Knock Knee Correction
The SAFE Limb Lengthening Solution
The knee is a complex joint with critical roles in balance and mobility. When the knee is misaligned, whether from birth or from injury, it can cause pain and limitations that have a significant impact on quality of life. Surgical correction can realign the legs and prevent degeneration of the knee joint. For patients with knock knees, surgery can pave the way for a richer and more active life, free of self-consciousness and discomfort.
At HeightRx in Baltimore, Maryland, board-certified orthopedic surgeon Dr. Michael Assayag has helped improve the lives of hundreds of patients seeking treatment for bone defects, limb deformities and stature enhancement, as well as bowleg and knock knee correction. We invite you to visit HeightRx at the International Center for Limb Lengthening (ICLL) to meet Dr. Assayag and learn more about your treatment options.
What Are Knock Knees?
In a normal leg, a straight line can be drawn from the center of the hip to the center of the ankle, passing through the center of the knee. A difference of just millimeters off the optimal placement of this line can make a big difference in the wear-and-tear on the knee joint.
The knock knee deformity is a type of misalignment in which the legs curve inward, causing the knees to touch or “knock” each other while the lower legs and ankles spread apart. If you draw a straight line from the hip to the ankle on someone with knock knees, the line passes on the outside of the knee instead of through the center. The medical term for knock knees is genu valgum.
What Causes Knock Knees?
Knock knees can be a normal part of growth. Many toddlers have knock knees and can participate in all their activities without difficulty. The condition usually resolves by itself during the elementary school years. No treatment is necessary in most cases. However, on some occasions, knock knees do not improve or worsen into adolescence and adulthood, and medical intervention may be necessary.
In adults, knock knees can be caused by residual effects from pediatric orthopedic disease, conditions arising from nutritional deficiencies, trauma, infection or arthritis. The misalignment does not resolve spontaneously but rather tends to worsen and increase the risk of knee joint degeneration and pain.
What Are the Symptoms of Knock Knees?
Knock knees may not cause any symptoms, but can be embarrassing due to their appearance. In other cases, knock knees can cause knee pain, joint stiffness, difficulty walking or balancing, changes in posture, hip pain, low back pain or reduced range of motion. Severe and long-standing cases of genu valgum can lead to joint damage, meniscus tears and osteoarthritis.
Osteoarthritis may develop from knock knees because there is an abnormal amount of stress placed on the outer region of the knee joint. Picture two people carrying a sofa down a set of stairs. The person towards the bottom of the staircase bears the largest weight burden. A person with knock knees has a similarly uneven weight distribution. The outer portion of the knee joint carries a bigger load, making it more prone to damage. Over time, the stressed part of the knee may develop osteoarthritis, causing pain, swelling, limitations with sports and exercise, and eventually, difficulty with activities of daily living.
How Are Knock Knees Diagnosed?
Diagnosing knock knees is usually a simple process that may only involve a visual inspection. When the patient stands upright, the knees touch, but there is a wide gap between the ankles. Observations of the patient’s standing and walking pattern will be taken, as well as measurements of the knee and ankle angles. Imaging studies like x-rays will be ordered if appropriate. A standing x-ray can provide more information about the severity of the condition and determine if the source of the deviation is the femur (thigh bone) or the tibia (shin bone).
What Is Knock Knee Correction?
In adults, knock knees are corrected with a surgical procedure called osteotomy. The goal of the procedure is to change the angle of the bones, even out weight bearing, stop disease progression and lower the risk of joint degeneration. A surgeon does this by cutting the relevant bones above or below the knee and realigning them.
Nonsurgical options will not correct the knock knee deformity in adults. However, they may be helpful in decreasing the uncomfortable symptoms associated with the condition. A doctor may recommend wearing special shoes or braces, performing strengthening exercises, icing and other conservative measures to minimize discomfort.
Is Knock Knee Correction Right for Me?
It’s crucial to match the right procedure with the right patient. Typically, the best candidates for knock knee surgery meet the following criteria:
- Are relatively young (under 60 years of age)
- Are not overweight
- Do not smoke
- Are willing to commit to a post-surgical physical therapy regimen
- Can limit weight bearing for six to eight weeks after the surgery
Dr. Assayag can help determine if osteotomy surgery is right for you during an in-person consultation. If he decides that it is not the best option for you, you may be a candidate for a partial or total knee replacement instead. Knee replacement can yield better results in elderly people with associated knee arthritis or if the deformity comes from the joint due to arthritis.
The Knock Knee Correction Procedure
Osteotomy is performed under general anesthesia. During the procedure, Dr. Assayag will remove a thin wedge of bone from either the femur or tibia. This decision regarding which bone to target is based on x-ray findings that identify where the deformity is. After the cut is made, Dr. Assayag will realign the bones and use plates and screws to anchor the bones in their new position.
There are two primary types of osteotomy. In one type, Dr. Assayag removes a wedge of bone and fills the gap with a bone graft. The graft is secured with a place and screws while it heals. In the other type of osteotomy, Dr. Assayag removes a wedge of bone and brings the remaining edges together. They are fixed in place with metal hardware.
What to Expect After Your Knock Knee Correction Surgery
It’s normal to experience some pain and swelling after knock knee surgery. Discomfort can be managed with a combination of appropriate medications, elevation of the limb and icing. Dr. Assayag will provide you with detailed post-operative instructions that should be followed closely throughout the healing process.
You will begin a rehabilitation program with a physical therapist soon after osteotomy surgery. The early start of muscle strength, knee motion and balance exercises reduces the risk of complications such as muscle atrophy and excessive scarring. Expect to use crutches for approximately two months while the bone heals. You may also be instructed to wear a brace.
Generally, patients can begin walking unaided eight to 12 weeks post-surgery. Complete recovery after osteotomy can range from 6 months to a full year.
Cost and Financing Considerations
Cost and financing options are important to consider before proceeding with any medical procedure. Dr. Assayag will prepare a detailed cost estimate to help you plan for your surgery. The expected fees include x-rays, hospital charges, medical equipment, transportation, physical therapy, follow-up appointments and more. If you are seeking the procedure for medical reasons, your insurance company may cover some or all of the cost. Please contact your insurance carrier directly to check your benefits for surgery and physical therapy.
Dr. Assayag is committed to providing exceptional care at an affordable price point. HeightRx has also partnered with LightStream to provide flexible payment options, ensuring patients from all walks of life have access to the medical care they need. Contact Dr. Assayag today to learn more about the cost of knock knee surgery and your financing options.
HeightRx is a leading destination for limb lengthening and deformity correction. If knock knees are causing you embarrassment or limiting your mobility, board-certified orthopedic surgeon Dr. Michael Assayag can help you lead a fuller life. Dr. Assayag will customize your treatment to meet your specific needs using the most advanced orthopedic techniques. As one of Baltimore’s top orthopedic surgeons, you can feel confident your care is in the right hands. Contact us or call Dr. Assayag today at 443-929-3480 to learn more about knock knee correction and what it can do for you.