bow legs knock knees-what are the possible complications of bow legs?

You might have noticed bow legs knee pain that in a new born child and children up to four years, the knees are normally bent and tend to touch each other. This is known as physiological genu varum because nature has devised it this way. Only if this deformity persists after four years of age then it is abnormal and you need to show to a doctor.

The disease of the knee can lead to more serious bow knee deformity that is not normal and needs to be treated by a doctor. Bow legs can be caused due to birth defects, postural abnormalities, developmental defects, rickets, hormonal disorders, degenerative disorders like osteoarthritis of knee which is a common cause.

Again occupational disorders in jockeys and some disease of the knee like pagets disease, Blount’s disease can cause bow legs. The problem is more common in elderly people that too females and is due to degeneration of knee joints and is called osteoarthritis of the knee. The primary deformity in genu varum is inward bowing of the knee.

Secondary deformities develop in the tibia and the foot and patients complains of pain during walking, standing etc. limps may be present and this leads to difficulty in carrying act ivies of daily living. In general bow legs are common in elderly people and are commonly due to osteoarthritis of the knee.

In case of bow legs the patient is examined in a sleeping position with knee extended, patella facing the ceiling and the ankles touching each other. If the separation of knee exceeds more than 3cm or it is unilateral, one should investigate for bow legs. Again a line is drawn from the outer aspect of the hip called the anterosuperior iliac spine through the centre of patella to inner side of the ankle called the medial alveolus.

Normally all the structures are in the same line but in case of bow legs the medial alveolus is medial to this line. Now for more accurate assessment, the angle of genu verum is calculated by the doctor on a standing radiograph of the whole limb. In case of genu varum the distance between the inner knees is more than the normal 3cms.

Radiograph of the whole limb should be done to assess the severity of bow legs or genu varum but also helps to know the extent of the disease of the knee especially osteoarthritis of the knee. Plain X ray of the knee helps to know the extent of bow legs or genu varum and also the disease like the osteoarthritis of the knee.

In general the treatment of bow legs is non operative and conservative until four years of age. During this age knee ankle foot orthotics with the medial bar and the lateral strap are used. Correction of the early deformity is done by dynamic bracing or splints. However after four years, significant deformity should be corrected by surgery.

The treatment of bow legs knee pain bow legs after the age of four years is mainly surgical and the methods which are applied are stapling the outer aspect of the knee when the child is within the growth period and cutting the outer portion of the tibia and straightening is called tibia osteotomy or high tibia osteotomy and it could be wither medial open or lateral closed wedge osteotomy and is done after the child has attained skeletal maturity. Now if you want some more information on possible complications of bow legs then please click here.