If you’ve always had “bowed” or “X” legs, it might have felt cosmetic. With pain, the question changes:
“Is this damaging my knee?”
Often yes: alignment can accelerate wear. Here’s how and what to do.
In 30 seconds
- Leg axis dictates load distribution.
- Overloading one side wears it faster.
- Osteotomy realigns to save the joint and delay replacement in selected cases.
- Best to correct before global wear.
Varus vs valgus
- Varus: “parenthesis” legs (load on the inner knee).
- Valgus: “X” legs (load shifts outer or changes patellar load, case dependent).
In Quito I often see active patients (trekking, soccer) who walk hills daily.
The “tire” effect
A misaligned tire wears on one side. Same for the knee:
- the overloaded side wears first,
- pain localizes,
- can progress to compartmental OA.
When it’s no longer esthetic
- Local pain (medial in varus, lateral in valgus).
- Recurrent swelling.
- Localized wear on X-ray.
- Limitation to walk/sport.
- Worsening deformity over time.
Osteotomy to realign
Surgery that corrects the axis to redistribute load.
- Unloads worn zone.
- Preserves your native knee.
- Delays replacement (years) in well-selected cases.
# Who benefits?
- Relatively active adults.
- Partial wear (not global).
- Clear axis deviation.
- Goal to preserve joint.
When to consult in Quito
- Pain on one side.
- Each month you tolerate less walking.
- Notice progressive bow/knock.
Dr. Calderón difference
I focus on joint preservation: save the native knee and delay replacement when possible. As AO & ISAKOS member and USFQ faculty, I use updated criteria to pick the right treatment at the right time.
Bottom line
With pain, it’s not just esthetic: it’s biomechanics. Biomechanics has solutions.
Book your evaluation in Quito (Fortune Plaza) to assess alignment and decide on therapy, orthotics, or an osteotomy. Download my guide on “Leg alignment and knee wear.”
Medical note: educational; not a consult.
