A malalignment of the lower extremity includes two conditions known as bow legged and knocked knees. These conditions can be caused by a congenital deformity or the result of a past injury or meniscus deficiency. While many patients display a certain level of improper alignment, many will not show symptoms such as pain and swelling. Dr. Matthew Provencher, orthopedic knee specialist in the greater Vail, Aspen and Denver, Colorado area, specializes in treating lower extremity alignment injuries with knock knees surgery and bow legged surgery techniques.
The two malalignment of the lower extremity conditions are varus and valgus.
- Varus (bow legged) – In this condition, the majority of the body’s weight passes through the medial (inside) portion of the joint. Potentially directly making the lateral collateral ligaments (LCLs) more susceptible to injury.
- Valgus (knocked knees) – In this condition, the majority of the body’s weight passes through the lateral (outside) portion of the joint. Potentially directly making the medial collateral ligaments (MCLs) more susceptible to injury.
In order for the knee joint to be properly balanced and stable, proper alignment must be in place. The body’s weight is transferred evenly through the middle of the knee joint in a healthy, properly balanced joint. When the knee becomes unbalanced from a congenital deformity, meniscus deficiency or a past injury, the knee will become overloaded, leading to an injury such as osteoarthritis, chondral defects, ligament tears and meniscal tears.
Knocked Knees and Bow Legged Symptoms
Knocked knees and bow legged conditions are usually visible when a patient is standing or walking. The most common symptom of each malalignment condition is pain within and around the knee joint. The pain can become more severe if the condition is left untreated or if the knee experiences an injury because of a stress overload. Certain patients may also experience inflammation, swelling and stiffness.
Knocked Knees and Bow Legged Diagnosis
Dr. Provencher will perform a complete medical review and physical examination of the knee to determine the extent of malalignment. He will examine the knee joint’s balance and see how weight is distributed. He will also examine the physical structure of the affected joint while a patient is standing. X-rays and an MRI may be performed so Dr. Provencher can examine the entire joint and determine if knock knees surgery or bow legged surgery is necessary.
Knocked Knees and Bow Legged Treatment
Many cases of lower extremity malalignment are treated with conservative measures. Dr. Provencher may prescribe an unloader brace, modified activities, medications to alleviate pain and swelling and a physical therapy program designed to strengthen the entire lower extremity. It is strongly suggested that patients work with the in-house physical therapists at Howard Head Sports Medicine to optimize their rehabilitation.
A surgical procedure may be necessary if conservative measures fail or if a knee injury is associated with improper alignment. Dr. Provencher may utilize one of several knock knees surgery and bow legged surgery techniques, such as unicompartmental knee arthroplasty (replacement), total knee arthroplasty, and osteotomy. In cases requiring an osteotomy, Dr. Provencher will begin the procedure by cutting a tiny portion of the bone to allow for the alignment issue to be corrected. Once the bone is placed in the proper position, Dr. Provencher will position the bone long-term with a plate and screws. Dr. Provencher will explain each treatment option in great detail at a patient’s first consultation.
For additional resources on malalignment of the lower extremity, such as knocked knees and bow legged, please contact the orthopedic office of Dr. Matthew Provencher in the Vail, Aspen and Denver, Colorado area.