An urgent knee-d
My one-year-old Corgi was diagnosed with grade four patella luxation on his right knee and the vet advised me to bring him for hydrotherapy. Given his stout frame, I’m worried that the chlorinated water will get into his nose and ears. How does hydrotherapy help, and are there alternatives to combat his condition?
The grading of patellar luxation is from one (least severe) to four (most severe), and patients suffering from a grade four patella luxation have their patella permanently positioned outside of the patellar groove—this often presents as bow-leggedness and persistent lameness.
Hydrotherapy is a rehabilitation technique that employs the resistive properties of water to improve muscle strength, maintain or improve joint range of motion for patients suffering from chronic conditions with secondary osteoarthritis, as well as assist with gait reeducation and improvement of stamina for post-operative patients. Patients diagnosed with patellar luxation are often unable to perform routine workouts due to lameness, and hydrotherapy allows these patients to exercise in a comfortable environment with less muscle exertion.
In terms of conservative treatment options for a patient diagnosed with grade four patellar luxation, weight maintenance or reduction (if overweight), oral pain relief medication and hydrotherapy may only temporarily alleviate the presenting symptoms. My professional recommendation for a patient diagnosed with grade four patellar luxation is surgical correction. A grade four patellar luxation will inevitably lead to progressive skeletal deformity if not corrected early and the patient’s quality of life will be compromised.
While conservative approaches such as weight reduction, pharmacological treatment using oral pain relief medication and hydrotherapy may temporarily alleviate the symptoms and simultaneously assist in the preservation of muscle strengths for these patients, the most optimal treatment protocol differs between each individual and is highly dependent on clinical signs, severity of luxation, concurrent skeletal deformity, as well as the age of the patient. In terms of managing patients diagnosed with a grade four patellar luxation, bone reconstruction via a surgical approach is highly warranted early in the course of the disease in order to mitigate progressive skeletal deformity and secondary osteoarthritis.
Expert: Dr Grace Chen BSc BVSc (Hons) Doctors Beck and Stone