MedicYatra provides the safe Genu Valgum (Knock knee) treatment and Surgery at its affiliate & trusted hospitals & clinics in various metro cities of India, like Mumbai, Delhi, Bangalore, Chennai, Pune etc.Our Associate Board certified doctors are extensively trained and vastly experienced and have performed hundreds of such cases at our state of the art JCI accredited hospitals & Clinics. Our aim is to provide you the best of the services at the most affordable costs. Don't forget to say hi at info@medicyatra.com

1. Email: enquiry@medicyatra.com
Knock Knees
Genu
Valgum
Copyright @ Forever Medic Online Pvt. Ltd

2. Email: enquiry@medicyatra.com
DEFINITION
• Defined by position of knees such that,
when standing with knees together, the
medial malleoli are not touching.
Copyright @ Forever Medic Online Pvt. Ltd

3. Email: enquiry@medicyatra.com
Normal Development
• Most children are “bowlegged” from birth
until around 3 years old, then become
“knock kneed” until age 4 to 5, and
straighten towards adult alignment by age 6
to 7.
Copyright @ Forever Medic Online Pvt. Ltd

4. Email: enquiry@medicyatra.com
CAUSES
Unilateral Bilateral
• Asymmetric growth: • Physiological: common
• Metabolic: renal
1-Trauma. osteodystrophy, rickets, h
ypophosphatemia.
2-Infection. • Neuromuscular: cerebral
palsy.
• Haemotological:
3-Tumor to tibia. myelodysplsia
• Skeletal dysplasia:
congenital dislocation of
patella
Copyright @ Forever Medic Online Pvt. Ltd

5. Email: enquiry@medicyatra.com
Presentation
• Knees touch each other while
standing.
• Legs are curved inwardly.
• Too much distance between feet.
Copyright @ Forever Medic Online Pvt. Ltd
Copyright @ Forever

6. Email: enquiry@medicyatra.com
EXAMINATION
In the consultation room:
1- Always compare the two
knees.
2- Watch the patient walk.
3- Looks at the knees whilst
standing.
Copyright @ Forever Medic Online Pvt. Ltd

7. Measurement of intermalleolar
Email: enquiry@medicyatra.com
distance
• intermalleolar
distance is a Distance
between two malleoli
when the knees are
gently touching with
legs in adduction.
• Up to 3 and a half
inches (9 centimeters)
with child lying down
is acceptable.
Copyright @ Forever Medic Online Pvt. Ltd

8. Email: enquiry@medicyatra.com
Possible Complications
• Difficulty walking (very rare).
• Self-esteem changes related to cosmetic
appearance of knock knees.
• If left untreated (for patients with intermalleolar
distance which is more than 9 cm and for age group
7 years), knock knees can lead to early arthritis of
the knee.
Copyright @ Forever Medic Online Pvt. Ltd

9. Email: enquiry@medicyatra.com
Management
RAPRIOP
Copyright @ Forever Medic Online Pvt. Ltd

10. Email: enquiry@medicyatra.com
Reassurance
1- Most parents are happy to be reassured that their child's
deformity is within normal limits and will disappear.
2- Some may need their confidence boosted by returning
for fresh measurements to be made six-monthly until
they are convinced it is disappearing.
3- For those who are still sceptical, radiographic
examination may be sufficient to alleviate their anxiety
with or without the addition of an orthopaedic opinion.
Copyright @ Forever Medic Online Pvt. Ltd

11. Email: enquiry@medicyatra.com
Advice
• To measure natural
improvement, Advice Parents
to take photographs of the child
in standing with their kneecaps
pointing forward every 6
months.
Copyright @ Forever Medic Online Pvt. Ltd

12. Email: enquiry@medicyatra.com
Prescription (Treatment)
Non-Operative Operative
• Special • Epiphysiodesis
shoes, exercise (physeal stapling) of
programs, splints and medial side, or
braces are not corrective osteotomy
recommended, as in children 10 years
these conditions old with intermalleolar
usually correct and distance 10 cm.
improve over time
with normal growth.
Copyright @ Forever Medic Online Pvt. Ltd

13. Email: enquiry@medicyatra.com
When to Refer ?
• Age > 7 years with knock knees.
• Unilateral problem i.e Asymmetry of legs.
• Intermalleolar distance > 3.5 inches (9
cms).
• Associated symptoms e.g Pain, Limp.
Copyright @ Forever Medic Online Pvt. Ltd

14. Email: enquiry@medicyatra.com
Investigations
X-rays Laboratory tests
• No X-ray required until • CBC, phosphorus, creati
18 months of age, then nine and alkaline
AP and lateral standing phosphotase may be
full leg length views. ordered if a systemic or
metabolic abnormality is
suspected.
Copyright @ Forever Medic Online Pvt. Ltd

15. Email: enquiry@medicyatra.com
Observe (Follow Up)
• Observe the patient every 6
months.
Copyright @ Forever Medic Online Pvt. Ltd

16. Email: enquiry@medicyatra.com
Prevention
• There is no known prevention for normal
knock knees.
Copyright @ Forever Medic Online Pvt. Ltd

17. Email: enquiry@medicyatra.com
• .
Thank you
Copyright @ Forever Medic Online Pvt. Ltd