Knee Malalignment
(Bow-Legs | Knock-Knees)
Conditions That Can Contribute to Joint Wear and Imbalance
Knee malalignment refers to a condition in which the knees are not properly aligned with the legs, affecting the way you walk and potentially leading to pain, discomfort, and other joint issues. Two common types of knee malalignment are bow-legs (genu varum) and knock-knees (genu valgum). Both conditions can affect individuals of any age and, if left untreated, may lead to long-term joint problems, including osteoarthritis.
WHAT IS BOW-LEGS AND KNOCK-KNEES?
Bow-legs (genu varum) and knock-knees (genu valgum) are types of knee malalignment, where the knees and legs do not line up in a straight, neutral position. These conditions can affect the way your body weight is distributed through the legs and knees, sometimes leading to pain, joint strain, or uneven wear on the cartilage.
Bow-Legs (Genu Varum): This is when the legs curve outward at the knees, creating a noticeable gap between the knees when the ankles are together. It can place increased pressure on the inner (medial) side of the knee.
Knock-Knees (Genu Valgum): In this condition, the knees angle inward and touch or come close together when the ankles are apart. It puts more stress on the outer (lateral) part of the knee joint.
Mild variations of these conditions are common in children and often correct naturally with growth. However, when alignment issues persist into adulthood or become more pronounced, they may contribute to joint pain, instability, or early onset arthritis, especially if left unaddressed.
Understanding whether your knee alignment is affecting your joint health can help guide appropriate treatment options and support long-term mobility.
CAUSES OF KNEE MALALIGNMENT
Several factors can contribute to knee malalignment, including:
- Genetics: Some individuals are born with a natural predisposition to bow-legs or knock-knees, which may become more noticeable during childhood.
- Developmental Changes: Knee alignment often changes during childhood growth spurts. While some degree of knock-knees or bow-legs is normal in young children, the condition usually corrects itself as they grow. If the alignment does not improve, it may require medical attention.
- Osteoarthritis: In adults, wear and tear on the knee joint due to osteoarthritis can contribute to malalignment, as the uneven distribution of weight and pressure on the joint can worsen the condition.
- Rickets: This bone disease, caused by a deficiency of vitamin D, calcium, or phosphate, can result in softening and weakening of the bones, leading to bow-legs or knock-knees.
- Injury or Trauma: Previous injuries or fractures in the leg can alter the alignment of the knee, causing it to develop a malaligned posture.
SYMPTOMS OF KNEE MALALIGNMENT
Individuals with knee malalignment often experience:
- Visible deformity: Either bowing of the legs or inward angling of the knees when standing.
- Knee pain: Discomfort around the knee, especially during physical activities such as walking, running, or climbing stairs.
- Stiffness: Reduced range of motion in the knee, making it difficult to fully straighten or bend the leg.
- Instability: A feeling of weakness or instability in the knee, increasing the risk of falls or further injury.
- Worsening joint damage: Over time, untreated malalignment can cause increased wear on the knee joint, leading to the early onset of osteoarthritis.
DIAGNOSING KNEE MALALIGNMENT
Accurate diagnosis is key to determining the best course of treatment for knee malalignment. Dr Liddell will begin with a thorough evaluation of your medical history, symptoms, and activity level. A physical examination will also be conducted to assess the alignment of your legs and the stability of your knee joints.
Imaging studies are often required to confirm the diagnosis and assess the severity of the condition:
- X-Rays: These can reveal the extent of the malalignment and any associated bone or joint damage.
- MRI Scans: If needed, an MRI can provide detailed images of the soft tissues around the knee, including cartilage, ligaments, and tendons, to identify any additional complications.
TREATMENT OPTIONS FOR BOW-LEGS AND KNOCK-KNEES
Treatment for knee malalignment depends on factors such as the severity of the condition, the patient’s age, and the presence of any underlying conditions. Dr Liddell offers both non-surgical and surgical options to correct the alignment and relieve symptoms.
Non-Surgical Treatments
A tailored physiotherapy program can help strengthen the muscles around the knee, improving stability and reducing the stress on the joint.
In some cases, braces or orthotic devices may be recommended to help correct the alignment of the knees, particularly in children.
Maintaining a healthy weight can reduce the pressure on the knees, which is particularly important for patients with malalignment and osteoarthritis.
Non-steroidal anti-inflammatory drugs (NSAIDs) can help manage pain and inflammation caused by malalignment.
Surgical Treatments
If non-surgical treatments are not effective, or if the malalignment is severe, surgery may be required to correct the condition and prevent further damage to the knee joint.
This procedure involves cutting and reshaping the bones around the knee to correct the alignment. It is commonly used in younger patients with early-stage arthritis to shift the weight-bearing load away from the damaged part of the knee.
In cases where osteoarthritis has caused significant joint damage, Dr Liddell may recommend partial or total knee replacement surgery to replace the damaged joint surfaces with prosthetic components, restoring alignment and function.
In children, a guided growth procedure may be used to correct malalignment by influencing the natural growth of the bones.
The recovery process following treatment for knee malalignment will depend on the specific treatment you receive. Dr Liddell will provide you with a comprehensive rehabilitation plan, tailored to your needs, to help you regain strength, mobility, and function in your knee.