Could you explain what an ITB release is and what its for? I was thinking of going with Dr Jamal originally and he doesnt do them so really I have no clue what its for. What are the pros and cons with the ITB release?
Also, have you seen or talked to the other guy since the surgery? If you see him could you ask if he is ordering meals from that guesthouse and if so roughly how much is it?
Quote from: ShortyMcShort on August 02, 2014, 11:07:37 AMCould you explain what an ITB release is and what its for? I was thinking of going with Dr Jamal originally and he doesnt do them so really I have no clue what its for. What are the pros and cons with the ITB release?
Also, have you seen or talked to the other guy since the surgery? If you see him could you ask if he is ordering meals from that guesthouse and if so roughly how much is it?
ITB release is when the surgeon makes a small incision about 2cm on the iliotibial band(ITB) around the knee region. Some doctors are advocates of ITB release while some are against it. It is quite controversial but many PRECICE surgeons do ITB release. This is suppose to make the lengthening easier without the resistance of the ITB band and maybe for optimal PRECICE nail function.
I saw the other LL'er yesterday and he is doing fine. I will ask him to join LL Forum and provide you with the cost etc....
all the drs, or most in the developed countries do releases.... birkholtz dos, palsy does, rozbruch does, etc etc , and even some in india do it
the ones that don't do it are old school, and generally against anything except externals for tibia,etc.... dealing with ballerina now makes me think releases are important and beneficial...
Quote from: crimsontide on August 02, 2014, 02:43:54 PMall the drs, or most in the developed countries do releases.... birkholtz dos, palsy does, rozbruch does, etc etc , and even some in india do it
the ones that don't do it are old school, and generally against anything except externals for tibia,etc.... dealing with ballerina now makes me think releases are important and beneficial...
Yeah the american doctors are strong advocates of ITB release. But i dont know whether its necessary for exfix/Lon or full weight bearing nails
i think its a good thing to get a release.... if i had a release before, i would not have ballerina now... femur has different issues, bt same principle applies..
btw,... trying to get a hold of reception... i think theres a strong likelihood i get a release done in sa, though not 100%...
Quote from: crimsontide on August 02, 2014, 02:43:54 PMall the drs, or most in the developed countries do releases.... birkholtz dos, palsy does, rozbruch does, etc etc , and even some in india do it
the ones that don't do it are old school, and generally against anything except externals for tibia,etc.... dealing with ballerina now makes me think releases are important and beneficial...
Its definitely not beneficial to do a tendon release, its always better to avoid it if possible, if the ballerina is to much to fix with pt, then a release might be necessary, but that does not in anyway mean it is beneficial, as it will weaken the tendon permanently.
if its not beneficial... why do the top drs do it routinely even for prevention... before any issues arise?
The proper treatment would to be test beforehand to determine if tendon, etc is too tight, and perform the surgery beforehand... again, drs like palsy do exactly this
Why do top drs do it if it's not beneficial? Majority, if not all patients after 6 cm will get issues, with tibia, it is ballerina... some guys seem to have issues a long time after because of not getting a surgery to fix it, such as sweden....
Tendon weakening is vastly overstated.... the issues that ballerina can and do cause are far more severe than possible weakness of muscle
Again, he top drs use these procedures as preventive measures, which would not be done if they did not feel it was beneficial to do.... and this is before any ballerina,etc happens
Quote from: crimsontide on August 02, 2014, 04:12:30 PMif its not beneficial... why do the top drs do it routinely even for prevention... before any issues arise?
The proper treatment would to be test beforehand to determine if tendon, etc is too tight, and perform the surgery beforehand... again, drs like palsy do exactly this
Why do top drs do it if it's not beneficial? Majority, if not all patients after 6 cm will get issues, with tibia, it is ballerina... some guys seem to have issues a long time after because of not getting a surgery to fix it, such as sweden....
Tendon weakening is vastly overstated.... the issues that ballerina can and do cause are far more severe than possible weakness of muscle
Again, he top drs use these procedures as preventive measures, which would not be done if they did not feel it was beneficial to do.... and this is before any ballerina,etc happens
Youre wrong, top doctors like Paley do not do tendon release preemptively on every patient, they do physical tests before hand in case the individual might need it. Every patient that does 8 cm needs it according to them, but we know even that isnt true since Rgkey managed 9 cm with pt instead. However just because releases help if you do very high ammounts of lengthening does not mean they are beneficial, it means they are necessary because you already damaged the legs by lengthening over the safe limit, and the preemtive release will damage the tendon further but allow you to get movement back faster, and it also means you will avoid having to do more complex and expensive surgery to fix it afterwards if you already got ballerina.
Also according to Paley, 50% of his patients who did below 5 cm did not require any tendon release. Those numbers doesnt sound that impressive considering i never had any sign of ballerina during my journey while doing 4.3 cm.
I got this info from here:
http://www.paleyinstitute.org/?q=node/47
"Are there any additional unexpected costs from the initial surgery?
Some patients require a fascia or tendon lengthening to PREVENT complications.
The need for this is determined at the first consultation.
Dr. Paley performs three muscle length tests (Ober test, Popliteal Angle measurement, and Ely test) to determine if the iliotibial band-fascia lata, hamstrings, and rectus femoris muscles are too tight. It is not possible to advise a patient of this without seeing them first. The greater the amount of lengthening the more likely is the need for such soft tissue releases.
For example, every patient with an 8cm lengthening requires an iliotibial band release while only 50% require this if less than 5cms is carried out. The additional cost for these ranges from $5000 for iliotibial band only vs $7500 for iliotibial band plus hamstrings, if needed. For tibial lengthening if the Achilles tendon is too tight as determined by the Siverskiold test (physical examination) then a gastro-soleus recession is required prior to lengthening (additional cost of $5000).
If these structures are tight before surgery and not prophylactically lengthened then muscle/joint contractures that require later more expensive surgery are required (in the lay literature these are referred to as duck ass deformity for tight iliotibial band and fascia lata, and ballerina feet for tight Achilles tendon). Prophylactic anterior compartment release is often done at the time of tibial lengthening. There is no additional charge for this procedure. This is done to prevent compartment syndrome."
So no, tendon weakening is not overstated, its worse for recovery to have the release. We have many patients who did 6 cm or more and did not require tendon release. Swedens issues with his ankles seem to have to do with his x-legs and lack of fibula fixation, not because of not having a tendon release.
Quote from: Wannabegiant on August 02, 2014, 04:24:07 PMYoure wrong, top doctors like Paley do not do tendon release preemptively on every patient, they do physical tests before hand in case the individual might need it. Every patient that does 8 cm needs it according to them, but we know even that isnt true since Rgkey managed 9 cm with pt instead. However just because releases help if you do very high ammounts of lengthening does not mean they are beneficial, it means they are necessary because you already damaged the legs by lengthening over the safe limit, and the preemtive release will damage the tendon further but allow you to get movement back faster, and it also means you will avoid having to do more complex and expensive surgery to fix it afterwards if you already got ballerina.
Also according to Paley, 50% of his patients who did below 5 cm did not require any tendon release. Those numbers doesnt sound that impressive considering i never had any sign of ballerina during my journey while doing 4.3 cm.
I got this info from here:
http://www.paleyinstitute.org/?q=node/47
"Are there any additional unexpected costs from the initial surgery?
Some patients require a fascia or tendon lengthening to PREVENT complications.
The need for this is determined at the first consultation.
Dr. Paley performs three muscle length tests (Ober test, Popliteal Angle measurement, and Ely test) to determine if the iliotibial band-fascia lata, hamstrings, and rectus femoris muscles are too tight. It is not possible to advise a patient of this without seeing them first. The greater the amount of lengthening the more likely is the need for such soft tissue releases.
For example, every patient with an 8cm lengthening requires an iliotibial band release while only 50% require this if less than 5cms is carried out. The additional cost for these ranges from $5000 for iliotibial band only vs $7500 for iliotibial band plus hamstrings, if needed. For tibial lengthening if the Achilles tendon is too tight as determined by the Siverskiold test (physical examination) then a gastro-soleus recession is required prior to lengthening (additional cost of $5000).
If these structures are tight before surgery and not prophylactically lengthened then muscle/joint contractures that require later more expensive surgery are required (in the lay literature these are referred to as duck ass deformity for tight iliotibial band and fascia lata, and ballerina feet for tight Achilles tendon). Prophylactic anterior compartment release is often done at the time of tibial lengthening. There is no additional charge for this procedure. This is done to prevent compartment syndrome."
So no, tendon weakening is not overstated, its worse for recovery to have the release. We have many patients who did 6 cm or more and did not require tendon release. Swedens issues with his ankles seem to have to do with his x-legs and lack of fibula fixation, not because of not having a tendon release.
wannabe... i did not state he does them on every patient...
read what i wrote,. "if its not beneficial... why do the top drs do it routinely even for prevention... before any issues arise?
The proper treatment would to be test beforehand to determine if tendon, etc is too tight, and perform the surgery beforehand... again, drs like paley do exactly this
again... patients determined to have a tight tendon, get a release.... before any issues arise... everything quoted supports what i said... again, tell me what is wrong with what i said? You do not even attempt to reply to that fact....that they are tested, and if found to have a tight tendon, get a release surgery before any ballerina, not after major ballerina, not after a little, but even before any ballerina... why??? as a preventive measure... that is simply a fact
you made this statement
"Every patient that does 8 cm needs it according to them, but we know even that isnt true since Rgkey managed 9 cm with pt instead. However just because releases help if you do very high ammounts of lengthening does not mean they are beneficial, it means they are necessary because you already damaged the legs by lengthening over the safe limit, and the preemtive release will damage the tendon further but allow you to get movement back faster, and it also means you will avoid having to do more complex and expensive surgery to fix it afterwards if you already got ballerina."
again, you are avoiding what paley actually says.... that if he determines their tendon to be tight, he will do a release.... he specifically says this... if the achilles is too tight, he will do a release... .. he says it is required if the test determines the tendon is tight
you also are not properly reading what he says.., the numbers,etc, he gives that you quote are for femur lengthening, not tibia
if you want to reply, you can reply in my thread if you like, as i don't wanna take over this thread
Merged the posts on ITB release from RisingShorty diary to the new thread here
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