Diagnosis
The diagnosis is of course made clinically in pronounced forms. Here the malposition can be easily recognized from the outside. In lighter forms, the X-ray image can be helpful.
In this case, the thigh bone, the knee joint and the ankle joint are x-rayed in a so-called axial image. To objectively record the extent of the deformity, an imaginary line is drawn from the femoral neck of the femur through the knee joint to the ankle joint. Normally, this line passes through the middle of the knee joint.
In X-legs, this connecting line hits the knee joint too far out. If the knock-knees continue to exist to an excessive degree, there are several options for action: First, a surgical correction of the knee, more about this later. Second, inserts in the shoes, or on the inside of the shoes.
This tilts the foot and lower leg outwards (virtually in the bow-leg direction) and changes the load on the knee: The pressure is taken from the outside of the knee and shifted to the inside of the knee – just as if the leaning tower of Pisa was straightened by wedges in the foundation. The third option is to wait and see and do nothing. While this may still make sense up to the age of eight, a therapy should definitely be carried out at the beginning of puberty when the knock-knees are still in the X-leg position.
This has both cosmetic and orthopedic reasons: The knee is unevenly loaded in the bow-leg or knock-knee position. As a result, the underlying cartilage and bone tissue is worn down and degenerates much faster. Knee damage, pain and massive malpositioning due to incorrect movements are the result.
In the course of time, this can make an endoprosthesis – an artificial knee joint or artificial hip joint – necessary. Furthermore, a malposition of the legs also affects the entire body with spine and back, which leads to further orthopedic problems – in view of the uncomplicated treatment a quite avoidable evil. Conclusion: While malpositions can be quite normal up to the age of 8 years (up to 20 degrees deviation), a correction or treatment should be carried out if they persist. Pediatricians or orthopedic surgeons may be considered to clarify a possible leg malposition.
