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Knee

Bow-leg and Knock-knee Correction
Leg Axis Malalignments

Leg axis malalignments describe a bow-leg or knock-knee curvature. These axial malalignments can be acquired (accident, inflammation, growth disorder) or congenital. Due to an axial malalignment, the mechanical load-bearing axis of the leg no longer passes through the centre of the knee joint with an even load distribution on the inner and outer joint sections, as is the case with a straight leg axis. Rather, a bow-leg curvature (genu varum) leads to an above-average load on the inner joint section, while a knock-knee curvature (genu valgum) leads to an increased load on the outer joint section accordingly. This can lead to premature joint wear in the correspondingly more heavily loaded inner or outer joint section.

 

Sportorthopädie Videos Video: Bow-leg and Knock-knee Correction | Knee

When is surgery needed?

Surgical Correction of Knock-knees and Bow-legs

This can delay the progression of premature joint wear. Such a procedure is performed when conservative measures for relieving joint pain have been exhausted. Frequently, the onset of wear has already been treated previously by means of arthroscopy.

What happens during surgery?

Based on the precise analysis of the malalignment, the bone is corrected in its misalignment either in the area of the femur or the tibia and fixed by means of a plate. The operation is performed under inpatient conditions.

Aftercare

Mobilisation begins on the first day after the operation with the aid of physiotherapy and forearm crutches. The operated joint/leg must not be fully weight-bearing for 3 to 6 weeks. During this period, temporary partial weight-bearing with forearm crutches must be observed. Medical thrombosis prophylaxis is required for this duration. After inpatient discharge, physiotherapy should be continued, possibly in the form of inpatient or outpatient rehabilitation. As a rule, a rehabilitation period of 12 weeks is to be expected following a joint malalignment correction. Patients should anticipate a period of incapacity for work lasting 3 months.

Detailed information on high tibial osteotomy at the knee joint can be found here.