Torsional Deformity Masquerading as Knee Instability

Persistent knee pain and gait disturbance exposed an overlooked lower extremity diagnosis.

1

A 15-year-old girl experienced chronic knee pain and gait dysfunction despite normal imaging and evaluations by multiple orthopedic surgeons.
2

Imaging revealed significant axial malalignment, including 44° of femoral anteversion and 35° of external tibial torsion.
3

Three-dimensional gait analysis identified dynamic abnormalities, including excessive knee varus and hyperextension during stance.
4

The patient underwent combined femoral and tibial torsional osteotomies, resulting in resolution of pain and normalization of gait mechanics.
5

Lower extremity torsional abnormalities are an underrecognized cause of anterior knee pain and atypical gait patterns in adolescents.

1