Knock Knee Surgery and Bow Leg Surgery

Believe it or not knock knees are a common problem that many people experience in their lifetime. I know me personally used to be so self conscious about my knocked knee problem that it would make me not want to be around other people. Knock knee surgery is an option but it should be your last option when nothing else will work.

A lot of people don’t even realize they have a problem until they reach an older age and notice that everyone else around them have straight aligned legs. This deformity causes your knees to touch and your ankles to remain separated.

Your legs will turn inward and it can cause pain and discomfort along with embarrassment. This condition is normal among children under the age of 2. However, genu valgum as it is called in the medical field can affect some people all the way up into their adult years.

Knock kneed adults have options available to treat this problem such as exercises, braces, and specially designed inverted shoes. However, most adults with this problem turn to surgical procedures to correct knock knees.

Knock knee surgery is only an option if other alternatives don’t work. Usually other knock knee correction methods will help if the deformity is a mild case. However, if too severe alternative knock knee treatments will only help improve the appearance of this lower leg deformity not correct them.

Knock Knee Surgery

knock knee surgery

When other treatments for knock knees or bow legs aren’t effective surgical procedures are recommended (usually for severe cases). The name of the surgery used the most to treat knock knees and bow legs is osteotomy, which realigns the bones in your leg to the proper angle of the knee by adding or removing a small section of bone.

To really get a good idea of what this form of surgery is about it’s a good idea to learn more about the anatomy of the knee.

The goal of osteotomy is to help prevent/reduce the pain of osteoarthritis, slow down the wear and tear of the knee due to them knocking together, and preventing a knee replacement surgery which is much more serious.

Femor  Osteotomy (reshaping of the thigh bone)

The surgical procedure for knocked knees most often carried out is called femoral osteotomy, while high tibial osteotomy is more commonly performed for bow legged patients.

Femoral osteotomy will involve the surgeon operating around the lateral part of the femur and the leg to help straighten/realign the knees. This surgical procedure helps knock kneed patients because it relieves the wear on the lateral (exterior part) of the knees that this leg deformity often causes.

High Tibial Osteotomy or HTO (reshaping of the shin bone)

In HTO the surgeon will focus on the medial (inside) area of your knee to shift weight towards the lateral (outer) position of the knee, which will cause your leg to shift inward a little.

It’s pretty much like realigning a knee that’s bow legged to a more knock knee position. This form of osteotomy is commonly performed on bow legged patients because of the amount of wear they develop on the medial (interior part) of their knees.

A high tibial osteotomy involves removing a piece of bone from the exterior part of your knee so that your leg will bend inward. To give you a better description it’s kind of like realigning a bowlegged knee to a position that’s knock kneed. After the surgery is complete your weight will be moved to the lateral or exterior part of your knee.

During this surgery the doctor will put you under local anesthesia and then they’ll determine the right size of the bone they’ll end up taking out. In order to determine this they’ll use an X-ray or CT scan before beginning the operation.

Once everything is ready an incision will be made along the exterior of your knee right beneath the kneecap. At the top of your tibia plateau guide wires will be drilled in and then the tibea plateaue will be lowered on the exterior. The top of your tibia plateau will then be attached using screws or staples by the surgeon.

On the day of the surgery you will most likely be told not to consume any food or beverage so that you won’t vomit while you’re under the anesthesia.

Difference Between Knee Replacement and Osteotomy

The main difference between these forms of surgery is that an osteotomy will maintain/preserve the natural tissue around the knee and all the bones and ligaments such as the femur, tibia, and patella.

If you still want to be able to do certain activities like running, climbing, squatting, or be able to play the sports you love then an osteotomy is best. Meanwhile, a full knee replacement will replace all your bones and ligaments with prosthetic that take a longer time to recover from and makes it harder to return to a full range of motion in the knee.

Moreover, when a full knee replacement is performed it will high impact sports or activities are usually not possible with a full knee replacement since the natural tissues and ligaments in the knee will be removed and replaced with a prosthetic knee joint, while a full knee replacement removes everything.

Moreover, the typical prosthetic components used during a knee replacement will last around fifteen years before it needs to be replaced, which means another surgery.

Before Surgery

Prior to the surgery doctors may ask you to keep your legs cleaned to reduce the risk of infection.

If the osteotomy requires for a piece of bone to be inserted rather than taken out then either a synthetic bone will be used or a bone from the body of another person. Sometimes the bone needed to be inserted to complete the surgery will be taken from the pelvic bone of the patient.

Before the surgery the surgeon will most likely recommend that you quit taking certain medications that could counteract with the procedure.

You’ll also most likely be told to stop smoking a couple weeks before the beginning of the surgery. The reason smoking is not allowed is because the nicotine can help cause complications during or after the surgery.

Determining What Kind of Osteotomy Should be Performed

To determine what form of osteotomy needs to be performed whether for knock knees or bow legs the surgeon will take measurements of the alignment of your legs. These measurements will help the surgeon determine wither the femur (thigh bone) or the tibia (shin bone) needs to be operated on.

How severe your bowed legs or knocked knees are will determine the size of the piece of bone that needs to be removed or added should be to achieve the proper correction/realignment in the legs.


Recovering from an osteotomy can be tough, which is why doctors will keep you in the hospital and monitor you for a few days after the surgery is over.

The typical time frame for a person to begin walking again after this surgery without any help is around 3 months. Some patients don’t recover post surgery until 6 to 12 months later.

It’s best to keep the incision on your knee as dry as possible to help the recovery. After a month your doctor will ask you to come back in so an X-ray examination can be performed to see how well your bones are healing.

During the first week or two after the osteotomy you will most likely feel some discomfort, swelling, and/or pain. This is normal but if you feel that your pain or discomfort is too much for you to handle you should contact your doctor immediately.

Preventing Infections

While in the hospital nurses and doctors will advise you on effective ways to keep the wound clean and free of infection so that you can heal properly. To help decrease the chance of your knee swelling post surgery doctors will advise you to keep your legs elevated as much as possible.

Preventing Deep Vein Thrombosis

Ice packs and certain medical devices will be recommended to prevent severe swelling and other complications such as Deep Vein Thrombosis (DVT).


Ice is an important part of recovery as putting some on your knees for a half hour a couple to a few times daily can help with reducing the pain you’re experiencing. Try to keep your knee elevated as much as you can to help cope with pain you’re feeling, especially while you’re sleeping.


A machine called continuous passive motion is sometimes used while in the hospital to help with recovery.

This machine is used while you’re laying on your back to help your legs stay in the air and elevated, and to also move your leg from a straight to a bent position repeatedly.

This CPM machine helps with initializing range of motion in your knee and legs after the surgical procedure.

Pain Medications

Usually patients will be given pain medication to help with recovering from this surgical procedure. Doctors will tend to your knee by bandaging it and putting it on ice if necessary.

Encouraging Circulation

Doctors may also recommend that you move your feet around every now and then to help encourage circulation, which is a good thing.

Preventing Stiffness in the Knee

To help your joints in your knees from getting too stiff after the procedure you may be advised to do some simple motion exercises.


If you experience any feelings of fever don’t be scared because this is common after the procedure. Nurses will give you medications like acetaminophen to help you get through it.

Crutches, Braces, and Casts

A knee brace is sometimes used during the recovery of the surgery to help push your knee in the right position. In other cases the doctor may feel that putting your knee in a cast for a month or two is the best way to help it recover and realign the way it should.

Once the knee brace, cast, or crutches are no longer required (usually 2 to 6 weeks) you’ll then be advised to begin exercises to help regain your normal motion in your legs.


Some of these exercises include stretching, aerobic, and weight training exercises. All of these exercises main goal is to help your knee recover it’s strength and realign the way it should.

The goal of these exercises is to build up a little range of motion until you regain full movement in your legs, which can take up to 4 weeks.

Once you have progressed properly with the simple motion, stretching, and strength training exercises you’ll then start doing more intense exercises such as walking or running.

Working out the legs on an exercise bike or other exercises that will help make the legs stronger will be recommended.


Like with any surgical procedure there are some risks associated. Some of these risks include:

  • Allergic reactions
  • Problems with breathing
  • Excessive bleeding
  • Infections
  • Bones don’t heal properly
  • Blood clot inside the leg
  • Blood vessel or nerve gets damaged
  • Inflammation
  • Bones don’t align properly

These risks are some of the main reasons why people with this leg deformity want to know how to correct knock knees without surgery. However, surgical procedures may be your only option if your knock knees or bow legs are too severe.

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