Genu valgum or knock knees

Understanding Genu Valgum in Children: Causes, Treatment, and Surgical Options

What is genu valgum?

So known as "knock knees", genu valgum is a condition characterized by an inward angulation of the knee(s), causing them to touch while the ankles remain apart.

What causes genu valgum?

Genu valgum can be caused by a variety of factors including normal growth (physiologic), heredity, obesity, or as a result of certain medical conditions such as rickets or injury. Physiologic genu valgum is common in children between ages 2 and 5 and typically corrects itself as the child grows. If the condition persists or is severe, it may lead to pain and difficulty in walking, warranting further medical attention.

How do we treat genu valgum?

In many instances, genu valgum is a self-limiting condition that corrects on its own without treatment as the child grows. In cases where the condition persists or is severe, treatment options are available to manage symptoms and correct the alignment. This could include physical therapy, use of corrective devices, weight loss, or vitamin supplementation in cases related to rickets or other nutritional deficiencies.

When is surgery required?

Surgery is usually considered for genu valgum when non-surgical treatments have failed to correct the alignment, and the condition is causing significant pain, discomfort, or impairing the child's normal function. Other indicators for surgery could include a persistent severe angle of deformity, abnormal gait, or if the condition is associated with an underlying disease like rickets that is not responding to medical treatment.

What types of surgery are there?

There are several types of surgery that can be performed to correct genu valgum, the choice of which depends on the child's age, severity of the condition, and the underlying cause. Procedures can include guided growth surgery (temporary hemiepiphysiodesis), external fixation correction, or osteotomy, or in adults in some cases, total knee replacement.

X-rays before, and after 11-year-old girl treated with Hemi epiphysiodesis using plates on the thighbone, distal femur.

These procedures aim to correct the knee alignment, alleviate discomfort, and improve function.

As with all procedures, there are risks which include infection, bleeding from a pain, stiffness, under or over correction, leg length, discrepancy and metal irritation.

However, the aim of the procedure is to give as straight a knee as possible with close monitoring afterwards. The plates usually require removal after the correction has been made.

We are committed to providing you with the most reliable and up-to-date information to help you better understand and manage genu valgum in children. We believe in empowering families with knowledge, offering support, and providing resources necessary for the best possible outcome.

Do note that the information presented here should not replace professional medical advice. If your child is experiencing symptoms related to genu valgum, please arrange an appointment with Mr Gupte or consult with a pediatric orthopedic specialist near you.