Long Bone Bowing Reclassifies Seventy Percent of Valgus Knee Phenotypes

Coronal plane alignment serves as a primary determinant of knee biomechanics, influencing joint loading, ligament tension, and the long-term risk of secondary joint degeneration [1]. In patients with genu valgum (knock-kneed deformity), increased stress on the anteromedial bundle of the anterior cruciate ligament can compromise joint stability and elevate the risk of non-contact injuries [2]. While individual knee phenotyping (the categorization of patients based on their unique anatomical traits) has recently transformed alignment paradigms in arthroplasty, the influence of extra-articular factors like long-bone morphology remains a significant challenge for surgical planning [3, 1]. Precise assessment of these deformities is critical, as minor initial malalignments may lead to unpredictable outcomes or rebound phenomena following guided growth interventions [4]. A recent retrospective analysis of 192 knees now investigates how metaphyseal bowing specifically contributes to the natural history of valgus knee phenotypes.