Quote from: FrankGarrett on February 19, 2014, 04:41:39 PMRod inserted inside tibia bone = permanent knee pain.
It can happen whether you do internals or external.
so all the 100 000 people who undergoes tibial lengthening or correction due to trauma, deformity, dwarfisism are all suffering permanent knee pain.
it all makes sense now. 
Quote from: kusop on February 19, 2014, 06:42:02 PMso all the 100 000 people who undergoes tibial lengthening or correction due to trauma, deformity, dwarfisism are all suffering permanent knee pain.
it all makes sense now.
30% of them anyway. I didn't bother elaborating because I sound like a broken record saying it nearly every time I log on.
Quote from: kusop on February 19, 2014, 04:15:35 PMOk everyone. Without letting this get out of hand. I thought the topic was long-term / permanent complications with the BODY not the hardware. Yes amatans precice malfunctioned, but that is fixed. it doesnt mean he is going to have long tern knee issues or ankle issues.
Same with all the betz nail bending or breaking. They get titanium replacement and they are back dancing (andrew) and skiing (oldie).
But in external patients case, alot have long term problems with their body. All the people who reported it in this thread did, externals no?
Where did you get your knowledge about these things? There are lots of Betz patients with long term and/or permanent damage. For example, when the nail breaks very often other things break too. Internals are good for femur lengthening. For tibia they are worse than externals for several reasons.
-Knee damage due to rod insertion
-Higher risk of compartment syndrome
-Slower consolidation
-Additional surgery to remove fibula screws
Another study here showing a huge risk of knee pain: http://www.ncbi.nlm.nih.gov/pubmed/8990026
Thanks kusop for this interesting topic!
Has anyone heard of long term complications with internal rods? If so, please tell us more about the details - thanks!
Another thing I would like to point out with lengthening a large amount is the risk of having to lengthen the other segment too, as in Talls (old forum ) case:
QuoteTall - Internal Tibias - Dr. Mahboubian - 2012 - A PRECICE Journey to Proportion
« on: February 20, 2012, 05:00:11 AM »
As some of you know I competed my Internal Femur LLing with Dr. Augustine Betz in Fall 2006. Since that time I have enjoyed my current height: 188CM. The height increase has been amazing! During the past few years I have been experiencing minor knee pain & discomfort. During various examinations by orthopedic doctors, I have been advised that in order to avoid future problems with my knees (arthritis) that I needed to correct the discrepancy between my femur/tibia ratio which was caused by my femur legthening. Don't get me wrong, I am very proud of my lengthening with Dr. Betz as I was his first 11CM patient. But, this confirms what I already knew & that was that most individuals should not legthen beyond 7.5 CM. I state this in most cases, as I know everyone's body is different and there are exceptions to the rule.
So I will be legthening both of my tibias separately by 6.5 CM with the new PRECICE nail starting on April 5, 2012 in Hollywood, CA with Dr. Shahab Mahboubian, D.O., MPH. Please stay tuned for a detailed diary.
It's strange how something so significant doesn't ever seem to be discussed by many orthopedic surgeons that perform CLL, or maybe they do and the patients just don't report it.
"Fourteen (67%) of the twenty-one patients treated with transtendinous nailing reported anterior knee pain at the final evaluation. Of these fourteen patients, thirteen were mildly to severely impaired by the pain. Fifteen (71%) of the twenty-one patients treated with paratendinous nailing reported anterior knee pain, and ten of the fifteen were impaired by the pain. The Lysholm, Tegner, and Iowa knee scoring systems; muscle-strength measurements; and functional tests showed no significant differences between the two groups."
http://www.ncbi.nlm.nih.gov/pubmed/11940618
I mean knee pain may be the trade off for people who need an IM nail inserted for trauma or deformity. But for CLL you may as well stick with externals, or discuss with your surgeon if LATP (lengthening and then plating) is an option -I saw a study call it FAP (fixating and plating) 
- so you get stabilization and somewhat reduced fixation time (not as reduced as LON/LATN but lower than external) without the anterior knee pain.
Quote from: old forum PartyLeaks on February 19, 2014, 06:46:51 PMOver 70% actually.
https://en.wikipedia.org/wiki/Intramedullary_rod#Complications
https://www.ncbi.nlm.nih.gov/pubmed/18758282
Quote from: FrankGarrett on February 19, 2014, 06:51:29 PMAnother study here showing a huge risk of knee pain: http://www.ncbi.nlm.nih.gov/pubmed/8990026
These studies should be terrifying to anyone even considering have internal lengthening done. I'm sure scared 
Quote from: Kilokahn on February 19, 2014, 07:12:13 PMI mean knee pain may be the trade off for people who need an IM nail inserted for trauma or deformity. But for CLL you may as well stick with externals, or discuss with your surgeon if LATP (lengthening and then plating) is an option -I saw a study call it FAP (fixating and plating) - so you get stabilization and somewhat reduced fixation time (not as reduced as LON/LATN but lower than external) without the anterior knee pain.
LATP sounds like a winner to me for when I lengthen my tibiae!
Quote from: BilateralDamage on February 19, 2014, 07:52:53 PMLATP sounds like a winner to me for when I lengthen my tibiae!
I'm going to discuss with the surgeon about doing that as well. Glad Dr Birkholtz told me about it because I wasn't too excited for external only either.
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