70 year old male from Ohio is presenting with advanced osteoarthritis of both knees. Patient's pain is more pronounced mostly upon walking. Stairs are very difficult, going down is a more of a big task. He has no pain sitting he says: "but I can not sit all the time". His past medical history is positive for Hypertension, he takes Diltiazam and Vitamins. He has been advised for   total knee replacement.



The picture depicts sever bow legged also known as genum Varus. of the knees. It is very important for the knee to be be aligned properly. Patients who develop bow legged-knees is usually because of more pressure on the medial (inner aspect of the) knees. This condition is also known as "Genu Varus." This abnormal distribution of weight causes wearing of the cartilage and joint to accelerate and makes arthritis worse leading to surgeries and possible  total knee replacement. In this condition legs are bowed outwards in the standing position (see the picture). This unusual misalignment usually occurs at the level of the knees, and then when the patient is standing with his or her feet together, the knees can not touch each other.