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Topic:

Genu Valgum

Issue:

Knee

Category:

​

Title:

Genu Valgum in Pediatric Patients Presenting With Patellofemoral Instability

Author:

Kirby, Julia C. MBBS; Jones, Hunter MD; Johnson, Benjamin L. MPAS, PA-C; Brenner, Madison E. BSA; Wilson, Philip L. MD; Ellis, Henry B. MD

Journal:

Journal of Pediatric Orthopaedics

Date:

March 2024

Reference:

44(3): p 168-173, DOI: 10.1097/BPO.0000000000002576

Level Of Evidence:

III

# of Patients:

279 patients (349 knees)

Study Type:

Retrospective cohort study

Location:

Single orthopedic pediatric sport medicine center

Summary:

This study aims to assess the prevalence of lower extremity valgus alignment in adolescent patients with patellofemoral instability (PFI) and investigate the relationship between valgus alignment, body mass index (BMI), and coronal asymmetry.

Methods:

Participants: Adolescent patients presenting with patellofemoral instability (PFI) to a single pediatric orthopedic surgeon. Data Collection: Retrospective chart review to collect demographic, clinical, and radiographic data (including bone age, sex, BMI, injury mechanism, and osteochondral fractures). Radiographic Analysis: Full-length standing hip-to-ankle alignment radiographs were graded for knee alignment, mechanical axis deviation, mechanical lateral distal femoral angle (MLDFA), and medial proximal tibial angle (MPTA).

Exclusions:

Not specified

Results:

Prevalence of Valgus: 60.6% (172 knees) of patients with PFI had valgus alignment. High-grade Valgus: 23.3% (66 knees) had high-grade valgus (zone 2 or greater). Asymmetry: 48.9% of patients had asymmetry in coronal alignment. BMI Correlation: A higher BMI was associated with valgus alignment (P = 0.03). Sex Differences: Female patients had a significantly higher MPTA than male patients (P < 0.001).

Conclusions:

A high prevalence of lower extremity valgus (60%) was found in adolescents with PFI, with nearly 1 in 4 presenting with high-grade valgus. The study highlights the importance of considering lower extremity valgus in the management of pediatric and adolescent PFI, as it may influence treatment and outcomes.

Relevance:

Limitations:

Perspective:

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