Arthritis and mechanical axis when altering the tibia/femur ratio

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Quote from: RealLostSoul on April 27, 2021, 11:02:57 PMI agree with the IT band dilemma. It's my biggest con with Betz. Ik it won't do much harm to cut it, without it it's like you said more of a gamble. You can be fine but you can end up needing it later (which is dumb tbh, ofc it's not a big surgery but unecessary). I know that case too but I also know for example tallertree who had an excellent recovery for an insane 9cm. Other surgeons that don't do it are Guichet and Monegal I think.
Yea I am interested in femur surgery. Not going with tibias. I probably will not even do them in the future, it depends on how I will feel after femur. So you are sure that for femur surgery there will not be a thickening? That's good news.
Yes the prophylactic cut is done in the calf (I think) with tibia LL to prevent compartment syndrome as it's devastating. Deffo one of the worse complications you can have. a full fasciotomy leaves you with a huge scar on the leg (almost the whole lower leg gets cut open, you need to release 4 muscle compartments which can be reached from one incision but that incision.. well you have seen images).
Never heard of the compression socks lol, do you get them all the time for tibia ll?

Interesting idea I think this is a good question to ask an expert. Is the caput tibiae larger (wider) in tall people and is it bad for the joints to lengthen the legs out of their natural size and will the joints adapt (you know like people with arthritis get extra bone formations near their joint region to adapt to the force of missing cartilage)?

I didn't know about Guichet but it doesn't surprise me since it uses almost the same nail. Anyway they are pretty ancient techniques. I don't like the nail.
No way any thickening for femur.
For the tibial thickeing I don't really know, it's a patients complain about tibia but I'm not very informed about it, if you like you can find even dr Lee talking about it in his youtube channel. I don't really have never thought a lot about it.
The bone formation aroung the arthrosis or generally arthritic regions should be actually considered more as an unavoidable process due to the bone friction...missing cartilage leads to bone damage and remodeling.

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Quote from: Body Builder on April 27, 2021, 11:31:47 PMI never did and "prophylactic" cut on tibia nor most LLers had.
Compartment syndrome is a bad complication but unusual too. If you lengthen slow and not more than your limits most LLers won't have any problem to need fasciotomies, tendon lengthenings etc for tibias.
For femurs itb release is a must though as it has only benefits and no risk so all the respectable doctors do it.

Well if I remember correctly Paley does a small (I think 1cm incision) cut on the calf to reduce the risk. This is the reason why people get thicker lower legs after LL. We are not talking about chronic compartment syndrome which is a different story. Accute compartment syndrome shouldn't happen once you already start lengthening but in the days after the surgery trauma.
Agree the risks of ITB release is none if done properly....

Quote from: Tartar on April 27, 2021, 11:35:39 PMI didn't know about Guichet but it doesn't surprise me since it uses almost the same nail. Anyway they are pretty ancient techniques. I don't like the nail.
No way any thickening for femur.
For the tibial thickeing I don't really know, it's a patients complain about tibia but I'm not very informed about it, if you like you can find even dr Lee talking about it in his youtube channel. I don't really have never thought a lot about it.
The bone formation aroung the arthrosis or generally arthritic regions should be actually considered more as an unavoidable process due to the bone friction...missing cartilage leads to bone damage and remodeling.

Yes in arthritis it's due to a negative effect but maybe in LL you get a remodelled tibia head too because of altered forces? This question can easily be answered by looking at longterm before and after xrays (I kinda doubt this is true though tbh).
Do you have a link to that dr lee video that would be sweet? ty

e:/ yes , if you check Paleys site under "additional costs" etc. he says for tibia LL he does anterior compartment release to prevent compartment syndrome. So I think that's pretty reasonable and should be considered (same safety measurement as that small tube that blows out the fat and stuff when drilling the IM canal, or heparin after the surgery, etc.)

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I don't really remember which video could it be...himself said it and it was asked at least once to one of the interviewed patient, those video are nice and informative and they last few minutes so if you like watch them.
I'll check the Paley additional procedure in his website.

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There are so many drugs on trial for arthritis right now, I really don't think this is a big concern. I would be surprised if arthritis isn't cured within the next 20 years. Some large companies are already in phase 2/3 trials I think, like Samumed for example.

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being obesity and inactive causes 20x more chance arthritis than a 2 degree shift from LL ever will