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Knock-knee Surgery Cost

Surgery is not always indicated for persons suffering from pain, stiffness or discomfort due to genu valgum (knock-knees). In severe cases, both children and adults may need surgery to correct their knee alignment, but many cases are able to correct with physical therapy and exercises. Cost of this type of surgery will depend on factors such as need for surgery, type of surgery, insurance, hospital and location. The type of surgery indicated to correct knock-knee may be a Guided Growth Surgery, osteotomy, metal plate insert or knee replacement.

Definition: What is the knock-knee?

Synovial Joints of the Body

Synovial Joints of the Body

Knock-knees is a bone deformity where the knees are turned inward. When a person stands straight, their knees are touching and there is at least a 3-inch gap between their feet.

The medical term for knock-knee is genu valgum. The bone deformity where knees are turned outward (bowed legs) is known as genu varum.

Causes and Risk Factors for Knock-Knee

  • What is the cause of knock-knee?
  • Are knock knees normal?

Toddlers and children ages 3-5 are most often affected by knock-knees, and it is nearly always corrected on its own by the time the child reaches 7-8 years of age. While knock-knee is observed and followed up by their pediatrician, up to 75% of children have some degree of knock-knee and is relatively common.

Knock-knees can also occur later in life. Risk factors include:

  • Obesity
  • Arthritis of the knee joint
  • Severe Vitamin D and Calcium deficiency–known as Rickets
  • Injury to the knee or leg
  • Bone diseases such as osteomyelitis, osteoporosis

Obesity can cause and make knock-knee worse. Studies in children have indicated a much higher incidence of knock-knees in children who were obese than in children who had a normal body weight.

Prevention of knock-knee

While knock-knees cannot really be prevented, it can be corrected fairly easily with minimally invasive treatments such as exercises, physical therapy or externally worn braces.

Things to think about in prevention of bone deformities such as genu valgum and genu varum are:

  • Regular exercise
  • Healthy diet (consider supplements for Calcium and Vitamin D)
  • Maintain a healthy weight

Diagnosis of knock-knee

If you are experiencing, or see that your child is experiencing signs or symptoms of knock-knee, speak to your doctor about conducting an exam to see if they do have knock-knee and to determine if there is an underlying cause.

Signs and symptoms of knock-knee may include:

  • Walking with a limp
  • Pain or stiffness in the knee joint
  • Unbalanced stance
  • Pain in hip, ankles or feet

At your doctor’s office visit the doctor will likely ask questions about the person’s medical history and about their complaints of pain.

They will also take measurements of leg length and knee angle alignment; assess walking and standing positions; and may look at the person’s shoes. Shoes may display uneven wear in persons with knock-knee.

In some cases, to determine bone structure and density, X-Ray or MRI imagine may be done.

Treatment of knock-knee

Treatments can be fairly effective for genu valgum, but of course depends on severity of the deformity and the underlying cause.

Almost always, treatments other than surgery will be attempted first. These treatment options may include:

  • Exercises and/or physical therapy to realign knees
  • Weight loss
  • Diet modifications (increase of foods high in Calcium and Vitamin D; may include taking supplements)
  • Braces or splints to insure normal bone growth in children
  • Orthotics (shoe inserts) may be used to help correct gait (walking posture) and relieve pain

In very severe cases or when the previously mentioned treatments are unsuccessful surgery may be indicated.

In children, surgery can be done to implant a metal plate in the knee. This type of surgery is called Guided Growth Surgery, as the implanted metal plate helps to guide the growth of the bone over time. As the bone grows, the implanted metal plate will eventually be removed.

In adults, metal implants can also be used to support normal alignment of the knees. A knee replacement may also be considered in some adults.

Guided Growth Surgery

What is Guided Growth Surgery?

This surgery must be done before a child’s bones have stopped growing in order to be effective. It works by temporarily implanting a metal plate (using a plate and two screws) into one side of the bone’s growth plate. It temporarily stops the growth of that side allowing the other side to ‘catch-up.’ After a certain amount of time the implant is removed and the bones continue to grow normally.

Who can have Guided Growth Surgery?

Guided Growth Surgery or ‘temporary hemiepiphysiodesis’ may be an option for children who are still growing to correct bone alignment. Females are said to stop growing around the age of 14 and males at the age of 16, however a bone-age may be determined by X-Ray imaging if there is question regarding if the child’s bones are still growing or not.

Who performs Guided Growth Surgery?

Orthopedic surgeons perform Guided Growth Surgery.

Scarring

The scar from the surgery is generally pretty minimal as the incision made is about one inch in length.

Hospital Stay & Recovery Time

Children who have the surgery done just on one leg can generally expect to go home the same day as the surgery. If it is done on both legs they may need to stay for one night.  

Children will be provided with either a knee brace or boot to assist with recovery. Most will be able to walk unassisted after two weeks and return to normal activities, such as sports, by about four weeks.

Definition: What is Genu Varum (Bowed Legs)?

Bowleggedness, or genu varum, is a bone deformity where the knees are bowed outward causing the feet to angle inward.

Bowleggedness may be congenital (infants are born with it) or may be due to an underlying cause. When an infant is born with bowed legs it is called congenital genu varum and usually corrects itself when the child begins to walk at 12-18 months of age.

If the child’s legs continue to bow beyond the age of two a doctor should be consulted as they may need further treatment to correct the malaligned legs. Overtime, if left uncorrected, bowleggedness can cause arthritis.

Risk factors & Causes of Bow-Leg

Underlying causes or risk factors for bowleggedness may include:

  • Rickets (condition caused by Vitamin D and Calcium deficiency)
  • Paget’s Disease (common in older people where bones do not rebuild correctly)
  • Dwarfism (bone growth disorder)
  • Blount’s Disease (shin bone develops abnormally)

Diagnosis of Bow-Leg

If you or your child begin to display signs of bowleggedness make an appointment to speak with your doctor. They will likely observe posture, gait (walking posture), take measurements of leg length and angles of knee or ankle alignment, as well as take X-Ray or MRI imaging of the leg bones.

The doctor can diagnose the severity of the bowleggedness and determine any underlying causes. A blood test may be done to help diagnose underlying disease causes.

Treatment of Bow-Leg

Treatment of bowleggedness may include exercises or physical therapy as well as the following:

  • Braces
  • Special Shoes
  • Casts
  • Surgery
  • Treatment or management of underlying cause

 

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