Knock knees are a consequence of a congenital misalignment of the feet, which can be corrected in moderation. If left untreated, knock knees can cause discomfort.
What are knock knees?
Under the term of Knock knees one understands a certain type of bending of the legs compared to a normal straight position. A distinction is made between two forms of angulation, namely the vagus position, which means bow-legged legs, and the valgus position, which is also known as knock-knees. In the latter position, viewed from the knee joint, the upper and lower legs are at an angle greater than 186 °.
causes
The causes of the Knock knees are not considered to be congenital, but are said to arise indirectly from a misalignment of the feet, which is, however, congenital. In children, knock knees are common and "grow together" again.
However, there are also forms of knock knees that result from a congenital weakness of the connective tissue. A deformation of the bones can, however - contrary to the above opinion - be congenital.
Such malpositions are the so-called arched arches, in which, as the name suggests, the foot is in a position that is slightly bent outwards to the side. In addition, the foot is lowered in such a misalignment, that is, it lies flat on the floor, since the natural padding of the foot is not used in the misalignment.
The result is that the legs are in an unfavorable position in relation to the knee. The "lever-like" effect of the lower leg on the knee impairs the growth of the leg, and later on it can also lead to knee and hip problems.
Untreated rickets in childhood may be one cause. In rickets, the bones do not harden properly and become deformed because they cannot fully support the body weight. In turn, the cause of rickets can be a deficiency in fat-soluble vitamin D. This is why children used to be given the unpopular cod liver oil. Rickets can also be triggered by a lack of phosphatase. One then speaks of hypophosphatasia.
The whole thing can lead to osteoarthritis of the knee joint, a so-called gonarthrosis. In addition, with knock knees, the thighbone joint is more stressed and thus also the outer meniscus. This can also lead to lateral osteoarthritis.
Other possible causes of the knock knees are broken bones, hormonal changes during menopause and obesity.
Diagnosis & course
The diagnosis is made on the basis of appearance and with the help of a so-called treadmill. X-ray technology is also used for osteoarthritis. The latter also applies to the slight shapes of the knock-knees, which are difficult to see from the outside.
But a diagnosis can also be made on the basis of various complaints that are common with knock knees. This is where knee joint problems are most likely to appear. This process can develop insidiously and will cause problems of the arthritic form.
Hip joint problems can also indicate an X-position of the legs. The orthopedic surgeon can also use a misalignment of the feet to determine whether there is a tendency to knock knees. If the diagnosis is made at a young age, the course can best be influenced.
Complications
As a rule, knock knees have a very negative effect on the quality of life of the person concerned. The patients suffer from very severe movement restrictions and thus from severe restrictions in their everyday life. Furthermore, it can lead to teasing or bullying, especially among children or young people.
As a result, many patients also suffer from depression or mental disorders. Carrying out strenuous activities or sporting activities is also not easily possible for the patient. This also significantly limits child development. The knee joints are also severely damaged by the knock knees, which can lead to osteoarthritis.
Bone fractures also occur more frequently, so that those affected have to protect themselves more against accidents and other dangers. As a rule, knock knees can be treated relatively well with the help of surgical interventions. The earlier the procedure takes place, the higher the chances of a complete cure. There are no complications. Furthermore, the patients are often dependent on examinations and on wearing insoles. The knock knees do not have a negative impact on the life expectancy of the patient.
When should you go to the doctor?
Knock knees are a visual change in body shape in direct comparison to the norm. Nevertheless, they do not represent any disease value for a large number of those affected. If there are no further complaints or impairment of locomotion, no doctor is required. A doctor should be consulted if there are physical or mental irregularities or conditions of stress. In the event of emotional suffering due to the visual flaw, the person concerned needs therapeutic help and support. Dealing with abnormalities should be learned so that no psychological sequelae or illnesses develop.If irregular locomotion occurs during the child's growth process, a doctor should be consulted.
In the case of pain, unsteady gait or poor posture, the symptoms must be clarified and examined. To avoid long-term damage and to prevent uneven posture, it is advisable to see a doctor. If physical activities can only be performed with great effort or if there are irregularities in the muscle system, the abnormalities must be discussed with a doctor. If the physical resilience drops or there are problems with the joints, medical help should also be sought. The sooner the changes in the skeletal system are discussed with a doctor, the faster regulation measures can be taken. It is therefore advisable to clarify the development as early as possible, especially with knock knees.
Treatment & Therapy
When in the growth phase Knock knees show, therapy is rarely necessary. However, if there is an axis deviation of more than 20 ° during puberty, surgery may be necessary.
There are several possibilities for this:
- A small piece of bone is surgically removed to correct the deformity.
- The growth plate is temporarily stiffened so that the leg no longer grows.
- The growth plate is permanently stiffened, even then the leg cannot grow any further.
A knock knee caused by rickets can resolve on its own if the deformity is not too pronounced. In the latter case, the muscles will reinforce the outward angle.
Another treatment option is to have insoles made for the shoes in order to correct the position of the feet a little. With knock knees you will reinforce the inside under the respective foot. The knee joint is then loaded more in the outward direction.
prevention
For the prophylaxis of Knock knees Basically only an operation against the deformity would be possible. Furthermore, if the growth is not yet complete, the growth plate can become deserted. To do this, the bone age must then be determined.
Aftercare
Follow-up treatment is necessary if the knock knees have been corrected as part of a surgical procedure such as an osteotomy. After the operation, the patient has to stay in the clinic for about four to five days. If there are no complications during this period, such as pronounced swelling, he may return home.
During the first two to three weeks after the osteotomy, the treated leg must be consistently protected. This means that loads of no more than 20 to 30 kilograms may take place. The patient uses forearm crutches for support for approximately four to six weeks. Because angle-stable plate systems are used nowadays as part of the operation, a full load on the leg can be carried out after only three weeks, but this also depends on the individual healing process.
Specific physiotherapy plays an important role in the follow-up treatment of the knock knees. The patient carries out special physiotherapy exercises that accelerate the healing process. Later, light sporting activities such as swimming or cycling are possible again.
In younger patients, the metal plates used can be surgically removed. However, many of those affected do not want removal at all, as the plates do not cause them any problems. After three to four weeks, the patient can go back to office work. For heavy physical work, the waiting time is usually three months.
Symptoms, ailments & signs
Knock-knees can be easily recognized from the outside. In this case, the legs are shaped like an X and are no longer in the optimal position to the knees. The child then has growth disorders in the legs. Small children often also suffer from arched arches.
In this case, the feet next to the knock knees are bent slightly outwards so that they lie flat on the floor. As a result, their padding to the floor is no longer optimal. Often the deformations of the legs are so easy that they grow out again on their own. Deviations of up to five degrees are still considered normal.
Misalignments start at a deviation of five degrees. However, in severe cases, surgical intervention is often necessary to correct the deformations. This is the case when the axis of the legs deviates by more than 20 degrees. In mild cases, the knock-knees in children and adolescents can often be corrected with the help of physical training.
In addition, special shoe insoles often help to correct the deformity. Knock-knees develop in adulthood for various reasons. Often, being overweight leads to this. But also tumors and hormonal changes can sometimes contribute to deformation of the legs. People with knock knees often suffer from knee problems due to constant inflammation. Osteoarthritis can develop in the severe forms.
You can do that yourself
In everyday life, general locomotion and gait can be deliberately controlled and optimized. The movements should be reflected on several times in the course of the day and changed in the event of irregularities. This is necessary to achieve long-term improvement.
Training units or exercises learned in physiotherapy can be carried out independently at any time. Lifting and carrying heavy loads can place particular stress on the skeletal system. Therefore, above all, these movements should be tailored to the needs of the organism. The wearing of optimal footwear is essential in order to alleviate existing irregularities and not cause the overall situation to deteriorate. Therefore, flat and closed shoes should be worn. These should not be too heavy and consist of materials that are comfortable and air permeable.
The choice of clothing can help relieve emotional discomfort. Pants with a wide leg cut and made of loose-fitting material help to hide the look of the legs. This can trigger an improvement in general well-being and thereby reduce cognitive stressors. In the long term, self-confidence needs to be supported and stabilized. As long as the knock knees do not lead to any physical discomfort, it is helpful to reduce the mental sensitivities. Overall, this leads to an improvement in the general quality of life.
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