Genu Valgum- Another name for Knock Knees- What is the Treatment?

It’s one of the most common concerns of parents and a major reason for their anxiety. Known as Physiological Genu Varum, normally a child's legs appear bowed inside till he 2 years old but the child’s knees appear to knock till he is 6 years old. Dr. Nargesh Agrawal, Consultant, Paediatric Orthopedics, Max Super Speciality Hospital, Shalimar Bagh says, in this case, if the child’s legs remain bowed after two years of age; the parents must start treatment for bow legs or Genu Valgum. During this growth period, due to calcium and vitamin deficiency, it can result in Rickets (Pathological bowing of legs). Moreover, parents should immediately seek treatment if the child’s knees remain knocked till 4 years of age.

What causes it?

Both bow legs and knock knees are normal at the early age of life. But the parents must start treatment for bowlegs or knock-knees if the symptoms are severe and persist longer. Most common cause of bowing and knock-knee is low calcium load in the body that can, later on, lead to a problem known as Rickets. There are many other bone diseases, which are linked with these types of deformities.

How will you identify this problem?

• Symptoms are obvious and one can easily detect an unequal angle of legs around the knee.
• Sometimes children may cause pain in leg and difficulty in walking and abnormal gait pattern.

How can I Diagnosis it?

Clinical examinations, like x-rays and scanograme, helps in diagnosing the exact cause of deformity. One should always look for sign of active rickets and its possible implications. Other cause of deformity should also be kept in mind while treating the patient.

 Know its Treatment

Knock knees and bow legs get corrected as the child grows. Hence, the orthopaedic surgeon often tries to treat the bone diseases non-surgically. If deformity persists and is severe then we need to correct them surgically. In younger age group it can be corrected by growth modulation (Hemi-epiphyseodesis) in which the hospital stay is less. If a child presents late with deformity then we need to correct it with a more invasive procedure like osteotomy, in which the hospital stay is longer.

What is the Outcome?

In early age, one should wait and watch to check whether the deformity gets spontaneously corrected but the focus should be on to correct the basic pathology like low calcium level. We need to examine the child’s knees and legs at regular intervals to assess the severity of symptoms and its progression. On the other hand, the surgery helps the child to straighten his bowed leg or knocked knees with good results.