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Adults and Bowlegs
In adults, bowlegs do not resolve spontaneously, but rather tend to worsen as arthritis leads to further malalignment. Bowlegs in adults are an independent risk factor for knee joint degeneration and pain. Multiple studies have shown that correction of bowlegs prior to the onset of end stage arthritis can delay or prevent the need for total knee replacement.
How is bowlegs diagnosed in adults?
While clinical examination is helpful, radiographic evaluation on a standing long leg film is the standard diagnostic method.
How is bowlegs treated in adults?
The aim of treatment will be to correct limb alignment, stop disease progression reduce the risk of further joint degeneration.
I. Acute osteotomy
The bone is cut and full correction is done in the operating room. The patient will typically have a plate with screws inserted internally to stabilize the cut bones and will be non-weightbearing for a period of 6 to 8 weeks until the bone unites.
II. Gradual correction using external fixators
The bowed legs can be corrected gradually using an adjustable frame. The surgeon cuts the bone, and puts an adjustable external frame on; it is connected to the bone with wires and pins. The parents receive a regimen outlining the daily adjustments that should be done to the frame. The patient walks, sleeps, bathes and does all of his or her daily activities with the frame in place. The bone gradually heals in the corrected position, and the patient visits the doctor every few weeks to make sure that everything is going as planned. Based on the follow up X-rays, the doctor may revise the schedule in order to achieve better results. After correction, the frame will need to be removed in the operating room.
Which treatment plan is best for me?
The treatment plan is decided based on many factors:
the nature of the disease and its tendency to progression,
the severity of that disease,
the presence of shortening requiring lengthening,
an abnormality or depression in the knee joint line, and
your patient preference.
All of these factors will inform the surgeon’s recommendation.
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Topic: Lengthening and straightening (Read 628 times)