Simple observation and reassurance are all that are required for physiological genu varum and genu valgum, given that these conditions spontaneously correct 99% of the time. When identified, underlying etiologies of extreme varus or valgum deformities must be effectively treated to improve angulation. Treatment of severe bowing or knocking of the knees caused by underlying disease is determined by the nature of the condition and may include wedge osteotomy or epiphyseal stapling.