Knee malalignment refers to a condition where the knee joint is not properly aligned, leading to various discomforts and potential complications. This is more commonly known as bowed legs or knock kneed.
Knee malalignment can occur due to various reasons, including:
1. Genetics: Some individuals may inherit structural abnormalities in the bones of the knee, leading to malalignment.
2. Muscle Imbalance: Weakness or tightness in certain muscles around the knee can pull the joint out of alignment.
3. Injuries: Trauma to the knee, such as ligament tears or fractures, can disrupt the natural alignment.
4. Overuse: Repetitive stress on the knee joint, often seen in athletes or individuals with certain occupations, can contribute to malalignment over time.
5. Arthritis: Degenerative conditions like osteoarthritis can alter the shape and structure of the knee joint, leading to malalignment.
The symptoms of knee malalignment can vary depending on the severity of the condition. Most patients will not experience any symptoms and the discovery of malalignment comes as a result of investigation for other conditions around the knee.
Common signs and symptoms include:
1. Pain: Persistent or intermittent pain around the knee joint, especially during movement or weight-bearing activities.
2. Swelling: Inflammation and swelling around the knee, often accompanied by warmth and redness.
3. Instability: Feeling of the knee giving way or buckling, particularly during physical activity.
4. Difficulty Straightening or Bending the Knee: Limited range of motion due to the misalignment of the joint.
5. Clicking or Popping Sensation: Some individuals may experience unusual sounds or sensations when moving the knee.
To diagnose knee malalignment, an Orthopaedic surgeon will perform a thorough evaluation, which may include:
1. Physical Examination: Assessing your knee joint for signs of swelling, tenderness, and range of motion.
2. Imaging Tests: X-rays, MRI, or CT scans may be ordered to visualise the internal structures of the knee and identify any abnormalities in alignment or bone structure. A specialised EOS scan will be performed to look at the entire lower limb during weight bearing for accurate assessment of alignment.
3. Gait Analysis: Observing your walking pattern to determine if there are any abnormalities in how you bear weight on your knees.
Treatment for knee malalignment aims to relieve symptoms, improve joint function, and prevent further complications. Depending on the severity of your condition, treatment options may include:
1. Physiotherapy: Targeted exercises to strengthen the muscles around the knee joint and improve flexibility. It is important to know that physiotherapy cannot change the alignment of the bones or joints but it can strengthen the muscles and keep the joint supple to improve function
2. Bracing: Wearing a knee brace or orthotic device to provide support and stabilise the joint. These braces are known as an offloaded brace and should be fitted by a trained orthotist or physiotherapist.
3. Medications: Over-the-counter or prescription medications to manage pain and inflammation.
4. Injection Therapies: Corticosteroid injections or viscosupplementation to reduce inflammation and improve joint lubrication.
5. Surgery: In severe cases, surgical intervention such as realignment osteotomy or knee replacement may be necessary to correct the malalignment and restore function. Which surgerical option is best for you is dependent on a number of factors and should be discussed with your surgeon.
Please see procedure section for information on Realignment surgery.
Depending on the symptoms experiencing and the severity of malalignment prognosis can vary.
Recovery from surgery is successful in the majority of cases in improving pain and restoring function.
While some causes of knee malalignment may not be preventable, you can reduce your risk of experiencing symptoms by:
1. Maintaining a Healthy Weight: Excess body weight can put strain on the knees, increasing the risk of malalignment.
2. Regular Exercise: Strengthening the muscles around the knee through regular exercise can help support the joint and improve stability.
3. Proper Footwear: Wearing supportive shoes that provide adequate cushioning and stability can help prevent knee problems.
4. Avoiding Overuse: Take breaks and practice proper technique during physical activities to prevent overuse injuries.
Living with knee malalignment can be challenging, but with the right treatment and lifestyle modifications, you can manage your symptoms and improve your quality of life. Remember to consult with your Orthopaedic surgeon for personalised advice and guidance tailored to your specific needs.
