Natural course of excessive genu varum without underlying pathology in children

Abstract

Background: Despite genu varum’s status as a common pediatric problem, there remain no serial studies investigating the natural course of excessive physiologic genu varum in children. This study, therefore, aims to identify the natural course of the anatomical tibiofemoral angle (aTFA) in children with excessive physiologic genu varum without any underlying pathological conditions. Materials and methods: Between 1997 and 2008, among 70 children who had been referred from a primary hospital to evaluate angular deformity of the knee, 29 consecutive limbs (10 bilateral and 9 unilateral) of 19 healthy Korean children with excessive physiologic genu varum equal to or greater than 2 standard deviations (SDs) of the aTFA at their initial visit until all children were 6 years of age. We analyzed the value of the aTFA as well as the changes in patterns, and compared our findings with results from previous studies. Results: The mean aTFA at the initial visit was 18° varus (range: 9° to 36°), the mean age of normalization was 3.2 years, and the mean value of the aTFA was varus 17.2° at the age of 1 year, followed by a steady decrease to 0° at almost the age of 3.3 years. Starting at the age of 4 years, the aTFA was a mean of 5.2° genu valgum and gradually changed until the age of 6 years, where it was sustained at an average of 3.4° genu valgum. Conclusion: Excessive physiological genu varum exceeding 2 SD in young Korean children improved spontaneously without the need for prosthetics or orthotics.