The knee is comprised of three bones: the femur (thighbone), tibia (shinbone) and patella (kneecap) as well as cartilage, tendons and ligaments. There are two joints within the knee: the tibia-femur joint and the patella-femur joint. Knee malalignment syndrome occurs when there is poor positioning between either of these joints. In knee malalignment of the patella-femur joint, the kneecap often feels like it is slipping or dislocating. This type of malalignment is also referred to as patellar instability. In knee malalignment of the tibia-femur joint, abnormal knee angulation can create uneven pressure on one the affected knee. Either of these types of knee malalignment can put an individual at higher risk for knee injuries such as dislocation and osteoarthritis. Knee malalignment syndrome can occur both athletic and non-athletic patient populations. Individuals who participate in running and high impact sports may experience significant pain and decreased function in association with knee malalignment. Tibia-femur malalignment can give the appearance of genu valgum (knock knee) or genu varus (bow-legged). Genu valgum displays when an individual is standing straight up, their knees are together, and their feet and ankles appear spread apart. Genu varus is shown when an individual is standing straight up, their knees are apart (lower legs curve outward from the knee), and their feet appear to touch. Genu valgum and genu varum can occur as a result of birth related issues, follow a traumatic accident, or a be associated with the aging process. Dr. Riley J. Williams, orthopedic knee specialist serving Manhattan, New York City and the surrounding New York boroughs has extensive experience in diagnosing and treating knee (miserable) malalignment syndrome as well as many other knee malalignment ailments.