Knock Knees

Knock Knees – Treatable Paediatric Deformity

What are Knock Knees?

“Knock Knees” are a condition where the knees touch each other and ankles are wide apart. This results in an angular deformity of the entire lower limb. It can occur on one side or both sides. Most cases develop during late childhood and early adolescence. Very rarely it may be present at birth.

How does “knock knees” develop?

There is an unequal growth cartilage(physis) present in the lower part of the thigh bone and upper part of the leg bone. The physis can get damaged due to trauma (fracture), Infection (osteomyelitis), radiation or most commonly due to nutritional deficiency of Vitamin D (rickets).

What is the treatment?

Some cases can undergo spontaneous correction, usually in toddlers. In adolescents, correction usually requires surgery-growth modulation (guided growth) or corrective osteotomy (the bone is cut and realigned to its correct position).

Can physiotherapy or special shoes/braces help in correcting the deformity?

No. Physiotherapy can only help to improve muscle strength  and walking balance, while special shoes/braces may help to prevent the worsening of the deformity in certain cases.

What is the modern method of treating “knock knees”?

Guided growth or growth modulation is a relatively minimally invasive procedure, where a small plate and screws are inserted across the growth cartilage to guide its growth during the preadolescent or early adolescent age. After a few months/years, once the leg alignment gets corrected, the plates are removed.


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