Antegrade vs Retrograde method (femurs)

Edit Post

In the future I intend to do leg lengthening. I have already decided that my femurs will be lengthened between 4,5 and 5cm through an internal method.

As many of you guys, one of my major concerns are the risks associated with it. This being said, I would love if you could give some information regarding these three questions:

1) what are the pros and cons of the antegrade (hip) and retrograde (knee) insertion of the nail?

2) Is there any corrrelation between the retrograde approach to femurs and knee pain?

3) How does the insertion of the fitbone and precise nail in the retrograde (knee) approach avoid damaging the patellar tendon? Isn't it blocking the insertion of the nail?



Thank you for your time 

Edit Post

I was also wondering about this question. Although this is a dead forum, I would like other people's opinions on this as well.

From what I researched, I believe retrograde carries the added risk of damage to the patella tendon and therefore it is avoided in favor of the antegrade but I don't know if there are is risks to doing antegrade.

Edit Post

Some docs (Birkholtz and Monegal) have said that retrograde minimizes misalignment/x-legs risk after long femur lengthenings done, so they prefer this method.

Other docs (Paley and Parihar) have said that there is no significant misalignment that occurs during antegrade insertion and that retrograde risks damaging the knee joints, so antegrade is preferred.