Introduction
The position and alignment of the knee joint play a crucial role in maintaining proper lower limb function. One of the most common alignment issues is the outward deviation of the knee, known as knee varus or knee valgus depending on whether it is the lateral or medial side of the joint that abnormally diverges. Knee varus, in particular, can lead to various symptoms and eventually, serious knee pathologies if left unchecked. Therefore, it is important to learn how to measure the degree of knee varus, which can help identify potential health risks and adopt timely interventions before the condition worsens.
An Overview of Knee Varus
Knee varus refers to the outward deviation of the knee that results from the abnormal inward angulation of the femur or the outward angulation of the tibia. The center of the knee joint should be roughly aligned on the midline of the body, with the thigh bone pointing toward the hip joint and the shin bone towards the ankle joint. When the thigh bone tilts too much towards the center of the body, or the shin bone deviates too much towards the outer side, the angle formed between them increases, resulting in increased stress on the outer side of the knee joint. As a result, the inner side of the knee joint becomes more compressed, leading to a variety of health issues and pathological changes, such as osteoarthritis, cartilage degeneration and even ligament or meniscus tears.
Measuring Knee Varus Angle
The degree of knee varus can be easily measured through several simple and non-invasive clinical tests. The two most commonly used methods are the gravity goniometer test and the prone external rotation test.
Gravity Goniometer Test
The gravity goniometer test involves the following steps:
Ask the patient to stand on one leg with the other leg hanging freely
Position the apex of the goniometer on the lateral epicondyle of the knee joint and align the external goniometer arm with the greater trochanter of the femur
Measure the angle between the axis of the femur and the vertical line of the goniometer, which reflects the degree of knee varus
Prone External Rotation Test
The prone external rotation test involves the following steps:
Ask the patient to lie prone with both knees flexed to 90 degrees
Evert the foot of the leg to be tested and flex the patient’s knee
Measure the angle between the horizontal line and the long axis of the femur, which reflects the degree of tibial external rotation
Interpreting Knee Varus Angle
The degree of knee varus measured by the aforementioned methods can be used to assess the severity of the condition and the potential health risks. In general, a knee varus angle less than 5 degrees is considered normal, while any angle above 5 degrees is considered abnormal and indicative of increased risk of knee pathology. A knee varus angle between 5-10 degrees is considered mild, while an angle between 10-15 degrees is moderate, and an angle over 15 degrees is severe.
Conclusion
Knee varus is a common orthopedic issue that, if left unchecked, can lead to various health risks and pathologies. Therefore, it is crucial to measure the degree of knee varus and identify potential health risks early on. The gravity goniometer test and the prone external rotation test are two simple and non-invasive clinical tests that can easily measure the degree of knee varus, which can be used to assess the severity of the condition and adopt timely interventions to prevent further damage.
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