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Genu valgum, commonly known as "knock-knees," occurs when the knees angle inward and touch while the ankles remain apart. This condition can result from a variety of factors, including weakness or injury of certain ligaments that stabilize the knee joint.

The medial collateral ligament (MCL) plays a key role in providing stability to the inner side of the knee. When the MCL is compromised—whether through injury, laxity, or degenerative changes—this can contribute to the misalignment of the knee, leading to the development of genu valgum. In this condition, the inadequate support from the MCL allows for excessive movement toward the midline, which is characteristic of knock-knees.

In contrast, the anterior cruciate ligament, posterior cruciate ligament, and lateral collateral ligament primarily contribute to the stability of the knee from different angles and directions. They do not have as direct an impact on the alignment of the limb in a mediolateral direction like the MCL does. Therefore, the involvement of the medial collateral ligament is directly linked to the development of genu valgum.