Bow legs and knock knees are not only a cosmetic concern. When the leg is out of alignment, load passes unevenly through the knee, concentrating on one side of the joint and wearing that compartment faster.
Dr. Vaibhav Bagaria treats adult leg malalignment at Sir H. N. Reliance Foundation Hospital, Mumbai — correcting alignment where the joint can still be preserved, and performing knee replacement where arthritis is already established.
In a well-aligned leg, weight passes down through the centre of the knee, distributing load evenly.
In bow legs, the knees stay apart when the ankles touch. Load shifts to the inner compartment, which wears faster.
In knock knees, the ankles stay apart when the knees touch. Load shifts to the outer compartment.
Both are normal at certain stages of childhood and usually correct on their own. In adults, persistent or worsening malalignment matters because it accelerates joint wear — and importantly, arthritis itself causes malalignment, so a knee that is becoming progressively bowed may be showing that arthritis is advancing.
Where the normal correction did not occur.
As one compartment wears, the leg bends progressively toward that side. This is the most common adult cause.
Malunion around the knee.
Asymmetrical growth after injury or infection.
Including rickets and vitamin D deficiency affecting bone development.
Longstanding instability can progressively alter alignment.
Consult an orthopaedic surgeon if you have:
Assessment matters most in younger adults. Correcting alignment can offload the worn compartment and potentially delay or avoid joint replacement.
Seek urgent care for sudden severe pain and inability to bear weight, obvious deformity after injury, or a hot swollen knee with fever.
When the deformity was noticed, whether it is progressing, previous fractures or childhood conditions, pain location, and walking capacity.
Standing alignment, the gap between knees or ankles, gait, ligament stability, range of movement, and assessment of the hip and ankle since deformity can arise above or below the knee.
Full-length standing X-rays of both legs are essential. Standard knee X-rays do not show the overall mechanical axis, which is what determines where load actually passes. CT may be used for rotational assessment, and MRI to evaluate cartilage before considering joint-preserving surgery.
Non-surgical treatment manages symptoms but does not correct the underlying alignment.
Where pain persists despite non-surgical treatment, where deformity is progressing, and importantly, where a younger patient has malalignment with cartilage still worth preserving.
The choice depends heavily on age, activity, how much cartilage remains, and where the deformity originates — which is why full-length imaging is required before deciding.
Knee arthritis
Knee cartilage damage
Post-traumatic arthritis
Over two decades of orthopaedic surgical
experience
Internationally fellowship-trained in the USA,
Germany and Australia
Surgery recommended only when it is
genuinely the better option
Among India's earliest robotic joint
replacement surgeons
150+ peer-reviewed publications and multiple
device patents
Structured rehabilitation planned before the
operation, not after
Dr. Vaibhav Bagaria is Director and Head of the Department of Orthopaedics at Sir H. N. Reliance Foundation Hospital, Mumbai, and one of the earliest surgeons in India to adopt robotic joint replacement. Over twenty-two years of practice he has treated patients across the full range of bone and joint conditions, with a particular focus on robotic knee and hip replacement, partial knee replacement, sports injury and arthroscopy, and complex pelvic and acetabular reconstruction.
Name
Dr. Vaibhav Bagaria
Experience
20+ Years
Qualifications
MS (Ortho) FASSI, FNUS, FNAMS..
Speciality
Practice
Schedule your consultation with Dr. Vaibhav Bagaria today
Dr Vaibhav Bagaria
Prarthana Samaj, Khetwadi, Girgaon,
Mumbai, Maharashtra 400004
02261305757
