ABSTRACT
Mechanical factors, such as patella maltracking, instability and lateral facet overload in association with genu valgum have been thought responsible for anterior knee pain in adolescents but the evidence is contradictory. There are several reasons for anterior knee pain in the adolescent. Frank persistent dislocation of the patella may occur in association with more severe degrees of genu valgum. In the majority of instances the deformity is in the distal femur. It is important that the site of deformity is identified. Genu valgum due to distal femoral pathology is generally masked when the knee is flexed while the deformity persists on knee flexion if the proximal tibia is at fault. Most children who present for an orthopaedic opinion are likely to have physiologic genu valgum. If there is insufficient growth remaining or the child is skeletally mature and if the cause of the genu valgum deformity is a disorder of the physis, hemiepiphyseodesis is unlikely to work.
