Genu valgum, commonly known as,” knock-knees. The condition usually accompanies femoral varus and tibial valgus. Most children develop a slight knock-kneed stance by the time they are 2 or 3 years old, frequently with significant separation at the ankles when the knees are touching. This is part of normal development and often persists through age 5 or 6, at which time the legs begin to straighten fully. By puberty, most children can stand with the knees and ankles touching. Mild genu valgum can be seen in children from ages 2 to 5, and is often corrected naturally as children develop.
Knock knees can also develop as a result of disease processes. Most frequently the cause has already been diagnosed and the knock knees are recognized as a symptom of the condition. It increases the risk of knee injuries (especially patellofemoral pain syndrome) because the abnormal angling of the thigh and lower leg imposes most of the athlete's weight on the inside of the knees. There is no known treat for knock knees post-childhood. Treatment may slow the progression of the condition and prevent recurrence. Contrary to common belief, no amount of orthotic treatment or bodybuilding exercise will straighten knock knees for adults.
If the condition persists or worsens into late childhood and adulthood, a corrective osteotomy may be recommended to straighten the legs. This however is more of a cosmetic remedy, and may hamper athletic performance in the future. In some cases, surgery may be considered for knock knees that persist beyond late childhood and in which the separation between the ankles is severe. Surgical treatment depends upon the maturity of the child. In younger children, whose growth plates are open and still growing, knee alignment can be changed by tethering the growth plates of the femur or tibia using staples.
As the increase plate grows on the untethered side, the knee will grow out of its extreme angle. In older children, who no longer have open growth plates, treatment consists of cutting, straightening and then holding the bones of the knee in place while they heal with metal implants, including pins, plates and screws. Although both treatments have high success rates, they should be done only if clearly essential and at the appropriate age. Bracing and physical therapy may provide a temporary reprieve of symptoms, but they do not afford long-term symptomatic relief.
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