Knee Valgus: Causes, Treatment Options, and Surgery Timing

Genu valgum

Hello Dr.
Shi, I would like to ask: (1) Is knee varus typically a problem that occurs in one leg or both legs? (2) Is osteotomy of the knee the only method for treating knee varus? (3) If it is already known that there is a problem with knee varus, is it better to have surgery as soon as possible to reduce wear on the knee cartilage? Thank you!

ha ha, 30~39 year old female. Ask Date: 2004/11/16

Dr. Shi Guozheng reply Orthopedics

Genu valgum typically occurs in both legs simultaneously; however, in patients with degenerative arthritis, it may sometimes present in only one leg.
Osteotomy is one of the treatment options, which can be considered for younger patients.
For those over sixty years old with arthritis, total knee arthroplasty may be considered.
If a patient is over fifty-five and only has issues on the medial side, a unicompartmental knee arthroplasty (commonly referred to as minimally invasive uni-knee surgery) may also be an option.
If the condition is not severe or asymptomatic, surgery is not necessary.
However, if the deformity is pronounced and causes pain or impairs knee function, surgical intervention is required.

Reply Date: 2004/11/16

More Info

Knee valgus, commonly referred to as "knock-knees," is a condition where the knees angle inward and touch each other when the legs are straightened. This condition can lead to various complications, including knee pain, osteoarthritis, and other joint issues. Let's address your questions one by one.

1. Is knee valgus usually a problem in one leg or both legs?
Knee valgus can occur in one leg (unilateral) or both legs (bilateral). In many cases, it is bilateral, especially in children, as it can be a normal part of growth and development. However, in adults, it is often associated with underlying conditions such as obesity, joint laxity, or previous injuries. If one leg is affected more than the other, it could be due to an injury or a structural abnormality. A thorough evaluation by a healthcare professional is essential to determine the extent and cause of the valgus deformity.

2. Is osteotomy the only method for treating knee valgus?
Osteotomy, which involves cutting and reshaping the bone to realign the knee joint, is one of the most common surgical options for treating significant knee valgus, especially when conservative treatments (like physical therapy, braces, or orthotics) have failed. However, it is not the only method. Other treatment options may include:
- Physical Therapy: Strengthening the muscles around the knee can help improve alignment and reduce pain.

- Bracing: Knee braces can provide support and help realign the knee.

- Weight Management: Reducing body weight can decrease the stress on the knee joints.

- Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) can help manage pain and inflammation.

- Injections: Corticosteroid injections may provide temporary relief for inflammation.

- Total Knee Replacement: In severe cases where the joint is significantly damaged, a total knee replacement may be necessary.

3. If knee valgus is already diagnosed, is it better to have surgery sooner to reduce cartilage wear?
The timing of surgery for knee valgus depends on several factors, including the severity of the deformity, the presence of symptoms, and the overall health of the knee joint. Early intervention can indeed help prevent further degeneration of the cartilage and reduce the risk of developing osteoarthritis. If the valgus deformity is causing pain, functional limitations, or is expected to worsen, it may be advisable to consider surgical options sooner rather than later.
However, it is essential to have a comprehensive evaluation by an orthopedic surgeon who specializes in knee conditions. They can assess the degree of valgus, the condition of the cartilage, and any other contributing factors to determine the best course of action.
In summary, knee valgus can affect one or both legs, and while osteotomy is a common surgical treatment, it is not the only option available. Early intervention may help prevent further joint damage, but the decision to proceed with surgery should be made in consultation with a qualified healthcare provider. Regular follow-ups and monitoring of the condition are crucial to ensure the best outcomes.

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