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Common childhood orthopadeic condition – knock knees

Genu valgum is also known as “knock-knee”.
• Origins of the name: From Latin, Genu means “knee” and valgus means bent outwards.
• This is a problem in which the knees are angled in and touch one another when the legs are straightened.
• This condition affects those individual who have severe valgus deformities.
How can you diagnose the problems in individuals – People affected show a characteristic – not able to touch their feet together, especially when they are asked to simultaneously straighten their legs.
• This condition actually describes the distal portion of the knee joint which bends outwards and the proximal portion is bent inwards.
• In the case of children from ages 2 to 5, a milder form of genu valgum can be seen.
• Like many such conditions relating to slight angling of joints in the body, this problem also gets outgrown as the child grows older.
• However, not every time. In some cases, it can also continue or worsen with age in some cases, especially in the case where there is another medical condition such as rickets or obesity.
• There is no known cause.
• Other systemic conditions may be associated such as Schnyder Central Corneal Dystrophy.

What causes knock knees?

• Osteomalacia or rickets
• Obesity
• An injury to the growth area of the shin bone (tibia)

How common are knock knees?

• In childhood, at younger ages, say at the age of 3, more than 20 percent of children have this condition.
• But as children grow older, most of them outgrow this condition; by the age of 7, only 1 percent of children usually have this gap.

How serious are knock knees?

• Well, in most cases, the condition generally self-corrects and as mentioned above, the condition becomes normal by the time a child is 7 or 8.
• In a very few cases, the condition is severe enough and may need surgery.

What are the risk factors for developing knock knees?

• Overweight children
• The condition is slightly more common in girls than boys.

How does a doctor diagnose knock knees?

• By observing the position of the legs, knees and ankles of the patient.
• By measuring the distance between the inner ankle bones of the patient. The greater is the distance between the ankles, the more severe is the condition.
• There is no known cure for knock knees post-childhood, including the fact that no orthotic (an external brace or other such physical device meant for straightening joints and others) treatment or bodybuilding exercise can straighten this condition.
So what can be done if no such therapy works ? Well, a corrective osteotomy may be suggested to straighten the legs or total knee replacement (TKR) surgery may be recommended, a method that has the convenience of relieving pain and complications.
What is the normal method of treatment ? Most doctors use leg braces in order to move the leg back into position.

Adults with uncorrected genu valgum are typically prone to:
• Injury
• Chronic knee problems
• Chondromalacia
• Osteoarthritis

Diagnostic test for Knock Knees

– Q angle
• This is the angle formed by a line drawn from the anterior superior iliac spine (which passes through the center of the patella), and a line drawn from the center of the patella to the center of the tibial tubercle.
• A typical Q angle is 12 degrees for men and 17 degrees for women.

– In women
• The Q angle should be less than 22 degrees with the knee in extension.
• It should be less than 9 degrees with the knee in 90 degrees of flexion.

– In men
• The Q angle should be less than 18 degrees with the knee in extension.
• It should be less than 8 degrees with the knee in 90 degrees of flexion.

Treat Your Own Knees The Knee Crisis Handbook Osteotomy with an inquiry into the aetiology and pathology of knock-knee, bow-leg, and other osseous deformities of the lower limbs

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