That Occasional “Skip”: A Surgeon’s Guide to Medial Patella Luxation (MPL) Surgery

Quick Answer: Medial Patella Luxation (MPL) correction is a safe and highly successful surgical procedure designed to permanently stabilize a dislocating kneecap by deepening the joint groove and realigning bone anatomy. Advanced anesthesia protocols and specialized micro-surgical tools ensure the procedure is exceptionally safe for tiny dogs, while early surgical intervention prevents progressive joint arthritis and secondary ligament damage. For dogs with bilateral MPL, addressing both knees in a single procedure offers the advantage of a single anesthetic event and one unified recovery period. Bone healing typically takes 8 weeks, with full post-operative rehabilitation and at-home therapy programs included in the standard cost of surgery at Veterinary Surgery Center.

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If you have a small breed dog—like a Yorkshire Terrier, Chihuahua, or Pomeranian—you might be familiar with the “skip.” You’re out for a normal walk, and suddenly your dog lifts one hind leg, does a little three-legged bunny hop for a few steps, kicks the leg out, and then goes right back to walking as if nothing happened.  As a veterinary surgeon at VSC (www.vscsarasota.com), this is a classic scenario I hear described every week. That little skip is the hallmark sign of Medial Patella Luxation (MPL), a condition where the dog’s kneecap (patella) pops out of its normal groove. When pet parents come to us with an MPL diagnosis, they naturally have a lot of questions and reservations. Today, I want to demystify the procedure, address the most common concerns we hear, and explain why correcting this issue is one of the most successful and rewarding surgeries we perform.

In a normal knee, the patella glides smoothly up and down within a groove at the bottom of the thigh bone. In dogs with MPL, that groove is often too shallow, and the alignment of the leg muscles pulls the kneecap inward (medially) until it dislocates.  To fix this permanently, we don’t just put the kneecap back; we realign the knee’s anatomy. The surgery generally involves three steps:

It is completely understandable to feel hesitant about orthopedic surgery. Here are the three most common concerns I discuss with pet parents in the exam room:

Because MPL is predominantly a small and toy breed condition, the vast majority of our MPL patients are under 20 pounds, and many are under 10 pounds! Our surgical suites are fully equipped with specialized, micro-surgical instruments designed specifically for tiny bones. Furthermore, our state-of-the-art anesthesia protocols and dedicated monitoring are tailored explicitly for the unique needs of miniature and toy breeds, making the procedure incredibly safe.

This is the most common—and most dangerous—misconception about MPL. Even if your dog only skips occasionally and doesn’t cry out, damage is actively occurring. Every single time that kneecap pops out of its groove and grinds back in, it scrapes away the protective cartilage. Over time, this leads to irreversible, painful arthritis. Furthermore, a dislocating kneecap changes the biomechanics of the entire knee, putting immense stress on the Cranial Cruciate Ligament (the dog’s ACL). We frequently see dogs present for a simple MPL, only to find they have now torn their cruciate ligament because we waited too long. Intervening early, while the cartilage is still healthy, prevents a lifetime of chronic pain and more complex joint issues down the road.

When both knees are affected, I almost always recommend single-stage bilateral surgery—meaning we fix both knees at the exact same time. While it sounds intimidating, there are massive advantages for your pet. First, it means only one anesthetic event. Second, it means only one period of strict postoperative confinement. Small dogs actually handle bilateral surgery exceptionally well; they naturally shift their weight to their front legs to balance while the hind legs heal. Doing both at once saves you time, reduces the overall financial burden, and gets your dog fully recovered and back to their normal life in half the total time.

Much like our other orthopedic procedures at VSC, healing takes time. You can expect about an 6-week recovery period while the bones heal into their new, correct alignment. During the first few weeks, your dog will need strict rest—no jumping, no stairs, and leash walks only for potty breaks. However, because we utilize long-acting local anesthetics and advanced pain management, your pet will be comfortable at home in the early stages. Just like our TPLO patients, customized at-home therapy programs are included in the cost of surgery at VSC. In addition we have a full sports medicine department to help with cases that need more attention; VSC is the oonly facility in Sarasota/Bradenton with full time specialty rehabilitationists! We will guide you step-by-step through gentle exercises to safely rebuild their muscle. By your 6-week recheck, your dog should be walking confidently on a stable, pain-free knee.

While hearing that your dog needs orthopedic surgery is never easy, MPL correction is a highly successful, incredibly safe, and routine procedure. The prognosis for returning to a highly active, happy, and comfortable life is excellent. If your dog is doing the “bunny hop” or has been diagnosed with a luxating patella, don’t wait for arthritis to set in. Reach out to our expert team at www.vscsarasota.com to schedule a consultation. We are here to get your little one’s knees back on track!