The new paradigm in LL; no longer are we aiming for 10cm

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Quote from: amatan on March 17, 2014, 11:14:26 PMThis is exactly the case I am in, I recently just did 5.5 on femurs and I'm considering doing 4 cm on tibias in a few years and can't decide between using another internal (maybe the precice) and going with externals on tibias. If price isn't a factor, the precice for tibias if you are looking for a smaller gain such as 4-4.5 cm imo can't be beat.

What was your experience like? How are you doing?  Do you have a diary? 

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Quote from: HK on March 17, 2014, 10:37:45 PMHey !
So, you're saying internal nails probably lead to permanent knee pain/issues ?

There are studies showing that inserting a rod into the tibia has lead to persistent knee pain even after rod removal. Depending on the study you will see a different percentage, but there was one showing as high as 70% had that issue.

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Hey Kilo,

Have you done any LL or are considering?  Would you do externals only?

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Personally for me, LON/LATN isn't even an option..even in my femurs, I wouldn't do nails, only externals for a 5cm gain. If people/results show external femurs for even small gains are a bad idea, then oh well, looks like I'll have to be happy with 5cm on my tibias.

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Quote from: shawty on March 17, 2014, 11:34:56 PMHey Kilo,

Have you done any LL or are considering?  Would you do externals only?

Will start lengthening this April. I'm not going to do externals. I'd prefer to do plate fixation.

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Quote from: shawty on March 17, 2014, 11:17:49 PMWhat was your experience like? How are you doing?  Do you have a diary?

Pretty bad compared to other precice patients, but I did achieve my goal in the end so I can't complain too much.

Pretty good right now.  I should be able to stand by the end of the month or early april. 

Yes, I have a diary, I did the procedure with Dr. Donghoon Lee in south Korea.  To sum it up, my right leg was not lengthening properly from the start (Dr. Lee thinks this was due to my incredibly fast bone callus formation in the right leg), I wasn't getting enough from each lengthening.  At about 4 cm the device stopped lengthening completely and they had to do a second surgery and rebreak the bone.  Afterwards, the device still didn't lengthen properly, but I was getting enough from each lengthening that I was able to hit my target of 5.4-5.5 cm eventually, putting me at 176.5 cm.  It was fairly comfortable 99% of the time with the exception of a few moments that were incredibly painful.   

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Hi Amatan.

Congrats for achieving your goal although, lots of hiccups there.

The answer may be obvious but still I want to know your general experience on LL. Would you recommend precice? Wound you recommend Dr Donghoon Lee?

Thanks.

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Hard to say so far, but based on patients I met who have done 6 or less cm lengthenings here (most Koreans are very conservative in how much they lengthen in comparison to Westerners, very rarely does anyone lengthen over 6.5cm here), they say they've regained all or pretty close to their previous athletic ability, although I have noticed that the femur patients  as a whole recovered better than the tibia patients.  One patient here who did 6 cm on tibias say his sprint speed for a certain distance I don't remember went from 12.0 seconds to 12.8 after two years post surgery, which I consider a pretty good recovery. Talking to a lot the patients made one trend stick out to me - stick to 6 cm or less if you want to recover very close to your pre-op athletic level.  This is the main reason I decided to stick in the 5-6 cm range rather than go for my original target of 7.5 cm. 

I believe the two cases of precice malfunctions here were more or less freak isolated incidents.  Looking back on it objectively, I would still recommend the precice, the only disadvantage it has is that most doctors do not let you weight bear with it.

Dr. Lee is probably one of the best surgeons in the world for LL.  It's something I've heard a lot of surgeons here say, and he is regarded as possibly the top orthopedic surgeon in the whole of South Korea in LL and deformity correction.  Dr. Paley himself even said that he could not have done a better job with the surgery than Dr. Lee did when he was observing him.     

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Quote from: amatan on March 18, 2014, 01:46:58 AM Looking back on it objectively, I would still recommend the precice, the only disadvantage it has is that most doctors do not let you weight bear with it.   

Thanks for sharing this. I have observed the same thing with Turkish doctors, they are usually conservative and don't allow you to bear weight with Precice, even though it's technically possible. May I ask what level of weightbearing are you referring to? Were you on a wheelchair like me during your lengthening phase, or were you able to use crutches, at least for making transfers? Wish you a quick recovery.

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Does anyone have any experience or information on external femur lengthening for 4-6cm gains