What are the causes of knee deformities?
Since the children begin to walk and until approximately the 2 years of age, the legs usually have form of parentheses or arched, phenomenon called genu varo. From the age of 3, the legs are accustomed to adopt a form of x, known as genu valgo. This posture is usually maintained until 7 or 8 years old, when the legs return to their normal position. Therefore, from the age of eight, any position in varus or valgus (in parentheses or in X) is abnormal, and may be mild or severe cases. Fortunately, a small group of these alterations are due to common growth diseases. The genu valgo or legs in x is decreasing with growth, so that the axis of legs between 7 and 8 years of age is normalized.
What complications can cause deformities in the knees of children and adolescents?
The genu varus (legs in parentheses) and genu valgo (legs in X) alter the mechanical axis of the knee, that is, they overload the inner or outer part of the knee. This can lead to pain, meniscal injury or osteoarthritis in adulthood.
What kind of deformities in the knees of children and adolescents can we find?
For the professional it is important to differentiate two groups of deformities. Those that we would call postural deformities , which suppose an exaggeration of the posture and between which are the knees in xo or the knees in parentheses. However, when performing the radiological and general clinical analysis we did not find any cause of bone development or any type of metabolic disease. That is, they are healthy children with the knees with this deformity. The other important group are pathological deformities. These are children who have deformed knees, in which there is an alteration of the growth of the same or other joints of the body. They are alterations due to congenital or genetic disorders.
What treatments exist to correct knee deformities in children and adolescents?
The only reliable treatments are surgical ones, which are given the generic name of hemiepifisiodesis , and allow temporary or permanent blocking of one side of the knee. Since 2007, we have had an advance for these treatments, known as guided growth control. This uses special tension plates with two screws that are placed through a small incision in the child's knee, without injuring the growth cartilage. The child is admitted one day, the next one begins to walk, and by 15 days can lead a normal life. The improvement of knee position in the consultation is monitored every four months.. When we are sure that the correction is complete, by means of a small incision in the same wound, the plates are removed and the growth continues unchanged. An advantage of this type of treatment is that it allows treating young children and children with diseases of growth cartilage.