Consultant, Orthopaedics & Joint Replacement, Artemis Hospital, Gurgaon
Part 12 of 12 in Spectrum of Orthopaedic Disorder - Evaluation and Management
Vitamin D Deficiency in Children: When Rickets Requires Corrective Knee Surgery
September 6, 2026
The final case in Dr. Rohit Lamba's Jivo Masterclass session moved away from arthritis and trauma to a paediatric bone deformity with a nutritional cause: rickets.
How vitamin D deficiency reshapes a growing knee
In children, prolonged vitamin D deficiency can cause rickets, and one of the deformities it produces at the knee is genu valgum, commonly known as knock knees. Left untreated at the right point in a child's growth, the deformity does not correct itself and instead becomes a fixed structural problem.
When the deformity needs surgical correction
Dr. Lamba showed a case where the deformity had progressed to the point that surgery was the only way to straighten the knees. Comparing the pre-operative and post-operative X-rays, the correction was substantial: both knees were brought back into a straight, aligned position.
This article is based on a Jivo Masterclass session conducted by Dr. Rohit Lamba, Consultant, Orthopaedics & Joint Replacement, Artemis Hospital, Gurgaon. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
This guide is based on a live Jivo Masterclass: Dr. Rohit Lamba taught doctors across Africa on April 6, 2025.
FROM THE LIVE Q&A
Doctor on the call (name unclear from transcript)
Is there a definitive treatment for arthritis?
Dr. Rohit Lamba
Dr. Lamba answered on the assumption the question was about rheumatoid arthritis, since a network issue had cut off part of the question. In the early stage, before the cartilage is damaged, it can be managed well with disease-modifying antirheumatic drugs (DMARDs); cases that do not respond well can move to biological disease-modifying drugs, but only after full evaluation by an orthopaedic surgeon or rheumatologist. Once the cartilage is already damaged, the definitive treatment is hip replacement, and with current implants a patient can expect to stay pain-free and active for the next 30 to 35 years.
Frequently Asked Questions
Which group of patients is hip replacement surgery indicated for?▼
Dr. Lamba outlined four categories. The first is congenital deformity, such as developmental dysplasia of the hip, where the hip is out of the socket from birth. The second is a childhood infection, Perthes disease, or a slipped epiphysis that reshapes the hip and leads to arthritis later in life. The third is avascular necrosis that has reached an advanced, arthritic stage in early adulthood. The fourth is a hip fracture that has not united properly, healing in a poor position that causes arthritis and pain.
Is there a definitive treatment for arthritis?▼
Dr. Lamba answered on the assumption the question was about rheumatoid arthritis, since a network issue had cut off part of the question. In the early stage, before the cartilage is damaged, it can be managed well with disease-modifying antirheumatic drugs (DMARDs); cases that do not respond well can move to biological disease-modifying drugs, but only after full evaluation by an orthopaedic surgeon or rheumatologist. Once the cartilage is already damaged, the definitive treatment is hip replacement, and with current implants a patient can expect to stay pain-free and active for the next 30 to 35 years.
Can vitamin D deficiency cause knee deformity in children?▼
Yes. Prolonged deficiency can cause rickets, which in some children produces genu valgum, or knock knees, at the growing knee joint.
Does knock-knee deformity from rickets always need surgery?▼
Only once it has progressed into a fixed structural deformity. Dr. Lamba's case required surgical correction because the deformity had reached that stage; earlier vitamin D correction is aimed at preventing it from getting there.
What does surgery for this deformity involve?▼
Corrective knee surgery realigns the bone so the leg sits straight, as shown in Dr. Lamba's before-and-after X-ray comparison for this case.
In This Series: Spectrum of Orthopaedic Disorder - Evaluation and Management
- 1.Spectrum of Orthopaedic Disorders
- 2.Understanding the Main Causes of Knee Arthritis
- 3.How Robotic and Computer-Navigated Systems Are Used in Joint Replacement
- 4.Developmental Dysplasia of the Hip: Treating a Childhood Hip Problem
- 5.Perthes Disease: When Childhood Hip Damage Surfaces Years Later
- 6.Avascular Necrosis of the Hip: Causes, Stages and Treatment
- 7.Hip Replacement and Sickle Cell Disease: Why Blood Transfusion Comes First
- 8.When Is Hip Replacement the Right Treatment?
- 9.ACL and Ligament Reconstruction: Grafts and When Surgery Is Needed
- 10.Treating Fracture Non-Union and Bone Infection with External Fixators
- 11.Reconstructing Severe Trauma: Distraction Osteogenesis for Bone and Limb Loss
- 12.Vitamin D Deficiency in Children: When Rickets Requires Corrective Knee Surgery