What are bow legs (varus deformity)?
Bow legs, known in medicine as a varus deformity, are a condition in which the axis of the leg is bent so that the knees are set apart even when the feet are together. When a person stands with their feet together, a visible gap remains between the knees, and the legs together resemble the shape of the letter “O”. In a varus deformity the axis of the leg is tilted inwards, so the body's weight is not transmitted evenly through the knee.
The key problem of a varus deformity is not merely cosmetic. When the axis of the leg is bent, the load is distributed unevenly through the knee joint — most often the inner (medial) side of the knee is excessively loaded. Over time this speeds up the wear of the cartilage in exactly that part and can lead to pain, inflammation and the premature development of knee arthrosis.
Bow legs correction essentially means straightening that axis — returning the leg to a more correct position so that the load on the knee is redistributed. This is most often achieved by an operation called an osteotomy, which we discuss in more detail below.
At Medical Time we approach every patient with bow legs individually. Mild bending in children is often part of normal development and does not require surgery, whereas pronounced deformities in adults, especially when they cause pain and wear of the joint, can be a reason for surgical correction. The decision is always made after a detailed assessment.
Causes of a varus deformity and who the correction is for
Bow legs can arise for several reasons, and both the assessment and the treatment plan depend on the cause. In small children mildly pronounced bow legs are often a physiological phenomenon that corrects itself during growth. In adults, however, a pronounced varus deformity usually has a clear cause and can progress.
The most common causes and conditions associated with a varus deformity are:
- congenital and developmental irregularities of the leg axis
- disorders of growth and of the bone's growth plate during childhood and adolescence
- consequences of fractures that have healed in an irregular position
- wear of the inner side of the knee and the development of arthrosis, which further worsens the bending
- conditions that in the past affected bone development (for example after infections or injuries to the growth plate)
- asymmetric loading and a deformity that has developed over the years, with pain and a difficult gait
Assessment before surgery — examination and measurement of the axis
Before the correction it is essential to precisely measure the degree of bending and establish at what level the deformity lies. The axis of the leg is assessed on special X-rays of the whole legs, on which the orthopaedist measures the angles and plans the exact site and amount of correction.
The assessment usually includes:
- a detailed orthopaedic examination with assessment of the axis, gait and mobility of the knee
- X-rays of the whole legs for measuring the axis and planning the correction
- additional imaging where needed to assess the condition of the cartilage and joint
- assessment of general health and laboratory tests before anaesthesia
- a conversation about the goals of the operation and the realistic course of recovery
Why precise planning is decisive
In correcting the axis, every degree matters. The aim is not only for the leg to look straighter, but for the load through the knee to be returned to a proper distribution. That is why the orthopaedist calculates the exact amount of correction on the imaging in advance, so that after the operation the weight is transmitted through a healthier part of the joint and further wear is thereby slowed.
How the correction is performed — osteotomy
The basic operation for straightening bow legs in adults is an osteotomy — a procedure in which the bone is cut in a controlled way and its axis is straightened into a correct position, after which it is fixed until it heals. In a varus deformity it is most often performed in the region of the shin (the upper part of the tibia), where the axis is corrected so that the load is shifted from the overloaded inner side of the knee to a healthier part of the joint.
In practice, the correction of the axis is performed by the orthopaedist making a cut in the bone that creates the conditions for the leg to be straightened by a precisely planned angle, and then fixing the achieved position. Suitable implants (for example a plate with screws) are used for fixation, holding the bone in the corrected position until it heals. The approach and technique are tailored to the degree of deformity and the condition of the joint.
In children and adolescents with a deformity in the growth phase, gentler procedures that guide the growth of the bone are sometimes used, whereas more pronounced deformities in adults are treated by osteotomy. Which method is the right one depends on the cause, the age, the degree of bending and the condition of the knee — and is always determined after a detailed assessment.
At Medical Time hospital we opt for the solution that gives the most reliable and predictable outcome for the particular patient, with the aim of preserving the joint and easing daily life.
Preparation for surgery
Bow legs correction is a serious orthopaedic operation and requires thorough preparation, so that the procedure is safe and recovery begins under the best conditions.
Preparation usually includes:
- a complete pre-operative examination and laboratory blood tests
- an ECG and, where needed, examination by an internist and anaesthesiologist to assess fitness for anaesthesia
- precise planning of the correction based on X-rays of the whole legs
- a conversation with the anaesthesiologist about the type of anaesthesia and the course of the day of surgery
- adjustment of regular therapy, especially blood-thinning medication, which is decided solely by the physician
- instructions on when to stop eating and drinking before the operation (most often fasting)
- preparation of the home and aids for recovery (crutches, an adapted space for moving around)
Course of the operation and duration
The operation is carried out under suitable anaesthesia, the type of which the anaesthesiologist decides together with the patient. During the procedure the orthopaedist approaches the bone at the pre-planned level, performs the osteotomy and straightens the axis of the leg by a precisely determined angle, then fixes the achieved position with an implant so that the bone heals in the correct position.
The operation itself most often lasts around one to a few hours, depending on the degree of deformity and the complexity of the case. After the procedure comes a hospital stay whose length depends on the course of recovery, general condition and the team's assessment.
As with other major orthopaedic procedures, it should be kept in mind that the operation is only the first step. The real correction is secured only once the bone heals in the corrected position, and that requires time, limited loading at first and regular follow-up imaging by which the orthopaedist monitors the healing.
For this reason bow legs correction should be understood as a process that does not end on leaving the operating theatre, but continues through recovery and rehabilitation, with continuous monitoring.
Recovery and rehabilitation — by phases
Recovery after bow legs correction is gradual and calls for patience. It is realistic that it is measured in weeks and months, because the bone must fully heal in its new, corrected position before full loading is allowed. Rehabilitation is a key part of the treatment and is carried out according to the orthopaedist's instructions.
Recovery most often passes through the following phases:
- Early period after the operation — calming pain and swelling, care of the wound and first mobilisation with aids, with limited loading of the operated leg
- Bone healing phase — loading is increased gradually, solely according to the orthopaedist's instructions and based on follow-up imaging that confirms the progress of healing
- Phase of restoring mobility and strength — exercises for the range of movement of the knee and strengthening of the thigh and shin muscles
- Phase of return to activities — gradual establishment of a correct gait and a return to everyday and later more demanding activities, as assessed by the team
Possible risks and complications
Bow legs correction is a serious operation and, like any major orthopaedic procedure, it carries certain risks. We talk about them openly, so that the patient can make the decision informed. In controlled inpatient conditions and with an experienced team, the risks are carefully monitored and reduced to the smallest possible measure.
Possible risks and complications include:
- slowed or difficult healing of the bone at the osteotomy site
- stiffness of the knee or a reduced range of movement if rehabilitation is not carried out consistently
- general surgical risks — related to anaesthesia, bleeding or slower healing of the wound
- discomfort or tenderness in the area of the fitted implant, which is sometimes removed later
- irritation of the nerves or changes in sensation, which are most often monitored and subside, but require attention
- in rarer cases — the need for an additional procedure or adjustment of the treatment plan
Why have bow legs correction at Medical Time
Correcting the axis of the leg is a procedure in which the precision of planning and the orthopaedist's experience directly determine the result. At Medical Time hospital we approach every patient individually — from measuring the axis on the imaging, through the operation, to guidance through recovery.
What sets our approach apart:
- an experienced orthopaedic team and precise planning of the correction based on imaging
- an individual approach — a plan tailored to the degree of deformity and the condition of the joint
- the aim of preserving the patient's own joint and slowing further wear of the knee
- guided rehabilitation and monitoring through all phases of recovery, with follow-up imaging
- everything in one place — examinations, diagnostics, surgery and check-ups
- the support of staff before, during and after the procedure
Price — bow legs correction
The price of bow legs correction is set individually, after an examination and the drawing up of an operative plan. There is no single price, because the costs depend on the degree of deformity and the extent of correction, the chosen technique and implant, the type of anaesthesia and the length of the hospital stay.
For this reason you receive an exact estimate and a personalised offer only after a consultation and a review of the imaging of the whole legs, when the orthopaedist can realistically assess your case. This way you know in advance exactly what is included, with no hidden costs.
For an individual assessment and offer, book a consultation or call 062-399-888.
Frequently asked questions about bow legs correction
A varus deformity, known as bow legs, is a condition in which the axis of the leg is tilted inwards, so the knees are set apart even when the feet are together — the legs then resemble the letter “O”. Because of the bent axis, the load is transmitted unevenly through the knee, most often overloading its inner side.
Mild bending in children is often part of normal development and corrects itself. In adults with a pronounced varus deformity, especially when it causes pain and wear of the joint, permanent straightening of the axis most often requires surgery — an osteotomy. Whether surgery is needed is assessed by the orthopaedist after examination and imaging.
It is most often done by osteotomy — the bone is cut in a controlled way and the axis of the leg is straightened by a precisely planned angle, and the achieved position is fixed with an implant until the bone heals. The aim is to redistribute the load through the knee from the overloaded inner side to a healthier part of the joint.
With bow legs the load on the knee is distributed unevenly, so the inner side of the joint wears rapidly, which can lead to pain and premature arthrosis. By straightening the axis the load is returned to a more correct distribution, which eases the gait and can slow further wear of the joint.
Recovery is gradual and is measured in weeks and months, because the bone must fully heal in the corrected position before full loading. Loading is increased gradually, according to the orthopaedist's instructions and follow-up imaging. The exact duration is individual and depends on the deformity, the condition of the joint and consistency in rehabilitation.
Yes. Rehabilitation is a key part of the treatment. Exercises for the range of movement of the knee and strengthening of the muscles help to restore full function, while respecting the rules on loading the leg protects the healing of the bone. Without consistent physiotherapy recovery is slower and the outcome poorer.
The price is set individually, after an examination and operative plan, because it depends on the degree of deformity, the extent of correction, the technique, the implant and the length of the stay. An exact offer is given only after a consultation and a review of the imaging. For an assessment and appointment, call 062-399-888.
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