Knock Knees (Genu Valgum) – Diagnosis & Treatment

What is Knock Knee (Genu Valgum):

Knock knee (Genu Valgum) means touching the medial side of the knee during standing and walking. In this problem, both sides of the leg goes outside.

What are the Causes of Knock Knees:

Knock knee occurs because of a decrease in the growth of distal femoral physis on the outside. Mostly knock knees occur because of weak bone in children which occurs mostly because of vitamin D deficiency. Other causes are trauma, an infection affecting the growing distal femoral physis.

What are the Symptoms of Knock Knees:

In Knock Knee child will complain of touching the medial portion of the femoral condyle (medial side of knee joint bone). it causes awkward wide-based gait, pain. In long term, individuals will develop flattening of the lateral femoral condyle, osteochondritis & ultimately arthritis of the knee joint mostly in the lateral compartment of the knee.

How Knock Knees can be Diagnosed:

Clinically by touching of medial aspect of knee and increase in normal distance between both ankle joint. The normal distance between medial malleolus is less than 8 cm but if it is more, then treatment should be started.

Tests needed for Knock Knees:

Full-length X-ray both lower limb AP VIEW is needed in standing position to confirm the diagnosis & to measure the angle of deformity. Vitamin D assessment is required to see the status of Vit-D deficiency.

Treatment for Knock Knees

Knock Knees Treatment depends on the cause and severity of the condition. Knock problem is physiological between 2-5 years of age and it correct naturally with age. But sometimes due to vitamin D deficiency, its severity may be exaggerated so children should be given VIt-D supplements. Dose and duration will be decided by a pediatric orthopedic surgeon & pediatrician. Many braces are prescribed but not of much use. After the age of 7 years and even at a younger age with severe deformity, the child may need surgery to modulate growing physis by the use of transphysial screw/ guided growth plate application. This principle can only be used if the child has sufficient growth remaining with the child. By this method deformity gradually correct with an increase in height of the child.  But if the child doesn’t have much remaining growth potential in adolescent near maturity and adult, then deformity need surgery by the osteotomy ( by cutting the bone & correcting the deformity in one go. ). Physical therapy is an essential part of knock knees treatment, particularly when surgery has occurred.

Knock Knees Treatment X-Ray - Before
Knock Knees Treatment - Before
Knock Knees Treatment X-Ray - After
Knock Knees Treatment - After

Frequently Asked Questions

Can knock knees be corrected in adults?

Yes, knock knees can be corrected in adults as well as there is no age limit for any surgery for knock knees.

Can knock knees be corrected with exercises?

No it can’t be corrected by exercise. In very early age of child it may correct naturally and with vitamin D supplement but otherwise need some surgery.

Can knock knees be corrected without surgery?

In most cases, knock knees don’t need any treatment in very early age child because as a child grows, this knock knees condition is corrected itself.

MEDICALLY REVIEWED AND EDITED BY DR. JITENDRA KUMAR JAIN
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Dr. Jitendra Kumar Jain is a famous name in the field of childhood physical disability pediatric orthopedic problems in North India. He has been an MS Orthopedics, DNB Orthopedics, Pediatric orthopedic surgeon & also a cerebral palsy specialist for over 21 years.

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