Bilateral Femur Lengthening Dairy: May 2021 with Dr Betz and Betzbone

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All the best for the release surgery. I wish everything works out well for you.

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49.51/46.65mm

Hey guys, I arrived in Athens yesterday and had my pre-ops done today. Several things to note

1) Due to a horizontal tendon running perpendicular to the IT Band, an ITB release will narrow the legs noticebly but not completely post surgery. Stretching and glute strengthening will need to continue to fully narrow the legs. Bearable gait is achievable a week after op with normal gait returning 1-3 months after lengthening ends.

2) Had I done the ITB release during nail insertion and stretched as I have since the beginning, I would not have experienced wide legs. Thanks Betz...

3) There will be no hospital stay. I will be discharged 5 hours after operation, though I'll have to stay in Athens for 3 days at my own expense.

4) Dr Betz seems to be ignoring my emails, as it has been 7 days since my last reply. (I did not mention ITB release with another surgeon)

Will update you guys tomorrow after my operation!

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50.50/47.64mm

Hi guys, I have just arrived home from my ITB release surgery. Following are points of note:

Procedure
1) The technical term for "wide legs" from leg lengthening is "post-operative fixed abduction deformity of hip joints".

2) A release is done by cutting a portion of the ITB from the intermuscular septum, seperating it from nearby tissues thus freeing it. Holes can be punctured into the band itself to make it even looser. The connection to nearby tissue as well as the holes will first scar, then remodel into its original fasia over time.
*This is partly why you want to lengthen as quickly as possible, especially in the beginning, since once the band and holes heal, you will be tight again.
*Most patients with ITB release complications tend to be runners or atheletes who put too much stress on their ITB before it fully heals
*Recovered bands usually appear and function near identically to uncut bands.

3) I have experienced a 50%~ reduction in "wide leg" and was able to walk immediately after I woke up. The best part is I can already walk further than I could pre-operation.

4) Left leg is pain free. Localized pain 5/10 when moving and 2/10 when sitting still on my right. I am not taking any painkillers and the pain should disappear tomorrow. It has not affected Betbone clicking.

5) They could not fully reuse the incision from Dr Betz. This is means I will have an additional deep scar in each leg. 

Doctor/Hospital
1) Dr. Giotikas is fantastic. He is reacheable instantly through Whatsapp and is extremely knowledgeable. He noted that significant abduction is very predictable and unlikely to be completely addressed with PT.

2) Compared to Kreiskrankenhaus St. Ingbert (Betz), Mediterraneo Hospital (Giotikas) is larger and more advanced given it's in Greece's capital instead of a small town in Germany. Even though the food wasn't that much better, all nurses and staff spoke English, which is a significant plus for international patients.

Conclusion
1) It is pertinent to mention that leaving wide legs to go on can lead to many complications. Our glutes compensate for lack of strength by widening our stance. This is why overweight people walk with wider legs. By allowing your legs to stay wide (due to tight ITB), it significantly weakens your gluteus muscles. This will give you a very ugly gait, and your butt will hurt when sitting on harder surfaces. Knee pain will also worsen as they're under pressure to bend in and downwards (Knock knees).

2) For those seeking to lengthen more than 5cm, I strongly recommend a surgeon who performs ITB release. For weight-bearing nails in Europe, the only alternative is Dr Guichet who uses a very similar nail to Betz but performs ITB release. He works in Milan and London.

3) If weight-bearing isn't your sole priority, then I would definitely go Giotikas with Precise (available in EU by August). You get more, and better service, for a lower price. Had I done the release during the initial operation, it would be free and I would not have needed to go through another general anesthasia, incision and flight -- recipies for more infection/scars/complications.

If you are one of the unlucky ones who has pain clicking in at least one leg, and have tight IT Bands, Betz would be a poor consideration. Remember, TFL is a very small muscle, and the ITB does not respond to stretching well. It's not something hard work can completely overcome. My wide legs reduced my mobility as much as non-weight-bearing nails would have. It is definitely not an "optional" procedure for many. Not doing it is deviating from standard practice.

Here's a video of how it's done. The actual incision is smaller than in the video.

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Quote from: SirStretchAlot on July 01, 2021, 04:50:27 PM50.50/47.64mm

Hi guys, I have just arrived home from my ITB release surgery. Following are points of note:

Procedure
1) The technical term for "wide legs" from leg lengthening is "post-operative fixed abduction deformity of hip joints".

2) Most ITB releases are "full", meaning that the entire width of the band is cut. This is completely safe. However, the length of the band (perpendicular to the width) is not cut because your legs and knees may lose lateral control. This is despite a length cut will reduce wide legs further.

3) I have experienced a 50%~ reduction in "wide leg" and was able to walk immediately after I woke up. The best part is I can already walk further than I could pre-operation.

4) Left leg is pain free. Localized pain 5/10 when moving and 2/10 when sitting still on my right. I am not taking any painkillers. It has not affected Betbone clicking.

5) They could not reuse the incision from Dr Betz. This is means I will have an additional deep scar in each leg. 

Doctor/Hospital
1) Dr. Giotikas is fantastic. He is reacheable instantly through Whatsapp and is extremely knowledgeable. He noted that significant abduction is very predictable and unlikely to be completely addressed with PT.

2) Compared to Kreiskrankenhaus St. Ingbert (Betz), Mediterraneo Hospital (Giotikas) is larger and more advanced given it's in Greece's capital instead of a small town in Germany. Even though the food wasn't that much better, all nurses and staff spoke English, which is a significant plus for international patients.

Conclusion
1) It is pertinent to mention that leaving wide legs to go on can lead to many complications. Our glutes compensate for lack of strength by widening our stance. This is why overweight people walk with wider legs. By allowing your legs to stay wide (due to tight ITB), it significantly weakens your gluteus muscles. This will give you a very ugly gait, and your butt will hurt when sitting on harder surfaces. Knee pain will also worsen as they're under pressure to bend in and downwards (Knock knees).

2) For those seeking to lengthen more than 5cm, I strongly recommend a surgeon who performs ITB release. For weight-bearing nails in Europe, the only alternative is Dr Guichet who uses a very similar nail to Betz but performs ITB release. He works in Milan and London.

3) If weight-bearing isn't your sole priority, then I would definitely go Giotikas with Precise (available in EU by August). You get more, and better service, for a lower price. Had I done the release during the initial operation, it would be free and I would not have needed to go through another general anesthasia, incision and flight -- recipies for more infection/scars/complications.

If you are one of the unlucky ones who has pain clicking in at least one leg, and have tight IT Bands, Betz would be a poor consideration. Remember, TFL is a very small muscle, and the ITB does not respond to stretching well. It's not something hard work can completely overcome. My wide legs reduced my mobility as much as non-weight-bearing nails did. It is definitely not an "optional" procedure for many.
how does the dr stitch those IT band peaces? thanks

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Quote from: dexter1930 on July 01, 2021, 05:18:21 PMhow does the dr stitch those IT band peaces? thanks

Hi, I added a lot more technical detail to the procedural section. Essentially the band will stick back to the tendons/ligaments around it and connect/heal by itself over time.

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52.06/49.20mm

Hey guys, it's third day after ITB release and...

1) The surgical wound pain has completely subsided.

2) There is no lateral (ITB) resistance to closing my legs. Hamstring is the only limiting factor.

3) It has made clicking slightly easier. (Less resistance)

4) Sporadic knee pain gone (ITB was pulling on my knees)

I would consider the surgery a complete success and would recommend anyone who wishes to lengthen >5cm to do it!

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That is great news! So if you plan to lengthen maximum 5cm and you experience pretty bad  wide legs, it can resolve pretty quickly during consolidation phase ?

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Quote from: Johnp86 on July 03, 2021, 07:34:17 PMThat is great news! So if you plan to lengthen maximum 5cm and you experience pretty bad  wide legs, it can resolve pretty quickly during consolidation phase ?

Not quickly. Perhaps 3 months. For me, probably 6 month if I stop at 5cm. If I am going for 8cm, surgical release is mandatory for return of function.

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Ok thanks. Hard to understand why Dr Betz doesn’t provide post IT band release on some patient that really need it. Even if you have to pay more, this should be an option. Good luck for the rest of the lengthening, almost there man

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Quote from: Johnp86 on July 04, 2021, 07:32:59 AMOk thanks. Hard to understand why Dr Betz doesn’t provide post IT band release on some patient that really need it. Even if you have to pay more, this should be an option. Good luck for the rest of the lengthening, almost there man
He refuses even at patient request because he doesn't want to damage good tissue. However, he does not understand that for some patients exercise cannot overcome this. He's 70 years old, and won't change his mind.

My ITB release was full, meaning that my band as well as intermuscular septum was severed. A blood-gello substaince will first form cover the area, followed by scar formation, then band recovery. There's almost no repercussion as it's a nerve-less tissue.

53.10/50.24mm

Interms of lengthening, there's good and bad news.

Good: Had the easiest clicking yet. Both legs were done in 20min. If you're in clicking hell, it does get better!

Bad: As I crossed 5cm, I have had my first taste of neuro pain. It's not extreme but very presistent, and cannot be alleviated through repositioning. Muscle relaxants aren't effective, so I'm back on painkillers. It's really getting my mood down too...

Can anyone recommend good ways to alleviate this neurotic pain/discomfort? I've been advised to use Gabapentin and extra Paracetamol, but Gaba is prescription so I'll have to talk to my doc.