Knock knees (genu valgum) is a condition in which the knees tilt inward while the ankles remain spaced apart. The condition is slightly more common in girls, though boys can develop it too. Knock knees are usually part of a child’s normal growth and development. Knock knee is usually bilateral – affecting both legs – but in some cases, it may only affect one knee. Most young children have knock knees to some degree for a period of time, though in some children it is more visible.
As it is an incorrect alignment around the knee that can affect can people of all ages. Over time, the imbalance of force it places on the knees can cause pain, joint damage and early onset knee arthritis. Correction of the deformity will improve knee mechanics and walking capability, reduce pain and prevent a rapid progression of damage to the knee.
These symptoms may include –
• knee or hip pain
• foot or ankle pain
• feet not touching while standing with knees together
• stiff or sore joints
• a limp while walking
• reduced range of motion in hips
• difficulty walking or running
• knee instability
• progressive knee arthritis in adults
• patients or parents may be unhappy with aesthetics
Knock knee can be caused by an underlying congenital or developmental disease or arise after an infection or a traumatic knee injury.Common causes of this disease include –
• metabolic disease
• renal (kidney) failure
• physical trauma (injury)
• arthritis, particularly in the knee
• bone infection (osteomyelitis)
• rickets (a bone disease caused by lack of vitamin D)
• congenital (inborn) conditions
• growth plate injury
• benign bone tumors
• fractures that heal with a deformity (malunion)
Your child’s doctor will look at the position of your child’s legs, knees, and ankles to determine the severity of knock knees. They may also measure the distance between your child’s ankle bones. The condition is considered more severe in children with more distance between their ankles.
Doctors typically look at the following factors to determine if a child younger than 7 has knock knees:
• weight and body mass index (BMI)
• height and length
• position of the knees as the child extends and rotates their legs
• leg lengths and symmetry
• walking pattern
If your child is older than 7, or if their legs aren’t the same size and shape on both sides, an x-ray of their legs may help determine if an underlying condition is causing their knock knees.
Most kids who have knock knees from normal growth and development don’t need treatment. It usually corrects itself as the child grows.
Severe knock knees or knock knees that are worse on one side sometimes do need treatment. In the past, kids with knock knees might wear braces and shoe inserts. They were found to not be helpful so are no longer used.
In rare cases where children have symptoms such as pain or trouble running, doctors might suggest surgery after age 10.
To treat knock knees from rickets, doctors usually recommend adding vitamin D and calcium to the child’s diet. Some kids with Rickets might need to see a specialist. Rickets due to a genetic condition may need more specialized treatment by an endocrinologist
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