People like to talk alot of biomechanics post LL on this and the old forum. Saying that LL on both segments changes your biomechanics considerably. I will try to convince you guys why that is simply not the case
First let's divide the joints (which are those affecting our biomechanics) related to legs' biomechanics; you have the hip joint, knee joing and ankle joint.
So how LL affects those?
Femoral LL: This LL greatly affects biomecanics because it changes the distances between the two "main" biomechanical joints (hip and knee). To make it simple; you gain 6cm. You went from 170 to 176. With femoral LL only the hip joint "went up" while the knee joint remained in the same distance from the earth... Thus, when you will lift your thigh to a 90 degrees (standing and rising one thigh) your feet will be 6cm further away from the floor than before. This greatly affects the biomechanics of walking and running because it means that in order to completely not lose balance, after femoral LL you will need to rise your thighs to a lower degree (thus making much more minimal movement with the hip join or coxo-femoral join).
Tibial LL: Unlike the previous LL in this LL doing 6cm you knee joins the hip and thus the distance between them remains the same. This means that once you will rise your thigh to 90 degrees your foot will be at the same distance from the floor as it was before LL. So from a purely biomechanical standpoint (not taking into account muscle damage caused by LL and all the other changes) tibial LL has a negligent effect on running and walking (if it has at all).
Tibia LL, Femur LL, biomechanics and YOU
I find this to be very true. And this is what BLOWS.
Femurs consolidate faster, and all doctors (Dr. G, Dr. R and Dr. P have all said this to me) prefer femurs for this reason. Less chance of complications and faster to recover.
But from someone who did 7cm in femurs...your walking will be UUUGGGLY for a while, even after consolidation. And you won't be sleeping while you're lengthening. Femur LL involves your hips (ouch), hip flexors, glutes, quads...it f*cks with everything.
The ONE thing I'm nervous about doing 3cm on tibias is the longer recovery time. I was told by Paley and Rozbruch I'd be able to get around on crutches a bit because I have a strong upper body...but still nervous about this. BUT...I'm also happy that it will be overall less painful, easier to sleep while lengthening, and once you finally do consolidate...your walking isn't nearly as ugly as the case of femurs.
Quote from: YellowSpike on March 28, 2016, 03:31:30 PMI find this to be very true. And this is what BLOWS.
Femurs consolidate faster, and all doctors (Dr. G, Dr. R and Dr. P have all said this to me) prefer femurs for this reason. Less chance of complications and faster to recover.
But from someone who did 7cm in femurs...your walking will be UUUGGGLY for a while, even after consolidation. And you won't be sleeping while you're lengthening. Femur LL involves your hips (ouch), hip flexors, glutes, quads...it f*cks with everything.
The ONE thing I'm nervous about doing 3cm on tibias is the longer recovery time. I was told by Paley and Rozbruch I'd be able to get around on crutches a bit because I have a strong upper body...but still nervous about this. BUT...I'm also happy that it will be overall less painful, easier to sleep while lengthening, and once you finally do consolidate...your walking isn't nearly as ugly as the case of femurs.
Do external tibias man... And there is not such a big difference between 3-5cm on tibias with regards to recovery time (according to Catagni). It takes 6-12 months (total time in frames) and you are able to walk on crutches day 1 after surgery. Internal femurs dont heal faster... Atleast everyone dont consolidate after 3 months after lengthening... You think you are recovered since you dont have any visible stuff attached to your leg... But you are still with a frame on (even though the frame is inside your bone...)
The "internal femurs heals faster" is a myth.
Quote from: TIBIKE200 on March 28, 2016, 03:37:51 PMDo external tibias man... And there is not such a big difference between 3-5cm on tibias with regards to recovery time (according to Catagni). It takes 6-12 months (total time in frames) and you are able to walk on crutches day 1 after surgery. Internal femurs dont heal faster... Atleast everyone dont consolidate after 3 months after lengthening... You think you are recovered since you dont have any visible stuff attached to your leg... But you are still with a frame on (even though the frame is inside your bone...)
The "internal femurs heals faster" is a myth.
I would do external tibs, but I don't know if I can be in frames that long. Dr. Rozbruch and Dr. Paley have said that doing an inch on tibs would take around 3 months total via precice. I also challenged them on knee pain, and they both said "highly unlikely." And I trust Rozbruch and Paley (as I still do Dr. Guichet).
I have to do more research on external tibs. I just wish I could bang this out in 3 months flat. Then I might be able to get my last inch, and make it work with my career which has been taking off.
Quote from: YellowSpike on March 28, 2016, 03:41:25 PMI would do external tibs, but I don't know if I can be in frames that long. Dr. Rozbruch and Dr. Paley have said that doing an inch on tibs would take around 3 months total via precice. I also challenged them on knee pain, and they both said "highly unlikely." And I trust Rozbruch and Paley (as I still do Dr. Guichet).
I have to do more research on external tibs. I just wish I could bang this out in 3 months flat. Then I might be able to get my last inch, and make it work with my career which has been taking off.
Why not do the double-cut technique? It will mean you could lengthen 1-1.5mm a day (since there are two osteotomies) which means you could be done with the lengthening fase in 20-30 days. Ask Catagni about it since he does it (I believe he was the one that actually introduced it... He doesnt use it alot though because he said that the lower osteotomy heals slower).
Still ask him about it.. A guy on the old forum who did a second LL with betz said that 6 years before he did double cut LL with catagni for 6.5cm and was frame free within 5.5 months
Quote from: YellowSpike on March 28, 2016, 03:41:25 PMI would do external tibs, but I don't know if I can be in frames that long. Dr. Rozbruch and Dr. Paley have said that doing an inch on tibs would take around 3 months total via precice. I also challenged them on knee pain, and they both said "highly unlikely." And I trust Rozbruch and Paley (as I still do Dr. Guichet).
I have to do more research on external tibs. I just wish I could bang this out in 3 months flat. Then I might be able to get my last inch, and make it work with my career which has been taking off.
I also would do internal tibia over external for sure, if there was relatively low risk of permanent knee pain. But from the journal's knee pain seems likely. Why does Dr. Rozbruch and Dr. Paley say otherwise you think?
Quote from: TIBIKE200 on March 28, 2016, 03:44:44 PMWhy not do the double-cut technique? It will mean you could lengthen 1-1.5mm a day (since there are two osteotomies) which means you could be done with the lengthening fase in 20-30 days. Ask Catagni about it since he does it (I believe he was the one that actually introduced it... He doesnt use it alot though because he said that the lower osteotomy heals slower).
Still ask him about it.. A guy on the old forum who did a second LL with betz said that 6 years before he did double cut LL with catagni for 6.5cm and was frame free within 5.5 months
Wow...that's amazing. 6.5cm and frame free in 5.5 months...he must have had amazing consolidation. But I will ask Dr. Catagni about this. Thanks!
I don't mind scarring, because I have hairy legs (and you can fix scars if they get terrible). And I think for only 3cm, the scarring shouldn't be that bad.
Quote from: CCMidwest on March 28, 2016, 03:45:47 PMI also would do internal tibia over external for sure, if there was relatively low risk of permanent knee pain. But from the journal's knee pain seems likely. Why does Dr. Rozbruch and Dr. Paley say otherwise you think?
I'm guessing because they're just higher quality doctors than many of the others out there and maybe they just get less complaints about it? I don't know. I have to do more research on this too, and also really press the issue when I start to prepare for doing tibs.
If there's a way I could do external and be frame free in like 4 months at the max, I'd consider it.
Until now I only heard bad things about the double osteomy, that it doesn´t decrease the recovery time and only increases the risks for instance.
If Dr. Catagni could assure us that it really works and is safe it would easily beat any internal nail. Not only would it be cheaper, but you´d also have a faster recovery with full wheight bearing from day 1 AND you can avoid the permanent knee pain and the potential damage that is done to the patella by splitting it twice.
If you speak to him again, please ask him about this topic. The idea of legthening 4cm´s in less than 4 months sounds just too good to be true 
.
Quote from: Alittletooshort on March 28, 2016, 04:25:12 PMUntil now I only heard bad things about the double osteomy, that it doesn´t decrease the recovery time and only increases the risks for instance.
If Dr. Catagni could assure us that it really works and is safe it would easily beat any internal nail. Not only would it be cheaper, but you´d also have a faster recovery with full wheight bearing from day 1 AND you can avoid the permanent knee pain and the potential damage that is done to the patella by splitting it twice.
If you speak to him again, please ask him about this topic. The idea of legthening 4cm´s in less than 4 months sounds just too good to be true .
You can also send him an e-mail
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