5 Key Takeaways

• 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.