What is Malalignment of the knee?

Malalignment is a complex topic and can occur in and of the three (X,Y Z) planes. For this section, we will focus on the most common malalignment – the coronal or frontal plane.

In the ideal setting, if we drew a line from the center of your hip to the center of your ankle, it should go directly through the center of your knee.  We call this scenario neutral.  However, like most things in the human body there is quite a bit of variability from that ideal.  In some patients, this line goes through the medial or inside part of their knee. This is commonly called “Bow-legged” but the medical term is varus.  Similarly, in some patients this virtual line goes through the lateral (outer) part of their knee.  This is commonly referred to as “knock-kneed” or valgus. Dr. Armando Vidal, orthopedic knee specialist, can successfully treat patients in Vail, Aspen and the surrounding Denver, Colorado communities who have malalignment of the knee.

Malalignment | Vail CO

Why does it matter if my knees are aligned or not?

Being varus (bow-legged) or valgus (knock-kneed) is in and of itself not a risk factor for cartilage damage or arthritis in most cases.  In fact, this variety is part of what makes us human.

The easiest way to think of malalignment and its effect on load is to think about the virtual line described above from the hip to the ankle. If the line goes through the medial compartment – it is that compartment that sees more load and vice-versa.

Malalignment only becomes significant when a patient develops a meniscal or chondral injury in the compartment where the load is greatest. Just treating a cartilage or meniscal injury without accounting for malalignment often leads to failure and is in fact the most common cause for failure of articular cartilage repairs.

Does my malalignment need to be addressed?

There is no “one size fits all” approach to these cases. As discussed in the articular cartilage section, a surgeon must have a deep skill set and awareness of how meniscal status, cartilage status, instability and alignment interplay to create a patient’s symptoms.  The knee must be thought of holistically as an organ and the influence of alignment on the current condition must be considered and accounted for in each individual case.

Malalignment Specialist

Do you have a family history of malalignment, or have you experienced previous trauma to the knee? You may be experiencing malalignment, or knock knees. This condition is common and requires the help of a knee expert to properly diagnose and treat misaligned knees. Knee expert, Doctor Armando Vidal provides holistic diagnosis and treatment for patients in Vail, Aspen, and the surrounding Denver, Colorado communities who are experiencing malalignment of the knee. Contact Dr. Vidal’s team today!


The Steadman Clinic – Vail, CO
180 S Frontage Rd W
Vail, CO 81657

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226 Lusher Court
Ste 101
Frisco, CO 80443

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322 Beard Creek Road
Edwards, CO 81632


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Mailing Address
181 Meadow Dr, Suite 400
Vail, CO 81657

970-401-8940 Direct
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