for naturally occurring unilateral
or bilateral patella luxation. One hundred thirty-one
dogs were included in the study after the exclusion
of dogs that had no clinically visible lameness during
physical examination. All included dogs were sub-
jected to stance analysis (PetSafe Stance Analyzer;
LiteCure LLC, Companion Animal Health) preopera-
tively and during the first and second postoperative
recheck examination (V1 and V2, respectively) when
one occurred. The V1 was recommended to occur at
4 or 8 weeks for all animals having a tibial tuberosity
transposition performed to evaluate bone healing on
radiography. Animals were returned for a follow-up
examination based on the client’s decision to sched-
ule a recheck examination. Records were reviewed
for V1 and V2 and included stance data that were
routinely collected at Kansas State University for
lame patients presented to the orthopedic service.
Stance analysis was performed according to
a protocol for clinical research approved by the
Institutional Animal Care and Use Committee of
Kansas State University. Individual owner consent
was not required because the stance analyzer was
routinely used for the clinical evaluation of every lame
orthopedic patient under the approved protocol.
Data were collected from the medical records of
client-owned dogs with a naturally occurring luxat-
ing patella. Data collected included breed, age, sex,
hind limb affected (right, left, or bilateral), laterality
of lameness (right, left, or bilateral), direction of lux-
ation, grade of patellar luxation, surgery performed
(right, left, or bilateral), and surgical method of sta-
bilization. Surgical corrections related to the luxating
patella included a trochlear wedge or block recession,
tibial tuberosity transposition, joint capsule imbrica-
tion, or release as a single procedure or as a combi-
nation of procedures. Animals that had a concurrent
procedure for a cruciate ligament rupture such as a
lateral suture or tibial plateau leveling osteotomy on
the surgical limb were classified under procedure as
“other.” Dogs were excluded if the luxating patella
was secondary to vehicular or major trauma or previ-
ous surgery. Dogs in the no MPL surgery group were
categorized as animals with a MPL but no surgical
correction for the MPL. Data were collected for the
initial visit (V0), V1, and V2, if one occurred.
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 The device for analyzing stance (PetSafe Stance
Analyzer; LiteCure LLC, Companion Animal Health)
was calibrated by the use of a registered known
weight in accordance with the manufacturer’s
instructions before use each day. The analyzer was
placed in the center of a dedicated gait analysis
laboratory, and leashed dogs were walked onto the
device from behind the analyzer and encouraged to
stand in a relaxed position with each foot placed in
its respective quadrant, and the percentage of BW
was recorded. A minimum of 5 valid measurements
were collected over 30 seconds and averaged for a
single percentage of BW value. Data were collected
on the day of the initial examination or at the time of
reevaluation before the administration of any seda-
tion used to facilitate other diagnostic procedures.
The contralateral hind limb (CHL) was recorded
in comparison to the lame hind limb (LHL). The LHL
was determined from the medical record according
to the presenting complaint from the owner, or in
patients with bilateral hind limb lameness, the hind
limb with the lowest percentage of BW was recorded
as the LHL for analysis.
Luxation was classified during physical exami-
nation into 4 standard grades and recorded as
follows: grade 1, easily luxated but immediately
reduces when released; grade 2, easily luxated and
will reduce when the joint is placed through a range
of motion; grade 3, permanently luxated but eas-
ily reducible with manipulation; and grade 4, per-
manently luxated and unable to be reduced.17 Any
dog that did not cooperate with being placed on the
stance analyzer or did not have valid measurements
recorded was excluded.
Patients were divided into the following groups
as having unilateral patella luxation, bilateral patella
luxation, unilateral patella luxation with a cruciate
tear, or bilateral patella luxation with a cruciate tear
for analysis.
Statistical analysis
The percentage of BW of LHL was compared
to MPL grade and animal sex/neuter status by mul-
tiple ANOVA with a Newman-Keuls post hoc. Initial
age and weight were assessed for correlation with
each other and with the percentage of BW of the
LHL by Pearson correlation coefficient. Weight
change over time by assessed by repeated-measures
ANOVA with Newman-Keuls post hoc. Changes
in the percentage of BW between V0, V1, and V2
were compared by repeated-measures ANOVA with
Newman-Keuls post hoc. A Student’s t-test was used
to analyze the relationship between the lame side
Table 1—Mean ± SD age, body weight, and results for stance analyses in terms of percentage of body weight (% of
BW) for 131 dogs undergoing surgery for naturally occurring unilateral or bilateral patella luxation between March
30, 2015, and February 12, 2020, grouped on the basis of whether dogs showed clinical signs of bilateral, left, or
right hind limb lameness on initial examination (V0).
Recorded hind Contralateral front
limb lameness Age (y) limb (% of BW)
Bilateral (n = 18) 2.0 ± 1.8 29.44 ± 7.67
Left (n = 57) 4.4 ± 3.5 30.32 ± 7.70
Right (n = 56) 5.7 ± 10.9 32.04 ± 7.56
AJVR
and V0 lamenesss, surgery side and V0 lameness,
and surgery side and age. The correlation of the last
postoperative recheck day, percentage of BW of the
LHL at the last recheck, and change in lameness of
the LHL from the initial presentation to last recheck
were assessed by Pearson correlation coefficient
analysis. Descriptive statistics were collected on age,
sex, body weight, patella luxation grade, and initial
lameness grade. Comparisons and correlations were
considered significant at P < .05. All statistical analy-
sis was performed via standard statistical software
(WINKS Kwikstat SDA 7 version 7.0.9; Texasoft Inc).
Results
Of the 131 dogs, sex was recorded as 61 males
(56 neutered; 5 intact) and 70 females (65 neutered;
5 intact). Age ranged from 5.0 months to 13.0 years
(mean, 4.62 years) and body weight ranged from
1.66 to 61.18 kg (mean 13.03 kg). Dogs were most
commonly reported as Yorkshire Terrier (17) fol-
lowed by 10 each of Chihuahua and English Bulldog;
7 Maltese; 6 Poodle mixed-breed dogs; 5 other
mix-breed dogs; 4 each of Boston Terrier, Cavalier
King Charles Spaniel, Miniature Poodle, and terrier-
type dogs; 3 each of Boxer, Labrador Retriever,
Pomeranian, and Wheaten Terrier; 2 each of Akita,
Beagle, Border Collie, Bichon Friese, Great Pyrenees,
Golden Retriever, Jack Russell Terrier, Miniature
Australian Shepherd, Miniature Schnauzer, Pit Bull–
type dog, and Toy Poodle; and 1 each of Australian
Shepherd, Australian Blue Heeler, Brittany Spaniel,
Belgian Malinois, Bullmastiff, Chow Chow, Cocker
Spaniel-Poodle cross, Doberman Pinscher, English
Mastiff, English Setter, Golden Retriever-Poodle
cross, German Shepherd Dog, German Shorthaired
Pointer, Havanese, Italian Greyhound, Labrador
Retriever-Poodle cross, Miniature Pinscher, Parson
Russell Terrier-Jack Russell Terrier cross, Pekingese,
Papillon, Rhodesian Ridgeback, Red Heeler, Shetland
Sheepdog, Shiba Inu, Spitz, and Whippet.
Eighteen dogs had bilateral lameness, 57 dogs
were lame on the left hind limb, and 56 were lame on
the right hind limb (Table 1). Surgery was performed
bilaterally in 15 dogs, on the left in 61 dogs, and on
the right in 55 dogs (Table 2).
A total of 71 dogs had tibial tuberosity trans-
position and wedge recession at the same time,
15 dogs received only a tibial tuberosity transposi-
tion, and 29 received a trochlear wedge recession
only. Ten dogs did not have a surgical procedure and
6 were classified as “other” (Table 3). A total of 66
Ipsilateral front Contralateral hind Lame hind Body
limb (% of BW) limb (% of BW) limb (% of BW) weight (kg)
33.50 ± 5.92 23.83 ± 5.48 13.22 ± 6.58 9.6 ± 9.1
31.88 ± 9.39 24.43 ± 8.59 13.96 ± 7.82 12.2 ± 9.0
32.45 ± 7.50 23.88 ± 7.07 11.64 ± 7.69 14.9 ± 12.8
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Table 2—Mean ± SD age, body weight, and results for stance analyses (% of BW) at V0 for the dogs described in
Table 1, grouped by which hind limbs were surgically treated.
Hind limb Contralateral front Ipsilateral front Contralateral hind Lame hind Body
operated Age (y) limb (% of BW) limb (% of BW) limb (% of BW) limb (% of BW) weight (kg)
Bilateral (n = 15) 2.1 ± 1.9 30.33 ± 7.68 33.40 ± 5.91 23.53 ± 5.28 12.73 ± 6.37 7.9 ± 7.8
Left (n = 61) 4.2 ± 3.5 30.08 ± 7.65 32.03 ± 9.19 24.40 ± 8.43 14.03 ± 7.73 12.4 ± 9.2
Right (n = 55) 5.8 ± 11.0 32.04 ± 7.63 32.40 ± 7.56 23.95 ± 7.11 11.62 ± 7.76 15.1 ± 12.8

Table 3—Mean ± SD age, body weight, and results for stance analyses (% of BW) at V0 for the dogs described in
Table 1, grouped by the type of surgical treatment performed.
Contralateral Contralateral Lame
front limb Ipsilateral front hind limb hind limb Body
Surgery Age (y) (% of BW) limb (% of BW) (% of BW) (% of BW) weight (kg)
Tibial tuberosity transposition 5.0 ± 9.9 31.66 ± 6.87 32.58 ± 7.26 23.80 ± 7.94 12.42 ± 7.60 12.5 ± 10.4
and wedge recession together
(n = 71)
Trochlear wedge recession 4.0 ± 3.2 30.38 ± 6.26 30.28 ± 8.56 25.66 ± 6.99 12.69 ± 8.32 10.7 ± 10.6
(n = 29)
Tibial tuberosity transposition 2.3 ± 2.2 29.20 ± 11.79 32.93 ± 12.20 23.60 ± 6.33 14.27 ± 7.68 17.8 ± 10.9
(n = 15)
Other procedure (n = 6) 6.8 ± 3.3 30.83 ± 5.95 34.50 ± 3.73 22.67 ± 7.42 12.00 ± 5.93 11.3 ± 10.3
No MPL surgery (n = 10) 5.8 ± 2.4 30.00 ± 10.36 34.50 ± 7.95 23.40 ± 8.67 12.10 ± 7.53 17.4 ± 14.1

MPL = Medial patella luxation.

had a unilateral luxating patella, 33 dogs had a bilat-
erally luxating patella, 30 had a cruciate with a uni-
lateral luxating patella, and 2 had a cruciate tear with
bilateral luxating patella (Table 4).
Only dogs that had surgery had their recheck
examination data included in the statistical analy-
sis. Sixty-six dogs returned for a V1, and 21 dogs
returned for a V2 (Table 5). Animals returned for a
recheck examination at a mean of 96.5 ± 124.9 days
(range, 14 to 672 days) for V1 and 278.25 ± 267 days
(range, 56 to 1,034 days) for V2.
The mean body weight of all dogs was 13.03 kg ±
10.9 kg (median, 8.44 kg; range, 1.66 to 61.18 kg).
There was a significant statistical correlation between
age and body weight at the initial visit (P = .025).
This difference showed an inverse correlation with
younger dogs presenting with a higher body weight.
The average weight did not change significantly from
V0 to V1 (P = .19) or from V0 to V2 (P = .74). There
was no statistically significant correlation between
body weight and the V0 percentage of BW of LHL
(P = .882) or age and V0 percentage of BW of LHL
(P = .062). As age increased, the V0 percentage of
BW of LHL tended to be less severe compared to
younger dogs but was not statistically significant (P =
.062). There was no statistical significance between

Table 4—Mean ± SD age, body weight, and results for stance analyses (% of BW) at V0 for the dogs described in
Table 1, grouped by whether their patella luxation was unilateral (S), bilateral (B), unilateral in combination with a
cruciate tear (C), or bilateral in combination with a unilateral or bilateral cruciate tear (CB).
Contralateral front Ipsilateral front Contralateral hind Lame hind limb Body weight
Surgery Age (y) limb (% of BW) limb (% of BW) limb (% of BW) (% of BW) (kg)
S (n = 66) 4.8 ± 10.1 31.26 ± 7.33 31.74 ± 8.43 24.35 ± 7.83 12.15 ± 7.88 13.8 ± 11.1
B (n = 33) 2.4 ± 2.5 30.03 ± 7.48 32.39 ± 7.35 22.91 ± 5.80 14.67 ± 7.49 11.5 ± 10.1
C (n = 30) 6.6 ± 3.2 30.37 ± 7.39 34.57 ± 6.32 24.70 ± 8.48 10.37 ± 6.87 13.6 ± 1.5
CB (n = 2) 7.4 ± 2.3 43.50 ± 19.09 18.00 ± 24.04 27.00 ± 12.73 11.50 ± 7.78 4.1 ± 0.6

Table 5—Mean ± SD body weight, results for stance analyses (% of BW), and timing of the first or second recheck
examination for the dogs described in Table 1, grouped by visit (initial examination [V0], first recheck examination
[V1], or second recheck examination [V2]).
Contralateral Contralateral
front limb Ipsilateral front hind limb Lame hind limb Body weight
Visit Duration (d) (% of BW) limb (% of BW) (% of BW) (% of BW) (kg)
V0 (n = 131) — 30.93 ± 7.64 32.34 ± 8.17 23.92 ± 7.8 11.75 ± 7.63 13.0 ± 10.9
V1(n = 66) 96.5 ± 124.94 31.91 ± 6.67 31.98 ± 7.99 22.83 ± 7.4 13.27 ± 8.75 14.6 ± 12.3
V2 (n = 21) 278.25 ± 267.03 30.5 ± 5.36 34.2 ± 8.46 17.65 ± 7.0 17.65 ± 5.77 12.5 ± 8.7

— = Not applicable.

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sex and the V0 percentage of BW of LHL (P = .306)
or if the percentage of BW of LHL was recorded as
bilateral, right limb, left limb, or not visibly lame and
V0 percentage of BW of LHL (P = .322). There was no
statistical significance in whether surgery was per-
formed on the right limb, left limb, or bilaterally and
V0 percentage of BW of LHL (P = .168) or whether
surgery was performed on the right limb, left limb, or
bilaterally and age (P = .317).
No significant change in the percentage of BW
of LHL was noted when comparing V0 (11.75% of
BW) to V1 (13.27% of BW, P = .67). The percent-
age of BW of LHL did significantly improve from V0
(11.75% of BW) to V2 (17.65% of BW, P = .008). There
was no significant difference in the CHL comparing
V0 (22.35% of BW) to V1 (13.27% of BW, P = 0.157);
however, a significant decrease was noted when
comparing V0 (22.35% of BW) to V2 (17.65% of BW,
P = 0.032). Postoperative recheck examination day
was significantly correlated with the percentage of
BW of the LHL at the last recheck examination (P <
.001, r = 0.4398) and to the increase in the percent-
age of BW from initial presentation to last recheck
examination (P < .001, r = 0.503) (Figure 1).
Figure 1—Scatterplot depicting results for change in
signs of hind limb lameness (as a percentage of body
weight [% BW]) from initial examination to last postop-
erative recheck examination for 131 dogs undergoing
surgery for naturally-occurring unilateral or bilateral
patella luxation between March 30, 2015, and February
12, 2020. Each circle represents results for 1 dog, and
the dotted line represents the line of best fit (Pearson
correlation coefficient r = 0.503; P < .001).
The groups did not influence the degree of the
percentage of BW of LHL at V1 (P = .72) or V2 (P =
.63). There was no effect on the improvement of the
percentage of BW of LHL when comparing groups
at V1 (P = .79) or V2 (P = .95). Initial patella luxation
grade had no effect on lameness as measured by the
percentage of BW at V2 (P = .62).
Discussion
Dogs with naturally occurring patellar luxa-
tion presented initially with a mean 11.75% of BW
on the lame limb compared to the expected normal
AJVR
of nearly 20% of BW on each hind limb. This study
showed a significant improvement in dogs that
underwent a surgical correction for their luxating
patella when they returned for a second follow-up
examination with a mean 17.65% of BW regardless
of the type of surgery recommended and performed
by the surgeon.
The follow-up for V1 was a mean of 96.5 days
(range, 14 to 672 days) for a total of 66 dogs. The V2
follow-up occurred at a mean of 278.25 days (range,
56 to 1,034 days) for 21 dogs. A longer outcome
would be preferable as some dogs diagnosed with
bilateral luxating patella during the study only had
surgical correction of a single side. A longer follow-
up would allow evaluation of the nonsurgical side for
a worsening lameness and if the grade of luxating
patella had any effect on weight bearing according to
stance analysis. Results indicated that lameness had
improved for the surgical and contralateral limb by
the second visit and that improvement in lameness
was significantly linearly correlated with increased
postoperative time.
Sixty-five animals were not returned for the
first visit. One hundred and ten animals were not
returned for a second visit. Patient return for recheck
examination was subject to the owner’s willingness
to return and limited the follow-up data in this study.
Our reported results are thus subject to nonresponse
bias.18 If animals are showing no signs of lameness at
8 weeks, owners may elect to not return for a recheck
examination, and thus the average improvement was
underestimated in this study, or alternatively, if own-
ers are disappointed in the clinical response to sur-
gery, they may not have returned to this hospital for
recheck examination, which would bias results in the
opposite direction.
Statistical analysis showed an inverse correlation
between age and body weight at the initial visit. This
may suggest that larger breed dogs were referred by
veterinarians at an earlier age due to a lower preva-
lence of luxating patella in large breed dogs.19 It was
not recorded if the patient was referred for a hind
limb lameness or for luxating patella specifically.
Large breed dogs with static or progressive hind
limb lameness could potentially be referred sooner
due to the concern for other conditions such as
osteochondrosis, hip dysplasia, or a cranial cruciate
ligament tear.
Despite the correlation between age and initial
lameness not being significant, a trend was noted
(P = .062). As age increased, the initial lameness
decreased. This could be due to older animals hav-
ing a lower luxation grade resulting in less second-
ary arthritic change and less secondary inflammation
and pain. It is also possible that younger animals with
a more significant lameness would be brought to the
hospital sooner resulting in surgery earlier versus
younger animals with mild lameness may receive
medical management and therefore delay the need
for surgery and referral. The purpose of this study
was not to evaluate arthritis progression.
Despite surgical intervention, several papers
have shown that dogs with patellar luxation often
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develop arthritis, with no difference in the amount
of arthritis present between animals with successful
surgical intervention and those that failed surgical
intervention.2–4 However, surgical intervention has
subjectively been shown to significantly improve
limb use in dogs with lameness due to MPL based
on a standardized questionnaire from the owner.4
The objective of this paper was not to evaluate the
amount of arthritis present but to objectively assess
lameness in animals with a patellar luxation. Based
on this paper, there was a significant improvement
when comparing V0 to V2 (P = .008). This objective
measurement provides a basis for future studies to
compare the outcome of other surgical interventions
in dogs with patella luxation.
The ability to assess occult or minimal lameness
may aid in guiding owner decisions regarding the
advisability of surgery. A major factor in the man-
agement of nonlame luxating patella cases is the
concern for developing severe arthritis in the future.
For patients with an occult lameness, it is possible
that arthritis is delayed or diminished by performing
surgery sooner.3 However, it is difficult to justify per-
forming surgery on a clinically sound dog. Having a
reliable way to objectively assess lameness in dogs
with a luxating patella can help guide clinician rec-
ommendations and owner decisions to pursue sur-
gery at an earlier date.
This paper did not indicate a specific surgical
procedure that resulted in an improved outcome. This
lack of a statistical difference between procedures is
possibly due to nonresponse bias. Postoperative ani-
mals without clinical lameness might be less likely to
return for a follow-up examination and may be lost
unequally from more successful surgical groups.
The initial patellar luxation grade did not signifi-
cantly correlate with lameness at the second visit.
There have been no studies comparing luxation grade
and long-term outcomes. It has been reported that
dogs with grade IV luxation were more likely to have a
concurrent cranial cruciate tear.20 It is possible to have
long-term follow-up for animals with a luxating patella
and gain objective information about lameness.
This study determined that patella luxation
presents with a detectable clinical lameness by
stance analysis and that there was no effect of luxa-
tion grade, surgical procedure, age, or sex on initial
lameness due to patellar luxation. Lameness on the
operated limb did improve after surgery at the sec-
ond follow-up, regardless of the surgical procedure.
This study also demonstrated a statistically signifi-
cant inverse relationship between age and body
weight at presentation for patella luxation, indicat-
ing that older animals may be able to compensate
for a prolonged time or that it is more concerning
for owners that have a young, large breed dog with
a luxating patella.
Acknowledgment
No external funding was used in this study. The authors
declare that there were no conflicts of interest.
6
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