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Sports Medicine

Meniscal damage & genu valgum after ACL tear

12/28/2009

Question:

One year ago my Left ACL tore after accumulative weakening and then twist pivot. After the injury I didn`t strengthen my knees sufficiently and have continued transfering patients and putting increased stress on the Right knee. Right knee now has meniscal damage and visible genu valgus. Besides changing my line of work and losing 10 pouinds (goals), can I prevent further genu valgus by exercising and strengthening certain muscle groups? Thanks.

Answer:

Genu valgum or a "knock-knee" configuration can be due to hereditary factors - in which case it is usually bilateral, and nothing can be done to prevent it - or can result from degenerative narrowing of the lateral/outer knee joint compartment.

The progression of such degenerative changes in a weight-bearing joint such as the knee may possibly be slowed by weight loss, by wearing shoes incorporating a medial wedge (to somewhat off-load the lateral knee joint compartment), and by maximizing function/minimizing symptoms in your opposite (left) knee (which would also serve to minimize overloading your right knee). A "functional" (as opposed to "structural") genu valgum may result from excessive hip internal rotation/adduction and/or foot hyperpronation, which may or not pertain to you... if such less-than-optimal alignment is present, and if this is due to strength and flexibility imbalances involving particular muscles, then strengthening as well as stretching exercises may play a useful role in the treatment of "functional" genu valgum.

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Response by:

Brian L Bowyer, MD Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University