About Genu Valgum (Knock Knees)

Overview

Genu valgum, also known as knock-knees, is a condition where the knees touch each other but the ankles do not. It is a knee misalignment that causes the knees to turn inward, resulting in a noticeable gap between the ankles. Genu valgum is most commonly seen in young children, typically between the ages of 3 and 6. In the majority of cases, this condition corrects itself as children grow older, usually by the age of 7. However, in some instances, genu valgum may persist into adolescence or develop later in life due to factors such as injury, infection, vitamin D deficiency, obesity, or arthritis. While it is not always possible to prevent genu valgum, various treatment options are available to help alleviate symptoms if necessary. These treatments may include physical therapy, exercise, orthotics (supportive devices), or in rare cases, surgery.

Causes and Risk Factors

Genu valgum is often a benign (not harmful) variation in a child's growth, occurring by chance. It may also be caused by injury or infection in the knee or leg bone, malformation from rickets (a disease caused by lack of vitamin D and calcium), other bone diseases, obesity (which puts extra pressure on the knees), or arthritis in the knee joints.

Non-modifiable risk factors (factors a person can’t change or control) of genu valgum include:

Genetic factors: Genu valgum seems to run in families, suggesting a genetic predisposition.
Metabolic bone disorders and genetic disorders can also contribute to the development of genu valgum.
Injuries such as fractures.
Tumors in the leg bone.

Modifiable risk factors (factors a person can change or control) of genu valgum:

Obesity: Being overweight can make genu valgum more severe, according to studies.
Lack of vitamin D and calcium: Severe deficiency in these nutrients may increase the chances of developing genu valgum.

Symptoms

Symptoms of genu valgum include:

Knees touching or close together while the ankles do not
Visual separation of the ankles when the knees are together
Walking with a limp

Less common genu valgum symptoms may include:

Stiff joints
Knee pain
Pain in the hips, ankles, or feet due to stressed ligaments and muscles
Problems with balance while walking

It's important to note that in most young children, genu valgum is not painful and naturally corrects itself by the age of 7. However, in rare cases, it may continue into adolescence or develop later in life.

Diagnosis

To diagnose genu valgum, healthcare providers may perform the following examinations, tests, and procedures:

Medical history: The healthcare provider will gathering information about any previous diagnoses, medical conditions, injuries or family history that may contribute to genu valgum.
Physical exam: This involves a thorough examination of the knees and legs to assess the alignment and range of motion. The healthcare provider may observe the child’s walk and run.
Lab tests: Specific lab tests, such as a blood draw, may be recommended to check for underlying conditions like vitamin D deficiency or calcium abnormalities.
Imaging studies: X-rays or MRI scans can provide detailed images of the knees and help assess the severity of genu valgum.

Additional examinations, tests, and procedures may be performed if one knee turns inward more than the other, the child has pain or weakness, or has difficulty running. A pediatrician may recommend seeing a bone specialist (orthopedic doctor).

Examinations, tests and procedures may vary based upon individual factors. It's important to follow up with your health care provider if any symptoms worsen or change after the initial examination.

Treatment Options

Most cases of genu valgum in young children do not require treatment and the condition corrects itself as the child grows, usually around age 7.

Treatment may be recommended If genu valgum is caused by an underlying disease, genu valgum doesn’t resolve by age 10, or if there is pain or difficulty walking or running.

If rickets is causing Genu Valgum, vitamin D and calcium supplements may be recommended to restore your levels.
Exercise: Regular exercise can help strengthen the muscles of the legs and improve leg alignment. Your doctor or physical therapist can evaluate your gait and recommend exercises that target the leg, hip, and thigh muscles. Strengthening exercises, such as leg raises, can be beneficial. Stretching exercises may also help relieve symptoms.
Surgery: Surgery is typically reserved for severe cases of genu valgum that don't respond to other treatments. Procedures like guided growth surgery or osteotomy can help realign the bones in the knee.

It's important to consult with your healthcare professional before starting any medication or exercise routine. They can provide personalized advice based on your specific condition and needs. Medication dosing and side effects may be affected by many factors. Check with your health care professional about dosing for your individual situation and read the information provided with your medication for additional side effect information.