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Knee discomfort can significantly affect daily life, and when accompanied by swelling, tenderness, or redness, it is important to seek medical attention. One possible cause of knee pain is knock knee deformity, where the knees angle inward, often leading to symptoms such as pain, instability, and difficulty walking. At Complete Orthopedics, our specialists are committed to providing the best care for knee pain, offering both non-surgical and surgical treatment options.<\/p>\n
Knock knee deformity, also known as genu valgum, is common in children and typically resolves as they grow older. However, it can persist into adulthood, especially if it is caused by underlying conditions such as arthritis. The condition is often seen in young children as part of normal growth, but in adults, it is more commonly linked to degenerative joint diseases, such as osteoarthritis or rheumatoid arthritis.<\/p>\n
Knock knee deformity often develops during childhood as part of normal skeletal growth. However, it can persist or develop later in life due to various factors, including rickets (a vitamin D deficiency), genetic disorders like Morquio syndrome, and injuries to the knee joint. In adults, knock knees are frequently caused by osteoarthritis or rheumatoid arthritis, which lead to cartilage damage and joint misalignment.<\/p>\n
The knee joint consists of the femur (thigh bone) and tibia (shinbone), with the patella (kneecap) sitting on the front of the femur. The knee is designed to allow smooth flexion and extension. When a person has knock knees, the alignment of the femur and tibia is altered, causing the knees to angle inward. This misalignment can affect the patella’s position and may lead to additional strain on the knee joint.<\/p>\n
Common symptoms of knock knee deformity include knee pain, especially on the outer side of the knee, and difficulty walking or standing. The pain may be aggravated by activity, and the individual may develop a noticeable limp. In more severe cases, the knees may rub together, and there may be a visible gap between the ankles when standing. The misalignment can also increase the risk of patellar dislocation and lead to chronic knee pain.<\/p>\n
Diagnosing knock knee deformity involves a thorough physical examination, including an assessment of gait and leg alignment. The doctor may take measurements of the legs to check for discrepancies and evaluate joint movement. Imaging studies such as X-rays may be used to assess the severity of the deformity and any underlying joint damage. Blood tests may also be conducted to rule out deficiencies in vitamin D, calcium, or phosphate.<\/p>\n
Knock knee deformity is classified by severity, from mild cases where the misalignment is minimal to more severe cases with significant angular deformity. In children, the deformity is often physiological and resolves on its own, while in adults, the condition is usually associated with degenerative joint diseases.<\/p>\n
Other conditions that may present with symptoms similar to knock knees include flat feet, osteoarthritis, and patellofemoral pain syndrome. These conditions can also cause knee pain, gait abnormalities, and misalignment, so a proper diagnosis is necessary to differentiate between them.<\/p>\n
Non-Surgical Care<\/strong><\/p>\n For children with physiological knock knees, no treatment is usually required, but regular monitoring is necessary to ensure that the condition resolves as they grow. In adults, non-surgical management may include physical therapy to strengthen the muscles around the knee and improve alignment. Orthotic devices such as braces, arch pads, and specially designed shoes may also help. For individuals with obesity, weight loss may reduce the severity of the deformity.<\/p>\n Surgical Care<\/strong><\/p>\n Surgery is required in more severe cases, especially when the deformity is caused by underlying bone diseases or arthritis. In children, guided growth procedures may be used to correct the alignment. In adults, total knee replacement is often recommended, especially in cases of osteoarthritis or rheumatoid arthritis. High tibial osteotomy may be performed for milder cases to realign the knee.<\/p>\n Recovery from knock knee deformity treatment depends on the type of intervention. After surgery, patients typically require postoperative care, including pain management, icing, and rest. Physical therapy is crucial for rehabilitation and includes exercises to restore knee function and strength. Gradual return to activity is encouraged, with an emphasis on low-impact exercises initially. Follow-up appointments will monitor progress and ensure proper healing.<\/p>\n Possible complications from knock knee treatment include infection, blood clots, or nerve damage, particularly if surgery is required. In total knee replacement surgeries, excessive stretching of the knee joint structures could lead to damage to the common peroneal nerve, which controls foot movement.<\/p>\n The long-term prognosis for individuals with knock knee deformity varies depending on the severity and underlying cause. In children, the condition often improves with age. For adults, early intervention and appropriate treatment can prevent further joint damage and improve mobility. Surgical options like total knee replacement offer long-term relief from pain and deformity, providing patients with improved function and quality of life.<\/p>\n Medicare<\/strong><\/p>\n CPT Code 27475 \u2013 Guided Growth (Hemiepiphysiodesis): $158.81 Under Medicare, 80% of the approved amount for these procedures is covered once the annual deductible has been met. The remaining 20% is typically the patient\u2019s responsibility. Supplemental insurance plans\u2014such as Medigap, AARP, or Blue Cross Blue Shield\u2014usually cover this 20%, meaning most patients will have little to no out-of-pocket expenses for Medicare-approved surgeries. These supplemental plans work directly with Medicare to ensure full coverage for the procedure.<\/p>\n If you have secondary insurance\u2014such as Employer-Based coverage, TRICARE, or Veterans Health Administration (VHA)\u2014it serves as a secondary payer once Medicare processes the claim. After your deductible is satisfied, these secondary plans may cover any remaining balance, including coinsurance or small residual charges. Secondary plans typically have a modest deductible, ranging from $100 to $300, depending on the specific policy and network status.<\/p>\n Workers\u2019 Compensation<\/strong> No-Fault Insurance<\/strong> Example Q. What causes knock knee deformity?<\/strong> Q. Can knock knee deformity be treated without surgery?<\/strong> Q. How long does recovery take after surgery?<\/strong> Q. Is surgery always necessary for knock knee deformity?<\/strong> Q. Can knock knee deformity lead to other problems?<\/strong> Knock knee deformity is a condition that causes the knees to angle inward, which can lead to pain, gait abnormalities, and other joint problems. While it is often a normal part of childhood development, it may persist or develop later in life due to various causes such as arthritis or trauma. Early diagnosis and appropriate treatment, whether non-surgical or surgical, are key to managing the condition and improving quality of life.<\/p>\n Orthopedic surgeons specializing in pediatric and adult knee surgery typically perform treatment for knock knee deformity. A team of physical therapists, radiologists, and other specialists may also be involved in the diagnosis and rehabilitation process.<\/p>\n If you or your child has knock knee deformity that persists beyond the typical age of correction, or if the condition causes pain or difficulty walking, it\u2019s important to seek evaluation by a specialist.<\/p>\n Seek emergency care if you experience severe knee pain, swelling, or instability, especially if the knee appears to be dislocated or if there is significant trauma to the joint.<\/p>\n Recovery from knock knee deformity treatment typically involves a structured plan of physical therapy, gradual return to activity, and regular follow-up appointments to monitor progress. Most patients can expect to resume normal activities after a period of rehabilitation.<\/p>\n Ignoring knock knee deformity can lead to worsening pain, gait abnormalities, and the development of osteoarthritis. It may also increase the risk of further joint damage and functional limitations.<\/p>\n While some causes of knock knee deformity are genetic or related to growth, maintaining a healthy weight, engaging in regular physical activity, and addressing any joint issues early can help prevent or reduce the severity of the condition.<\/p>\n A balanced diet rich in calcium and vitamin D is essential for maintaining bone health and preventing conditions like rickets, which can lead to knock knee deformity. Proper nutrition supports bone strength and joint function.<\/p>\n To prevent or manage knock knee deformity, it\u2019s important to engage in regular low-impact exercises such as swimming or cycling. Avoiding activities that put excessive strain on the knee joint can also help reduce symptoms and prevent further damage.<\/p>\n [\/et_pb_text][et_pb_text admin_label=”FAQ Headline” _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”]<\/p>\n [\/et_pb_text][et_pb_df_faq admin_label=”FAQ Module – Change the FAQ Category Here” filter_by_category_on=”on” accordion_bg_color_closed=”#1f7714″ accordion_bg_color_open=”#1f7714″ accordion_icon_color=”#FFFFFF” accordion_icon_color_open=”#FFFFFF” _builder_version=”4.24.3″ _module_preset=”default” question_text_color=”#FFFFFF” answer_text_color=”#FFFFFF” hover_enabled=”0″ global_colors_info=”{}” include_categories=”5356″ sticky_enabled=”0″]<\/p>\n [\/et_pb_df_faq][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_sidebar area=”sidebar-1″ _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n [\/et_pb_sidebar][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":" Knock Knee Deformity Knee discomfort can significantly affect daily life, and when accompanied by swelling, tenderness, or redness, it is important to seek medical attention. One possible cause of knee pain is knock knee deformity, where the knees angle inward, often leading to symptoms such as pain, instability, and difficulty walking. At Complete Orthopedics, our […]<\/p>\n","protected":false},"author":37,"featured_media":3986,"parent":57534,"menu_order":0,"comment_status":"open","ping_status":"closed","template":"","meta":{"_seopress_robots_primary_cat":"","_seopress_titles_title":"Knock Knee Deformity New York | Knee Specialist Bayside NY","_seopress_titles_desc":"Knock knee is an angular deformity of the knees with the knees pointing inwards on standing straight. The patient has their knees touching together but ankles wide apart when standing straight.","_seopress_robots_index":"","_et_pb_use_builder":"on","_et_pb_old_content":" Knock knee is an angular deformity of the knees with the knees pointing inwards on standing straight. The patient has their knees touching together but ankles wide apart when standing straight. Knock knees deformity or genu valgum is usually a part of normal growth and development in children. It is different from genu varum or bow legs where the knees are wide apart but the ankles touch on standing straight.<\/span><\/p> Knock knees in adults may be a result of the residual knock knee deformity, trauma to the knee joint, and arthritis. Usually, in the older age groups, arthritis, such as rheumatoid arthritis may cause knock knee deformity. The deformity increases with time in adults as every step with a mal-aligned knee joint further damages the outer side of the knee.<\/span><\/p> The knee joint is formed by the lower end of the thigh bone and the upper end of the shinbone. A common concern for parents, knock knees and bow legs are quite common in growing children.\u00a0<\/span><\/p> There is a normal outward deviation of the knees (bow-legs) from birth until one year of age. The bow leg deformity usually corrects by itself to a neutral axis by the age of two years. The deformity then changes to knock knees with the knees angled inwards as the child grows.\u00a0<\/span><\/p> In young children, the knock knee deformity increases till the age of three and a half years. The deformity usually reaches a normal angle which is slight knock knees by the age of 7-8 years. The deformity may point to an underlying bone disease if it doesn\u2019t correct by itself or appears later in life.<\/span><\/p> Persisting knock knee deformity may present with symptoms such as knee pain, limp, instability of the knee, or difficulty walking. Pain is present usually as a result of excessive pressure on the outer side of the knees. The pain may be absent initially and only appear a few years later. The pain is generally diffuse and exacerbated with activity.\u00a0<\/span><\/p> The child or adult may walk with a limp which is characteristically circumducting. The severity of limping increases with the increase in the intensity of the knee pain. Pain and limping may severely limit the patient\u2019s physical activities.<\/span><\/p> With knock knee deformity, the kneecap is unable to properly sit in the cavity of the lower end of the thigh bone. The kneecap, therefore, is at an increased risk of dislocation. <\/span>Patellofemoral mal-tracking<\/span><\/a> may result in chronic pain in front of the knee.\u00a0<\/span><\/p> Visibly, there is a gap in between the ankles as the patient straightens the lower limbs. The gap can be even 3 inches or greater causing a cosmetic deformity as well. The outer side of the knee joint remains under extra pressure. This may lead to meniscal tears or osteoarthritis in the future.<\/span><\/p> In advanced cases, the lower end of the thigh bone and the upper part of the shinbone are rotated outwardly. The lower part of the shinbone rotates inwards to compensate for the rotation in the upper part. This may result in flat foot and outwardly rotated foot deformity.\u00a0<\/span><\/p> Most commonly in the majority of cases, it is a physiological part of normal bone growth. Persistent knock knee deformity after the normal age may be a result of underlying bone disease.<\/span><\/p> Rickets is a common cause of persistent knock knee deformity. It is due to deficiency of vitamin D, calcium and phosphate in the body. Most commonly nutritional in nature but may result from an underlying disease of kidneys. Rickets may also be inherited and causes weakening or softening of the bones.\u00a0<\/span><\/p> Knock knees may also result from developmental syndromes such as Morquio syndrome. Injuries to the growth plate of the knee joint may also result in deformity. The injury may be physical trauma, fractures,\u00a0 infections or loss of blood supply to the growth plate. The deformity is usually unilateral or single-sided.\u00a0<\/span><\/p> Rarely, knock knee may be present because of underlying benign tumors such as osteochondroma. Obesity may mimic knock knee deformity but there is no underlying bone deformity. Obesity may increase the severity of deformity when already present.<\/span><\/p> Knock knees deformity in adults may result from <\/span>osteoarthritis or rheumatoid arthritis<\/span><\/a>. The cartilage damage on the outer side of the knee joint leads to decreased joint space and knock knee deformity. The deformity gets significantly worse with time. The constant pressure on the outer side of the knee joint leads to progressive worsening.<\/span><\/p> On doctor visits, the attending physician will take a detailed history regarding the progression of deformity, any congenital diseases, and birth history. Physical examination may involve a detailed evaluation of the gait of the patient.<\/span><\/p> The doctor may further take measurements of the leg and assessment of any leg length discrepancy. The range of motion and rotational movements of the joints are assessed. Hips, ankles, and feet are evaluated to rule out any deformity in them.\u00a0<\/span><\/p> Knock knee deformity could lead to significant laxity on the inner side of the knee joint. There may be tightening of the structures on the outer side of the knee joint.\u00a0<\/span><\/p> Blood tests may be required to rule out any deficiency of vitamin D, calcium or phosphate. The doctor may further request imaging studies in the form of X-rays to assess the degrees of deformity.\u00a0<\/span><\/p> Most children with physiological knock knees only require close monitoring and frequent evaluations throughout the growing period. The deformity usually disappears as the child reaches the age of 7 or 8 years. If the bone and joint deformity is a result of underlying medical illness, the treatment is first directed to correct the medical illness.\u00a0<\/span><\/p> Nonsurgical methods of treatment are required only after the age of 7-8 years when the deformity doesn\u2019t correct by itself. Leg braces may be used to align the knees in the mechanical axis of the legs. Further, arch pads or specially designed orthopedic shoes may be utilized. In obese and overweight patients, weight loss may be advised.<\/span><\/p> Surgical management is usually required for only a small percent of children. Guided growth procedures are done to modulate the growth of the knees. Small pins or metal implants are used to tether the inner part of the knee designed to stop the growth. The outer part of the knees grows normally correcting the deformity.\u00a0<\/span><\/p> The implants are placed at a strategic time and need to be removed at a set time for accurate correction of the deformity. The procedure is not a major surgery and patients return to their activities early. Osteotomies are done after the end of the growth spurt in older children.<\/span><\/p> Knock knee deformity in adults secondary to osteoarthritis or rheumatoid arthritis usually require <\/span>total knee replacement<\/span><\/a>. Total knee replacement promises correction of deformity, pain-free mobility, and faster rehabilitation.\u00a0<\/span><\/p>Recovery and What to Expect After Treatment<\/h3>\n
Possible Risks or Side Effects (Complications)<\/h3>\n
Long-Term Outlook (Prognosis)<\/h3>\n
Out-of-Pocket Costs<\/h3>\n
CPT Code 27447 \u2013 High Tibial Osteotomy (HTO) \/ Total Knee Replacement (TKR) (Medial Opening Wedge): $303.02
CPT Code 27418 \u2013 Tibial Tubercle Osteotomy: $193.59<\/p>\n
If your knee surgery is work-related, Workers’ Compensation will fully cover all treatment-related costs, including surgery, hospitalization, and rehabilitation. You will have no out-of-pocket expenses under an accepted Workers’ Compensation claim.<\/p>\n
If your knee injury resulting in surgery is caused by a motor vehicle accident, No-Fault Insurance will cover all medical and surgical expenses, including guided growth, high tibial osteotomy, and total knee replacement. The only possible out-of-pocket cost may be a small deductible depending on your individual policy terms.<\/p>\n
James, a 61-year-old patient with knee osteoarthritis, required high tibial osteotomy (CPT 27447) and tibial tubercle osteotomy (CPT 27418). His estimated Medicare out-of-pocket costs were $303.02 for the HTO and $193.59 for the tibial tubercle osteotomy. Since James had supplemental insurance through Blue Cross Blue Shield, the 20% that Medicare did not cover was fully paid, leaving him with no out-of-pocket expenses for the procedures.<\/p>\nFrequently Asked Questions (FAQ)<\/h3>\n
A. Knock knee deformity can be caused by a variety of factors, including normal growth in children, rickets, genetic disorders, trauma, and arthritis in adults.<\/p>\n
A. Yes, in many cases, non-surgical treatments like physical therapy, weight loss, and orthotic devices can help manage knock knee deformity.<\/p>\n
A. Recovery time depends on the surgery performed, but generally, it takes several weeks to months, with a focus on physical therapy to regain strength and mobility.<\/p>\n
A. No, surgery is not always necessary. In many children, the condition resolves naturally as they grow. In adults, surgery is usually considered when the deformity causes significant pain or functional limitations.<\/p>\n
A. Yes, if left untreated, knock knee deformity can lead to osteoarthritis, meniscal tears, and other knee joint issues due to increased stress on the affected areas.<\/p>\nSummary and Takeaway<\/h3>\n
Who Performs This Treatment? (Specialists and Team Involved)<\/h3>\n
When to See a Specialist?<\/h3>\n
When to Go to the Emergency Room?<\/h3>\n
What Recovery Really Looks Like?<\/h3>\n
What Happens If You Ignore It?<\/h3>\n
How to Prevent It?<\/h3>\n
Nutrition and Bone or Joint Health<\/h3>\n
Activity and Lifestyle Modifications<\/h3>\n
Do you have more questions?\u00a0<\/h2>\n
Symptoms<\/b><\/h2>
Causes<\/b><\/h2>
Diagnosis<\/b><\/h2>
Management<\/b><\/h2>