Managing Genu Varum in Adolescents to Reduce Risks of Progression to Knee Osteoarthrosis

Abstract

Introduction: Genu varum is not uncommon in adolescents. Managing the condition to reduce its progression may decrease the prevalence of incident knee osteoarthrosis in adulthood. The present review examines studies on risk factors contributing to the progression of genu varum and associated with the degeneration of the medial tibiofemoral joint. We proposed approaches to decrease the magnitude of genu varum and external knee adduction moment, to reduce the incidence of knee osteoarthrosis in the aged population. Methods and Materials: Literature searches were conducted in Pubmed, Embase, and Cochrane Systematic Reviews, using keywords individually and in combinations. We excluded papers on pathological genu varum, tibia vara, Blount disease, nutritional rickets, imaging, and surgery and included only articles on genu varum involving children and young adults. Reference lists of the included papers were also screened manually for additional references. Results and Discussion: Search results showed that many children with physiologic genu varum are deficient or insufficient in vitamin D. High-impact exercises in late children and adolescents promote genu varum. In contrast, therapeutic exercises reduce the magnitude of genu varum in young adults with postural bowlegs. Lateral wedge insoles decrease the external knee adduction moment. We proposed to check the serum vitamin D level of children and adolescents with genu varum. Growing children with genu varum should be advised to reduce the frequency of performing high-impact exercises. Adolescents with genu varum should strengthen the external hip rotators and use lateral wedged insoles.