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The varus knee, also known as geno varus or “cowboy legs”, is a normally genetic condition in which the knees remain apart even when the person is able to touch one ankle against the other, and happens when the tibia and femur bones are not correctly aligned, giving the leg line a different shape.
This condition is common in babies and usually disappears after the first years of life, but when it does not disappear and worsens over time, it is recommended to seek an orthopedist, so that possible causes such as rickets, Blount's disease and other diseases related to growth bones are confirmed or discarded.
The treatment for varus knee can vary according to the cause and degree of the alteration, which can range from just being vitamin D calcium supplementation in cases of rickets, for example, to surgery to realign the bones.
How to identify the varus knee
The varus knee is usually identified by the child's pediatrician in routine consultations, however it is also common for parents and family members to notice the deformity of the arched legs, in which case it is important to report to the pediatrician so that the referral to the orthopedist or physiotherapist be done in order to investigate possible causes and thus initiate appropriate treatment.
Possible causes
The most common cause of varus knee is the genetic pre-disposition that can be corrected alone until the age of 2 without the need for treatment. However, if there is no pain or difficulty walking, this condition can remain until 8 years of age without the need for specific treatment, although it has to be evaluated by a pediatrician, orthopedist or physiotherapist, so that the evolution or improvement can be monitored.
Other possible causes of varus knee are:
- Bone infections;
- Bone tumor;
- Conditions such as rickets and achondroplasia;
- Paget's disease
- Blount's disease;
- Obesity;
- Lead or fluoride poisoning;
- Ligament laxity;
- Walking early.
Despite being more common in children, the varus knee can happen in adults when there was no treatment in childhood or in cases of joint diseases such as osteoarthritis, for example. Better understand what osteoarthritis is and how it is treated.
How to confirm the diagnosis
To confirm the diagnosis, the asymmetry of the feathers, gait and angle of the varus knee will be observed, but in order to know the severity of the case, it is common for the orthopedist to request X-ray examinations of the legs and knees standing, front and side.
If there is a suspicion of a disease involved such as Paget or Blount, for example, blood tests and images such as computed axial tomography (CAT) and nuclear magnetic resonance (NMR), can be ordered.
How the treatment is done
Treatment for varus knee is done according to the cause and degree of the problem. Some of the most used treatment options include:
- Calcium and vitamin D supplementation: used mainly in cases of rickets, due to the lack of these nutrients in the body;
- Physiotherapy for muscle strengthening: when it is physiological or caused by achondroplasia and does not have any associated disease and aims to strengthen the muscles while aligning the leg bones;
- Surgery: used in severe cases, when the curvature to the outside is very sharp and causes pain and difficulties to walk.
The surgery called high tibial osteotomy, is usually only indicated for adolescents and adults, since physical therapy has positive results when started in childhood, and aims to adapt the shape of the bones to reduce the pressure on the joint and allow the realignment of the tibia with the femur.
Examples of varus knee exercises
Exercises to help correct the varus knee should always be guided by a physical therapist or orthopedist after physical evaluation, because the current deformity can end up damaging the cartilage, bones and muscles during the exercises. Some of the exercises that can be advised by the professional are:
1. Exercise to strengthen the side of the thigh
This exercise can help strengthen the muscles and reduce the curvature of the varus knee.
On a gym mat, lie on your side with both legs flexed, open and close your knees as shown in the image.
2. Exercise to strengthen the gluteus
In the case of varus knee, it is also very important to strengthen the gluteus maximus and, for this, one must have 4 supports on the floor and then raise one leg towards the ceiling. This movement should be done slowly and repeated between 8 to 10 times, for 3 sets, with each leg.
3. Exercise to strengthen the back of the leg
To do the exercise, you must stand and support your hands on a chair or wall, and then, with your knees together, bend your leg back without separating your knees. This exercise should be done between 8 to 10 times with each leg, for 3 sets.