here is some info on this
Medial Luxating Patella
Luxating Patellas
Medial patellar luxations are graded to assess severity.
Grade I: The kneecap can be moved out of place manually but will fall back into its natural position once the manipulator lets go.
Grade 2: Same thing except that the kneecap does not move back to its normal position when the manipulator lets go.
Grade 3: The patella is out of place all the time but can be manipulated back into its normal position manually (though it will not stay there).
Grade 4: The patella is not only out of place all the time but cannot even be manipulated back into place by hand. Such a dog has extreme difficulty extending his knees and walks with his knees bent virtually all the time.