Leg misalignments can be divided into the following categories:

1. Knock-knee (Genu valgum): The knees move closer to each other while the ankles are apart.
2. Bow-leg (Genu varum): The knees are far apart while the ankles touch each other.
3. Structural misalignment: Anatomical cause, usually due to growth disorders or injuries.
4. Functional misalignment: Caused by muscular imbalances or postural defects.

The main causes of leg deformities can be divided into several categories:

- Genetic predisposition:

- Congenital factors, such as a weak connective tissue structure, can promote the development of knock-knees or bowlegs.

- Growth disorders:

- Rickets (vitamin D deficiency) or other bone diseases in childhood can cause deformities.

- Overweight:

- Excessive strain on the joints can contribute to the deterioration of existing deformities.

- Muscular imbalances:

- Imbalance of the pelvic and thigh muscles negatively affects the leg axis.

- Injuries or fractures:

- Traumatic events can disrupt the growth or alignment of the leg axis.

The symptoms of knock-knees or bowlegs vary depending on the severity of the misalignment and include:

- Knee pain: Pain, especially under stress, such as when walking or standing.

- Load asymmetry: Overloading of certain joint areas, which can lead to premature wear.

- Postural problems: Changes in overall body posture that can cause discomfort in the back or hips.

- Movement restrictions: Limited mobility of the knee joint, especially in severe misalignments.

- Long-term consequences: Higher risk of knee osteoarthritis due to uneven cartilage wear.

The diagnosis is made through a combination of medical history, physical examination, and imaging techniques:

- Medical history: The doctor inquires about the patient's medical history, existing complaints, and family predispositions.

- Physical examination: Visual inspection of the leg axis while standing and moving, often with the help of an axis ruler.

- Imaging techniques:

- X-ray: Precise measurement of the leg axis and assessment of joint wear.

- MRI: Visualization of soft tissue damage and accompanying conditions such as cartilage loss.

Conservative Therapy

In mild cases, bowlegs and knock-knees can be treated with conservative measures:

• Physiotherapy:
  • Strengthening exercises: Strengthening of the pelvic and thigh muscles to improve the leg axis.
  • Stretching exercises: Promoting flexibility to balance muscular imbalances.
• Orthopedic aids:
  • Use of special insoles or shoe corrections to relieve the knee joints.
• Weight management:
  • Weight reduction to minimize the load on the knees.

Surgical Therapy

In cases of severe misalignment or complaints that cannot be alleviated by conservative measures, surgery is necessary:

• Corrective osteotomy: Surgical straightening of the leg axis by adjusting the bone.
• Joint replacement: In advanced cases with osteoarthritis, knee joint replacement may be required.

To prevent leg misalignments, the following measures are recommended:

1. Regular exercise: Targeted exercises to promote a healthy leg axis and muscle balance.
2. Healthy diet: Adequate intake of calcium and vitamin D to promote a stable bone structure.
3. Correct posture: Avoiding unilateral strain through ergonomic sitting and standing.
4. Early detection: Regular examinations in childhood to identify and treat misalignments.
5. Suitable footwear: Shoes that provide good stability and support can reduce misloads.