Genu Valgum Treatment and Management

Introduction to Genu Valgum

The American Academy of Orthopaedic Surgeons recommends that treatment for genu valgum should be guided by the severity of deformity, age of the patient, and functional impairment, with surgical intervention recommended for severe cases that persist despite optimized medical treatment or cause symptoms interfering with function 1

The pathophysiology of genu valgum involves both osseous and ligamentous components, and if left untreated, can lead to potential progressive joint damage 1
Assessment of genu valgum should include evaluation of functional impairment and symptoms 1

Strengthening exercises for quadriceps muscles are strongly recommended for improving knee alignment and function, with both strengthening and aerobic fitness training showing benefits for pain and function 3
Custom-molded foot orthoses may improve distal alignment at feet and ankles and secondarily decrease genu valgum 2
Lateral wedge insoles are NOT recommended for patients with symptomatic medial compartmental knee osteoarthritis (which may develop secondary to genu valgum) 4, 5

Surgical intervention should be considered when deformity persists despite optimized medical treatment, presence of symptoms interfering with function, or radiographic deformity (Mechanical Axis Deviation Zone 2 or greater) 1
Guided growth techniques must be performed at least 2-3 years before skeletal maturity (age 14 in girls and age 16 in boys) 1
Complications associated with osteotomy are reduced when surgery is performed later in childhood or after skeletal maturity 1

Regular clinical and functional assessments should be made following surgery, with radiographic assessment at 12 months post-surgery, or earlier if deformity worsens 1
Further assessments should follow intermittently until skeletal maturity 1
Functional assessment should be performed according to standardized tools such as the Pediatric Outcomes Data Collection Instrument (PODCI) 1