Medial Patella Luxation In Bulldogs
and French Bulldogs

Medial Patella Luxation (MPL) Problems and Bulldogs

Medial patella luxation in bulldogs and French Bulldog (MPL) is better known to most veterinarians as a small breed orthopedic condition, one which is rarely diagnosed in the larger breeds. Bulldogs, however, are the exception to this rule, and, despite being a large breed dog, Medial Patella Luxation in bulldog puppies is as common a disorder  as it is for small breed dogs.

Medial patella luxation in bulldogs and french bulldog puppies can lead to arthritis, pain and ACL tears

Medial patella luxation in bulldogs and french bulldog puppies can lead to arthritis, pain and ACL tears

The patella or knee cap, is a small bone that is buried in the tendon of the quadriceps muscles of the thigh, and attaches to the top front of the tibia, just below the knee. The patella, together with its tendon and the quadriceps muscle, form the “extensor mechanism” and are normally well-aligned with each other.  YourEnglish bulldog, american bulldog and french bulldog puppy patella normally rides in a groove within the knee and when luxated it will ride outside the femoral groove. The patella luxation is further characterized as medial (inner) or lateral (outer), depending on whether the knee cap rides on the inner or outer aspect of the stifle. Normally, when your bulldog puppy hind leg is flexed and extended, the patella should glide up and down in the trochlear groove at the end of the femur.  This  groove should ideally be deep enough for the patella to fit into it comfortably. When your bulldog puppy tendons, muscles and bones are properly aligned, the result is a stable knee joint.  However, when these structures are improperly aligned, the major muscles of the thigh pull towards the inside (medial) aspect of the leg, applying abnormal stress to the knee joint. These forces pull the patella out of place and toward the inside of the leg.  As the patella is allowed to pop in and out of place, the normal gliding motion of the cartilage within the joint is interrupted.  The cartilage of your bulldog puppy knees becomes degraded, leading to rubbing of bone against bone which then leads to arthritis (DGD, Degenerate Joint Disease)

Medial patella luxation in bulldogs and French Bulldog Puppies (MPL) is a multi-factorial condition. What we typically find in patella luxation in dogs is a trochlear groove that is too shallow, with a weakened and stretched lateral patellar ligament, which is likely a result of the shallow groove. The third problem occurs when the lower attachment of the kneecap ligament is too far to the inner side of the shinbone or tibia. This, I believe, is due to your bulldog and french bulldog exceptionally short legs relative to the body. It is also possible for this lower point of attachment to shift inward – throwing off the entire joint alignment.

Medial patella luxation in bulldogs and French Bulldog  puppies (MPL) other causes include:

  • Abnormal conformation of the hip joint common to bulldogs, such as hip dyspepsia, subluxating hips joints and total luxations of bulldog hip joints)
  • Malformation of your bulldog femur, with abnormal angulation
  • Malformation of your bulldog tibia
  • Deviation of your bulldog tibial crest, the bony prominence onto which the patella tendon attaches below the knee
  • Tightness/atrophy of your bulldog puppy quadriceps muscles, acting as a bowstring
  • A patellar tendon that may be too long or too short

The severity of Medial patella luxation in bulldogs and French Bulldog (MPL) has been graded on a scale of one to four, based on orthopedic examination of your bulldog puppy knees.

Grade I: Your Bulldog puppy patella can be manually luxated when the leg is extended, and the patella is pushed over but will go back into place when released.

Grade II: Your Bulldog puppy patella sits loosely in its normal position but will luxate medially when the leg is flexed.  Reduction is possible with manipulation.  A “hopping” gait is generally noted in this case.

Grade III: Your Bulldog puppy patella is displaced medially most of the time but can be reduced manually when the leg is extended.

Grade IV:  Your Bulldog patella is displaced medially all of the time and cannot be manually reduced.  A hunched over stance is often noted, and some dogs may even appear bowlegged.

Medial patella luxation in bulldogs surgical treatment is typically considered in grades 2 and over

The course of action that needs to be taken depends on what structures in your bulldog and french bulldog puppy knees are abnormal and how abnormal they are. No two cases are exactly alike. There are three surgical procedures that are used to treat patellar luxation. One, or several, of the following strategies may be required to correct your bulldog patella luxation:

  • Reconstruction of soft tissues surrounding your bulldog knee cap to loosen the side toward which the patella is riding and tighten the opposite side
  • Deepening of the femoral groove so that your bulldog kneecap can seat deeply in its normal position
  • Transposing the tibial crest, the bony prominence onto which the tendon of the patella attaches below the knee. The tibial crest is moved in the opposite direction of the luxation and reattached to the bone with a pin. This will help realign your bulldog quadriceps, the patella and its tendon

Dr. Kraemer’s V4B Medial patella luxation in bulldogs Maintenance

Keeping your bulldog and french bulldog puppy lean and trim will help prevent these problems. Encourage walking and try to avoid daily upstairs climbing, sofa jumping, skate boarding and frisbee fetching. Provide your bulldog a joint supplements such as Dr. Kraemer’s V4B Total Joint Care and V4B Joint Protector. In addition, supplements containing Omega-3 fish oil like Dr. Kraemer’s V4B Fish Oil Skin & Joint are good anti-inflammatories and can be used long term with no adverse effects to help ensure your pet remains pain-free.

Dr. Kraemer’s V4B Medial patella luxation in bulldogs Rule of Thumb:       

Bulldog Medial Patella Luxation,  bulldog Anterior Cruciate Ligament injury  Bulldog Hip Dysplasia and Bulldog Elbow Dysplasia are the three orthopedic conditions most commonly diagnosed in bulldogs. Surgery is  recommended for Grade 2 MPL’s or worse, preferably as early as a few months of age.  When surgery is done early, before arthritis or other knee injury occurs, the prognosis is excellent and your bulldog puppy should regain full use of its leg.

Bow legs lead to Medial Patella luxation in bulldogs

Bow legs lead to Medial Patella luxation in bulldogs

Dr. Kraemer’s V4B Medial patella luxation in bulldogs  Tips & Warnings

Dr. Kraemer’s Medial patella luxation in bulldogs (MPL) Tip #1 (StemCell4Pet.com): Dr. Kraemer also offer additional therapeutic healing and pain relief modalities that includes, cutting edge in house Stem Cell Therapy with Cryobanking, Platelet Rich Plasma (PRP), Cold Laser Therapy, and Pulse Electromagnetic Therapy (PEMt). Most of our orthopedic  cases opt to combine one or few of those nor pharmaceutical anti inflammatory, healing, pain relief new age modalities with the surgery repair.

 Dr. Kraemer’s Medial patella luxation in bulldogs (MPL) Tip #2 (DrKraemers.com): In order for the patella not to jump out of its tract, the  groove (trochlear) must be made deep enough to accommodate and cradle the patella as it moves up and down in the groove.

Dr. Kraemer’s Medial patella luxation in bulldogs (MPL) Tip #3: (Vet4HealthyPet.com) Most Bulldogs with MPL are either born with that condition (congenital) or have a developmentalmisalignment of the extensor mechanism, a result from a group of abnormalities involving your bulldog puppty entire hind limb that slowly change the contour of the bones as your puppy grows.

Dr. Kraemer’s Medial patella luxation in bulldogs (MPL) Tip #4:  Many bulldogs and french bulldogs puppies have a “bow-legged” wide stance, which results in the muscles of their thighs pulling their patella to the inside of their knees. Often this extra inner load is further aggravated due to forces generated by dysplastic hips, a condition common to the breed ( hip dysplasia). This abnormality is aggravated when the tibial crest, which is the point the quadriceps tendon attaches to on the lower limb, is internally rotated and the trochlear groove is shallower than normal.

Dr. Kraemer’s Medial patella luxation in bulldogs (MPL) Tip #5: The problem in bulldogs and french bulldog puppies might start from the hip with coxa vara and decreased anteversion of the femoral head and neck. In other words, there is a decreased angle of inclination between the femoral longitudinal axis and the femoral neck, combined with a lesser caudal to cranial angle of the femoral neck. This skeletal abnormality in the growing bulldog puppy displaces the extensor muscles of the hind limb, chiefly the quadriceps group, medially. This muscular displacement has an effect on the distal femoral physis (growth plate), resulting in impaired growth of the medial side and accelerated growth of the lateral side of the distal extremity of the femur. The net effect is medial bowing and rotation of the distal extremity femur and proximal extremity of of your bulldog puppy tibia. The patella is simply pulled along with all the other bony and soft tissue structures. Further compounding the problem is the fact that a chronically luxated patella does not exert pressure in the trochlear groove, which is crucial in producing a groove of sufficient width and depth in the growing bully.

Dr. Kraemer’s Medial patella luxation in bulldogs (MPL) Tip #6: Clinical signs associated with patella luxation vary greatly with the severity of the disease. It might start as just a brief few step limp and as the disease progresses in duration and severity, this lameness becomes more frequent.

Dr. Kraemer’s Medial patella luxation in bulldogs (MPL) Tip #7: On very rare occasions, patellar problems are the result of direct or strain-injuries to the knee cap or accidental trauma to the knee joint that tear the collateral ligaments that keep the patella moving in line.

Dr. Kraemer’s Medial patella luxation in bulldogs (MPL) Tip #8: Most times the diagnosis of  bulldog patella luxation is based on palpation on orthopedic examination. Nevertheless radiographs of the pelvis, knee and tibias are always recommended.

Dr. Kraemer’s Medial patella luxation in bulldogs (MPL) Warning #1:  Once arthritic changes have developed, surgery is much less likely to produce a pain-free leg.

Dr. Kraemer’s Medial patella luxation in bulldogs (MPL) Warning #2: The luxation is medial (inward) in most cases and often both knees are affected.

Dr. Kraemer’s Medial patella luxation in bulldogs (MPL) Warning #3: Every time the knee cap rides out of its groove, cartilage, which is the lining of bones within joints, is damaged, leading toosteoarthritis and pain.

Dr. Kraemer’s Medial patella luxation in bulldogs (MPL) Warning #4: It is our experience that left alone the abnormal alignment of the patella may also aggravate the shallowness of the femoral groove and lead to deformation of the leg.

Dr. Kraemer’s Medial patella luxation in bulldogs (MPL) Warning #5: The abnormal position of the knee cap destabilizes the knee, increasing weight load on the inner part of the knee thus predisposes your bulldog to a rupture of his cranial cruciate ligament (ACL Tear), at which point they typically stop using the limb.

Dr. Kraemer’s Medial patella luxation in bulldogs (MPL) Warning #6: We know that bulldogs and french bulldogs that have this problem tend to pass it on to their puppies.

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