Bow Legs and Knock Knees in Children and Adults

The problem of leg bowing is considered one of the most common conditions that appear in children during their first year of life. Interestingly, some cases of leg bowing resolve spontaneously, while others may worsen. This depends mainly on the underlying cause of the deformity.

In today’s article, we discuss the condition of bow legs and knock knees in general — both in children and adults — and highlight the most important treatment methods used to correct this problem.

How Does Inward or Outward Leg Bowing Occur?

Leg bowing is a health problem that can be easily noticed with the naked eye, as both knees tend to point either inward or outward.

It is important to note that this problem is not limited to a certain age group; it can occur in both children and adults. However, age plays a role in determining the method of treatment. Children often recover spontaneously, while adults usually require medical intervention.

There are many possible causes for this condition, but first, it must be divided into two main types:

1. Inward bowing (Knock knees – Genu Valgum)
In this condition, the knees appear close to one another while the feet are apart. It may result from one of the following causes:

  • Obesity and being overweight

  • Knee osteoarthritis

  • Knee injuries

  • Rickets in children

2. Outward bowing (Bow legs – Genu Varum)
In this condition, the knees appear far apart while the feet are close together. It may result from one of the following causes:

  • Bone tumors

  • Osteomalacia (soft bones)

  • Incorrect healing of fractures causing bone deformity

  • Osteoporosis

  • Dwarfism

  • Blount’s disease, which is a hereditary condition affecting bone growth

Symptoms of Inward and Outward Leg Bowing

In addition to the abnormal distance between the knees, patients with bowed legs may experience several other symptoms, including:

  • Pain in the hip or knee joint

  • Shortened stride length

  • Difficulty walking or running, or limping while walking

Ignoring these symptoms and leaving them untreated may expose the individual to more serious complications, such as arthritis. With proper treatment, these symptoms improve and walking becomes more comfortable.

Methods of Diagnosing Leg Bowing

As previously mentioned, leg bowing is often easily noticeable, but doctors prefer to perform several tests to determine the exact angle of the deformity. The most important of these tests include:

  • X-ray imaging or other radiological studies to visualize the deformity in the legs and knees.

  • Laboratory tests (blood tests) to determine the exact cause of the condition — whether it is due to rickets or another reason.

Treatment Options for Inward and Outward Leg Bowing

Not all cases of leg bowing — whether inward or outward — require treatment. In many situations, especially in children, the condition resolves on its own over time.

However, if medical examinations reveal that the condition is worsening and not improving, the doctor may choose one of the following treatment options:

  • Prescribing medications that contain vitamin D and calcium, especially if the deformity in children is caused by a deficiency.

  • Surgical intervention, which is considered the best option for treating leg bowing in adults, and includes the following procedures:

1. Tibial Osteotomy (Corrective Bone-Cutting Surgery)

This surgery aims to correct the deformity and restore the normal alignment of the leg. It may involve one of the following techniques:

  • Making a surgical cut in the tibia and realigning the leg

  • Using metal plates and screws

  • Using an external fixator (Ilizarov frame)

2. Knee Joint Replacement Surgery

In this procedure, the knee joint is replaced with an artificial joint in cases where treatment was delayed and the condition progressed to severe knee osteoarthritis.

To determine the most appropriate treatment option for your specific condition, it is essential to consult Dr. Ibrahim Gadou, Consultant of Orthopedic Surgery and Joint Replacement

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