Knock Knees

“Knock knees” is an abnormal alignment of the legs in which the legs curve in toward the knee. This condition often does not allow one’s ankles to come together without shifting one leg or the other. To say that this is an “abnormal” alignment of the legs, it is important to understand first what “normal” alignment is. 

With normal alignment of the legs, the centers of the hips, knees, and ankles form a straight line downward. If this line from the hips to the ankles runs outside the knee, this is knock knees, also called inverted knees. Many times, toddlers who have inverted knees will outgrow them as they age. Sometimes, however, surgery is necessary to correct the problem.

Inverted knees in adults generally do not improve with time. Rather, they worsen with arthritis and joint degeneration, sometimes resulting in knee replacement surgery. SPORT Orthopedics has corrected this problem many times in both children and adults with top-of-the-line therapeutic and surgical techniques. If you or someone you know is suffering with knock knees, visit SPORT Orthopedics in Dallas and Frisco for your personalized treatment plan.

Someone with knock knees will stand with their knees together, and their lower legs are abnormally far apart. Small distance between the ankles is normal, but for people with knock knees, the gap could be over 3 inches wide. While this condition does not normally cause major problems, severe cases cause pain in the knees, limping, or even difficulty walking. If the condition does not improve over time (which is only possible in young children), your risk of developing arthritis will increase.

Sometimes, there is a greater cause for seeking medical advice. If you or your child experienced any of the below symptoms, we recommend seeking medical advice right away.

• The ankle gap is greater than 8 centimeters while the knees are together
• The problem is worsening
• Your child has knock knees before the age of 2, or after the age of 7
• Only one led seems affected
• There are symptoms such as pain or difficulty walking
• You have developed knock knees during adulthood

There are different causes for knock knees in children and adults. Children sometimes develop inverted knees normally between ages three to four. They are not an uncommon occurrence, and most toddlers will outgrow it. In these cases, there is no known cause for knock knees, meaning the cause is idiopathic. Knock knees in children are also caused by different types of rickets, which we detail below.

• Renal rickets: This is related to either kidney failure or renal osteodystrophy, which is a failure of the kidneys to keep proper levels of phosphorus and calcium in your blood that leads to bone disease.
• Hypophosphatemic rickets: This is vitamin D-resistant rickets.
• Nutritional rickets: Rickets caused by vitamin D or other nutritional deficiencies.

In adults, knock knees often result from untreated pediatric orthopedic issues. They can also be caused by physical trauma to the legs or knees, as well as infection or arthritis.

During your appointment, our Dallas orthopedic specialists will first examine the physical appearance of your legs and knees. While you stand upright, we will examine whether your knees touch while there is a wide space between your ankles. If this is the case, we will order an X-ray, and draw a line from your hips to your ankles. As stated above, if this line passes outside of your knee, you have knock knees.

When examining children, we examine the quality of their bones, as well as the width of their growth plates. Growth plates are responsible for the lengthening of their limbs as they age. If the child has a nutritional deficiency, especially a vitamin D deficiency, they will often have irregular growth plates. This presents alongside knock knees. If we suspect nutritional deficiencies, we will order a blood test to confirm which condition is causing the child’s knock knees.

Our main goals in treating this condition are to align your limbs normally, stop the progression of knock knees, and reduce the risk of degeneration in your joints. Children may present with knock knees in their toddler years, but they often grow out of the condition with time. Unfortunately, this is not always the case. In pediatric cases where the child has irregular X-rays or blood test results, we will recommend special treatment.

If the inverted knees are the result of nutritional deficiencies, we often recommend supplements or replacements to correct the problem. When this proves unsuccessful in straightening the legs, we may discuss surgical correction. In children who are still growing, we perform minimally invasive surgeries which correct the growth of the legs. Over a period of 6 to 18 months, the growth of the legs is corrected with the help of staples, plates, or screws along the growth plates. Most times, we recommend minimal physical therapy at our Frisco and Dallas locations after surgery.

Yes! Although guided growth options are no longer an option in adults or older children with very little time until maturity, there are still options with corrective surgery.

1. Acute osteotomy: During this process, our experienced orthopedic surgeon will cut the bone, and correct it in the operating room. They will put in a plate and screws to secure the bones. After surgery, the patient must refrain from bearing weight on the affected leg for 6 to 8 weeks until the bone grows back together.
2. External fixator: Fortunately, there is also a gradual corrective method for adults and older children. This is accomplished through the use of an adjustable external frame. Our surgeon will cut the bone and connect it to the adjustable frame with pins and wires. We will assign a regimen for each patient, with outlines of all daily adjustments to the frame. Each patient conducts all daily activities with the frame, and the bone gradually corrects. We schedule a visit for every few weeks to ensure that the correction process goes smoothly. Our practitioners examine follow-up X-rays, and make adjustments as needed. Once correction is complete, the frame is removed in the operating room.

At SPORT, we identify the source of your pain and then use top-of-the-line therapeutic techniques to restore your range of motion, as well as your quality of life. Depending on your specific condition and its severity, we develop personally-curated treatment plans. These plans may include physical therapy, medication, shots, or even surgery.

If you have knock knees, you may want to seek medical attention right away. The longer you wait, the worse the condition will get. Call SPORT at (469) 200-2832 to schedule a consultation, or fill out our online intake form.