While most cases are a normal variant of growth physiological knock knees , further investigation is needed pathological knee knocks if the knock knee angle is large, if they appear late or worsen after eight years of age, occur on only one leg, are painful or cause a limp. Pathological knock knees can occur in some neurological conditions, such as cerebral palsy or spina bifida, as a result of the altered muscle pull on the bones.
So pathological knock knees may be one of the early signs of an underlying disorder. Bone diseases resulting from poor mineralisation, such as rickets , may present through large knee angles during childhood. When pathological knock knees are seen in combination with short stature and other bone and joint misalignment, a skeletal dysplasia or metabolic bone disorder may be the cause. Obesity during adolescence is also associated with more severe knock knees, and is more commonly seen in children with flat feet and those with hypermobile overly flexible joints.
It is usually parental concern for the way a child looks when standing or walking that sparks initial review by a health professional.
Children presenting with physiological knock knees do not require treatment or ongoing monitoring, as they will grow out of it with time. Conservative treatments may be beneficial such as exercises and weight loss programs to reduce obesity and improve knee movement in children, or knee braces and foot orthoses for painful osteoarthritis associated with knock knees in adults.
Children with severe or worsening pathological knock knees might need orthopaedic surgery to correct their knee alignment, particularly in the presence of persistent pain or disability, regardless of the underlying cause. There are many operations for pathological knock knees. This then corrects the knee angle to a straighter position. A study reporting outcomes two years after this operation showed correction in 34 of 38 knock knees.
Another surgical procedure for pathological knock knees is a wedge osteotomy, where the top of the shin bone or bottom of the thigh bone is cut and a small portion removed to correct the knee alignment. In a study of 23 adolescents and adults with painful arthritic knock knees, a wedge osteotomy was found to show improvements in walking ability and alignment after two years. Genu valgum is not typically diagnosed in younger children, as the condition is common in early development.
In older children and adults, a doctor will attempt to diagnose the cause of genu valgum. The cause will determine if any treatment is needed to correct the condition. Questions will include information about family history and any other known pre-existing conditions that might cause knock-knees. If pain is present, a doctor will likely ask a person to identify where it is located, how severe it is, and when it occurs. In some cases, a doctor may order an MRI or X-ray to examine the bone structure.
Treatment for genu valgum will largely depend on the cause and severity of the condition. Typical treatment options may include some of the following:. If an underlying disease is causing genu valgum, the disease will need to be treated first in order to correct the leg alignment. This may be treated with medications and supplements.
A doctor may recommend some simple exercises and stretches or refer a person to a physical therapist. Exercises and stretching can help strengthen muscles of the legs and realign the knees. The exercise routine will likely include plans to add weights or switch the routine as the muscles develop.
If a person is carrying excessive body weight , it can be a contributing factor to genu valgum. Extra weight puts additional strain on the legs and knees, which can cause knock-knees to worsen. A doctor will likely recommend that a person who is overweight lose weight through a combination of diet and exercise. This may be especially helpful for people with genu valgum who have one leg that is longer than the other. Braces or splints may be used for some children in addition to or instead of orthotics.
The braces are designed to help the bones grow in the correct position. Surgery is not typically the first treatment choice for a person with genu valgum. Surgery is usually reserved for the following cases:. For children, a procedure called guided growth surgery is often used. A surgeon inserts a small piece of metal into the knee. This metal plate helps the bone grow in the correct direction.
Once the bone is aligned correctly, further surgery is done to remove the metal plate. Skip to Content. Urgent Care. In This Section.
Knock Knees Genu Valgum In knock knees, the lower extremities turn inward, causing the appearance of the knees to be touching while the ankles remain apart. What Is Knock Knees?
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