Knock Knees

What is knock knees?

Knock knees (also called genu valgum) is a condition in which the knees bend inward when a child is standing up straight. In children with knock knees, it looks like the knees are touching while the ankles stay spaced apart. Knock knees are more common in girls than boys.

Knock knees are typically part of a child’s normal development. Most children will grow out of the condition without any treatment. Knock knees are usually most noticeable at around age 3. In most cases, the child’s legs will gradually straighten out and become aligned by age 7. In some rare cases, knock knees can be a sign of an underlying condition, such as a bone disease.

What are the symptoms of knock knees?

You may notice knock knees when your child is standing. Symptoms may include:

• Knees bending inward while the ankles stay spaced apart
• Outward pointing feet
• An unusual walk

Children who have knock knees that are part of another condition may have different symptoms. Talk with your child’s doctor if your child has:

• Asymmetric legs
• Knock knees that become worse or that first develop after age 6
• Knock knees that develop before the age of 2
• A short stature for their age

What causes knock knees?

In most cases, knock knees are part of a child’s normal development. Most infants are slightly bowlegged (outward angle of the knees) until about age 1 or 2. After this time, the legs begin to straighten out. Around age 2 or 3, some children develop knock knees. Most children grow out of knock knees by about age 7.

In a small number of cases, knock knees are caused by another condition. Talk with your child’s provider if you have any questions about how their legs are developing.

How is knock knees treated?

Most cases of knock knees do not require treatment and your child will grow out of the condition. Your care team at Arkansas Children’s is experienced in treating knock knees and will work with you to create the best treatment plan for your child.

• If the knock knees do not get better on their own, your child may need surgery. The type of surgery your child needs depend on their age and developmental stage.
• In younger children who are still growing, the doctor may suggest guided growth surgery. In this procedure, small metal plates are placed on the inner side of growth plates (area where bone growth occurs) around the knee. This will slow growth on the inner side of the knee while the outer side continues to grow, allowing the leg to straighten.
• Children who are done growing may need osteotomy surgery. In this procedure, your child’s surgeon will cut a part of the bone above or below the knee to change the angle of the knee. Your child may need physical therapy after osteotomy surgery to help with the recovery process.