Dr Franz Birkholtz (Pretoria, South Africa)

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Quote from: Cooper on February 14, 2014, 04:27:12 PMDr. Franz,
Upfront question...how many precise rod have you implemented? Any way we can see the x-rays. It may be helpful for posterity.

Also, do you allow about 7.5 cm on femur if rehab is good.
Thanks
We've only had it available for a relatively short time. We've done five precice cases for indications other than cll.
Unfortunately I cannot make the xrays abailable (patient confidentiality).
7.5 is pushing it, but it may be possible in extreme cases where rehab is exceptional. I think a realistic goal for femur is 5-6 cm.

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Dear Dr. Birkholtz,

Thank you for all your contributions in this forum, we really appreciate your valuable input.

I'm a current LL patient still in the lengthening phase, currently lengthened around 4,60 cm in femurs. A couple weeks ago, my doctor suggested that I had fast bone consolidation, and told me to speed up the lengthening to 1,4 mm daily. After a while, I had a numbing sensation, particularly on my right tibia, starting from the knee (and the back part of the knee). I felt my hamstring stretching and it began to hurt, so on the follow-up consultation we lowered the lengthening speed to 1 mm again. However, during my last weekly follow-up, my doctor analyzed the X-ray and told me that we needed to speed up again for a while, left leg was fine but the right leg had a risk of early consolidation, so I'm currently lengthening both legs at 1,4 mm again. And once again, I have a numbing feeling on my leg (below the knee) - it feels as if someone is sticking needles to my leg, or an electric shock. My physiotherapist told me that it could be related to the femoral nerve trying to adjust to the lengthening pace of the leg. My feet and knees are still perfectly aligned and I have excellent range of motion, but the pain really bothers. I wonder if cold therapy or hot therapy could help, maybe placing an ice pad on my leg? Dr. Birkholtz, have you had a similar case in any of your patients? I'm not worried, just medical curiosity really     Thanks in advance.

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Quote from: Franz on February 15, 2014, 04:53:55 PMWe've only had it available for a relatively short time. We've done five precice cases for indications other than cll.
Unfortunately I cannot make the xrays abailable (patient confidentiality).
7.5 is pushing it, but it may be possible in extreme cases where rehab is exceptional. I think a realistic goal for femur is 5-6 cm.

I am considering CLL with you as an option along with Guichet and Dr.Donghoon.

I know you wrote that you would post a cost estimate, and I know that someone posted a quote from an email of 52k USD.
But it would be nice to hear it confirmed from you.

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Hi guys,

We've spent the last week number crunching and obtaining quotes from the relevant service providers.
Our cost for bilateral precice lengthening is 52K USD. This includes the following:
All professional fees for surgeon, anaesthetist, physio, psychologist, occupational therapist.
High care unit for 1 day.
Normal hospital ward for 5 days.
All followup visits, erc sessions and woundcare visits.
Daily physio for 75 days.
Doctor contact at least twice a week.
Support by a multi disciplinary team experienced in limb reconstruction.
Accommodation in a four star rated guesthouse close to hospital on a dinner bed and breakfast basis. Includes wifi and satellite tv. Also includes daily transfer to clinic for adjustments. The accommodation is for two people. This is a self catering unit.
As you can see, everything is included, except for potential complications.

Our lists are generally booked a couple of weeks in advance, but provided I am not on congress or holiday, we can accommodate most of the year.

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Quote from: ChrisIsaak on February 15, 2014, 05:06:15 PMDear Dr. Birkholtz,

Thank you for all your contributions in this forum, we really appreciate your valuable input.

I'm a current LL patient still in the lengthening phase, currently lengthened around 4,60 cm in femurs. A couple weeks ago, my doctor suggested that I had fast bone consolidation, and told me to speed up the lengthening to 1,4 mm daily. After a while, I had a numbing sensation, particularly on my right tibia, starting from the knee (and the back part of the knee). I felt my hamstring stretching and it began to hurt, so on the follow-up consultation we lowered the lengthening speed to 1 mm again. However, during my last weekly follow-up, my doctor analyzed the X-ray and told me that we needed to speed up again for a while, left leg was fine but the right leg had a risk of early consolidation, so I'm currently lengthening both legs at 1,4 mm again. And once again, I have a numbing feeling on my leg (below the knee) - it feels as if someone is sticking needles to my leg, or an electric shock. My physiotherapist told me that it could be related to the femoral nerve trying to adjust to the lengthening pace of the leg. My feet and knees are still perfectly aligned and I have excellent range of motion, but the pain really bothers. I wonder if cold therapy or hot therapy could help, maybe placing an ice pad on my leg? Dr. Birkholtz, have you had a similar case in any of your patients? I'm not worried, just medical curiosity really     Thanks in advance.


It does sound like a nerve that is stretching a bit fast. It is a bit of a catch 22 in that premature consolidation would mean another osteotomy.

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Dr. B, is accommodation for 75 days as well? Also how much does LON/LATN cost??

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Quote from: Arche on February 15, 2014, 06:22:28 PMDr. B, is accommodation for 75 days as well? Also how much does LON/LATN cost??

Quote from: Franz on February 15, 2014, 05:56:52 PM
Accommodation in a four star rated guesthouse close to hospital on a dinner bed and breakfast basis. Includes wifi and satellite tv. Also includes daily transfer to clinic for adjustments. The accommodation is for two people. This is a self catering unit.
As you can see, everything is included, except for potential complications.


Quote from: Franz on November 22, 2013, 09:07:17 PM
Should tibial LONs be performed, the price will drop to approximately 25K euro.

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Okay first off precise was quoted at 40K Euro, and so isn't it okay to inquire how much the Tibial LON price has changed?

Also where in your bolded sentences does it say how long the accommodation is? I'm not asking this just for myself, I'm asking this for the entire community. Don't PM me and say I'm polluting this thread when I am just trying to achieve as much transparency as possible.

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Quote from: Arche on February 15, 2014, 07:22:54 PMOkay first off precise was quoted at 40K Euro, and so isn't it okay to inquire how much the Tibial LON price has changed?

Also where in your bolded sentences does it say how long the accommodation is? I'm not asking this just for myself, I'm asking this for the entire community. Don't PM me and say I'm polluting this thread when I am just trying to achieve as much transparency as possible.

Hey Arche,

It is 75 days accommodation.

LON is still around 25K euro or 34K USD, depending on exchange rates.

Precice is 52K USD, which is 2K cheaper than the quoted euro amount.

Anyway, thanks for the interest.

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Quote from: Franz on February 15, 2014, 08:03:41 PMHey Arche,

It is 75 days accommodation.

LON is still around 25K euro or 34K USD, depending on exchange rates.

Precice is 52K USD, which is 2K cheaper than the quoted euro amount.

Anyway, thanks for the interest.

Dear Dr. Birkholtz,

Thank you so much for your reply back. I apologize if I have bothered you in any way. I truly appreciate what you have done for this community.