knock knee - very fat kid

A friend of mine and his wife have had their head in the sand about the state of their boy. He is 3 years old and seems to have bone disorder of the knee. I think it may be caused because he is extremely fat - 3 years old, 46KG (half Thai which mostly makes kids smaller framed). I just looked on the internet and the condition seems to be called genu valgum.

I spoke bluntly with them yesterday and want to follow up with some advise. I think the kid needs to see an orthopedic doctor right away. He cannot get close to standing upright with his knees and heels together.

I have no medical / physiological background so any general advise to tell them would be helpful. Photo attachedAttachment 872

dear Simon,

I understand your concern but also know how difficult is it to give 'un-asked-for' advice.
Parents have to see the problem themselves, you cannot change that, but being a friend you could give them some information.
Below a few samples of articles on the subject.
[Presence of genu valgum in obese children: cause ... [An Pediatr (Barc). 2003] - PubMed result abstract in english, article in spanish
http://www.idosi.org/wjss/1(1)08WJSS/5.pdf article about older girls
ISPUB - Study of Knee Angle Development in Healthy Children aged 3-16 years in Ahwaz, IRAN article on study of knee angle development (iran)

Hope this helps you a little.

kind regards

Esther

as far as i know the combination of orthorpeadic and Pediatric doctor told him to loose 10 kg quick through balanced exercise and change of diet.

What i dont understand is his cannot get anywhere near touching his knees and ankles together stood upright. Am I missing something??

That's his knee... Genu Valgum can be from different causes but if it's skeletal then the boys bones are acually alined such that he couldn't possibly get the ankles together and stad up. If it's not congenetial then in lying you may be able to bring the ankles together without too much pressure at the knee, in which case his weight has caused the position and the medial knee will be very lax, he will also grow into this position and as the surgeon says it is imperitive he loose weight so as not to worsen this condition. He very likely lacks the muscular control to keep his leg straight and as such may need strengthening exercises... which may be very very hard for him to do given his age. I suggest telling the parents that his weight will worsen the genu valgum - this is true. See Heuter Volkmann law (Answers.com - What is the heuter-volkmann law) which basically says if asymmetrical load is going onto a growing bone then it will grow assymetrically and in this case only cause worsening of the genu valgum. He may need corrective surgery in the coming years, but he is very young now and has lots of growth left to do. He needs to loose weight and likely needs to get some more strength in the legs.