My 10-year-old was perfectly fine until about two months when I noticed he was walking funny and he started complaining that his right knee hurt. He’s been diagnosed with Blount’s disease. The pediatrician thinks it’s because he gained a lot of weight and is about 80 pounds overweight. If he loses weight will this problem go away?

It’s a fact that more and more children, pre-teens, and teens are obese and facing problems they wouldn’t otherwise deal with. You may have heard that diabetes is one of those problems. But diabetes isn’t the only problem overweight children and adolescents face. As your child is now experiencing, Blount disease (bowlegged deformity) is another possible adverse effect of obesity. And it can lead to growth arrest at the knees, leg length differences, and early degenerative arthritis, so treatment is important.

Adolescents who develop Blount disease are usually treated surgically as the condition does not resolve or correct itself and bracing is not effective. Weight loss is a big help in many ways and essential overall, but once the damage is done at the joint, it is irreversible at this age. The most common surgical procedure is an osteotomy. This procedure is done before permanent damage occurs.

In an osteotomy, a wedge-shaped piece of bone is removed from the medial (inner) side of the femur (thigh bone). It’s then inserted into the tibia to replace the broken down inner edge of the bone. Hardware such as pins and screws may be used to hold everything in place.

If the fixation is used inside the leg, it’s called internal fixation osteotomy. External fixation osteotomy describes a special circular wire frame on the outside of the leg with pins to hold the device in place. Growth modulation is an alternative approach to refers to the use of small tension band plates and screws to guide growth and correction of the deformity. For more details on treatment, see our publication A Patient’s Guide to Blount’s Disease in Children and Adolescents.